HomeMy WebLinkAbout97-00918
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1)1~'lTt'lON lrOlt 1)IUlnA'l'l~ und GltANT (W unTl~RS
Rltate (II _tiYlo-1l.Ll.....QYSl1J&,,~---~'" N(I, ,_~~_,~1..:~,.1::3,'J---,---
nl,mklWWIIII,l__tlyln LnY..all'u"--~-.. Tn: .
. ' __~-'----._.._,__~---'- 1(1)~IRler of WJIIR for Ih.o I
, ' , , , . /lC('PII,lcd, CO\IIIlY of :c;:umllct' ~,1II1C ~ hUhe
,~nc/III Secl/r/ly N(I, J.6.2~~J;.IK6.6----,--- CUl1l1l1ol\woAlthof POI\I\RyIVI\I1IA
Tho petltlol1 of Iho \llIdcrRl~l\od rORllcclfully relHCROl\tR Ihllll
Your pOllllol1or(R), who IR/ure 18 YC\1rR of IIse llfuldor 11111119 eKecul~;1.x-- _I1Amod
111 the InRI will of tho Rbovedecodel\l. elllled ~_.__.A\.I.IWfI " 2 -~. t9..a7--
IIl1doodlcll(R) duted ..-nuno---
._________-........m..-.------.---.,.............---
---------........--.
.......+~.__.---_......--
--
\.IRlo tol'YRIII oIrOI1I11I\III1',", 0,9, t011111101allll1l; 110.111 or "oolllor, 010,)
PQcel1dol\1 wnR, dmnlcllod nl del\lh 111 -_..CUlllD.l:!r1~~t--- COUl1ty, PCIII1RylVnl11n, Wllh
h sf' InRI fmnllY or prll1c1plIl tORldol1co nl..llU 11'1 nr~v.a. H"chan;l.a.~l>11"'1l
_ ' __~u____--_.c-_j.l;).War...ALllU1~'O+-t.....cull1bllr1 and Co.
(11.1 .Itool, IIl1iuhot allll I11l1n.h.llIl1y)
\)eccl1dent, then ",_!llL-- Y,ol\r~ of ",8 e, died _.._tl.o.'l.mlllloL.l -, 19 97, '
At_,Jla.r.rillbUri7.-llo.ll.p.:I..~l..-1Ia.r.r.iaburp",J..JL-. " , '
aKcep! nR follol\'s, docedel11 did 1101 mAttY, wnR 1101 divorced nl1d did not hRve n child bO,rn or adopted
Rflot e~ee\lllol1 ot tho will offored fPi nobnlel WRS 1101lho vlcllm of 1I kllllns and WAS ncvor adjudlcatod
Incol11pelUnl1 - ,--_.~~--' .
'[Joccndent at denlh owned properlY wllh eslhnlllcd valnes as follows I
(If dottllellec\ In I'll,) , ,\11 perRlInAI proporty
(If Ilot d011llclled hI Pa,) Pmonnlproperly Inl'onnsylvnnla
(If nol domiciled In I'll.) , 'l'otRol1al property In County
Valuc of renl cRtalo In Penl1Rylvatlla .
sltunted as followsl _~ none
$ 2i,nnn,nq_
$
$
$
-
WIWRBflORB, potllloner(R) respeclfully requeRt(R) tho probRle or Ihe Insl will and eodlell(s)
preRcnled herewllh "nd the sranl of 10Ilers__,t:..GJit/lmBtlt"A]'.lL.
, (I"IIII1I,"ll1rYl R<lIl1lill'ltntloll o,l,s,I'nllmloI8ItRII0R lI,b,u,o,\'s,)
t \erOIl,
b
It
I~t V;('Z:,<<:i
J . e k..JB,nc '
. 'fom ~"~~ P\~1;,-....
--
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-
-
OATH OF PERSONAL REPRESENTATIVE
COMMONWML'tH 011 PltNNS\'I.V ANIA } ss
COUNT\' 0\1 .ClJHBEP,LAND
'l'ho. petltloner(R) I\boveonnmce\ sweur(s) or nfflrm(R) that Ihe Rlntel1lontslnthe foregolna potltlon nte
ttue nnd correello Ihe host 01 tlic knowledso and bcllef of potlllonor(R) and thM ns personal teptesen'
Intlve(R) of Ihe nbove decedcnl pelltloner(R) Wll~.~~1I and tru~y n 1\~.~tJI1e eslRlC a~eordlnllto laW,
S,wotn to" or nrnrl11,fI.,, d And, subserlbcc\.,.'..,,_1l- , ...1:-(--(--> .,!<-~.I!",,' t
b~efore l\\e this ~~21~_ dRY of I' !\ e . IIi ch . '" -
, '~ER ~7'-: <-- 19_21-_ '---fp. :.- ' -
. ,/. . _.<-'!t("Ud,(d'J~ ,(/;i'#~~,'-
. ,%' ReI/Mer - . " ""
15'-':<11/ ,..1 "
=
.'orm AU' t..ul' Will and TU'lmen'
21~97.918
LAST WILL AND TESTAMENT
.,' II~ 1'1' KNOWN, lhull , 17'(/C:0' t ~;"-.r-ef!(:~ , ,u
rosldofll o~"i'11.e~.,....k'4"'~'....c"u~J. i!.;.r , COlll1ty of e~Ae,~t~o ,.l ..",.P ~ , Il1lho Stlllo (If
.' , ' " holr)S nf sOUllllmll1d, do I1lllko IIl1d dcclllro 'llrls to ho my l.Ilsl Will
lUld Testllrnofll'oxprossly royoklllgllllmy prim Wills IIl1d Cndlclls 1I11l1lY limo mlldo.
I. ptmSONAL tUWIlI~SI~N1'A'I'IVI~1
, . IIIPPllll1l~' . it.....~ ';/'~t~ , , ,nf .,}'(,.../",./
7~~~.. ',,...), ,ns I'nr8011111 RcprnSnnlUlII'(\ Oflhls my 1,IIS1 WIIVl1rlll
~slnmol 111~oYhlc If lit 'l'orsol1ul RoprosoI11n,l/yC Is Ul1l1hlc or UI1WII II 111110 SN' J Ihlm IlIppoll1l
C ,..,."(",,. )'I....".J:t.f,...4, , IIn IIIrN'IIII" P(I.Hotl ((C.prOSC1IUlllvo, My l'orSOIlIlII{cprosOIlIIlIIYc
,nlllin 1II111"'r1~cd l~ .1(11)' mj?i;1I proYlslol1s of Ilrls Will al1d PUy my JUSI dchls,ohllgollollS IIl1d flll10rlll
('XllOIlSOS, I fUl'\hor proYldo Illy Porsollal Rcproscl1tntlYc shollllot ho relllllrcd 10 poSI surelY hnl1d III lhls or
ony oUler Jllrls~lotJOII,lIl1d dlrccllhal no oxpert opprnlslII he modo Of,!lly eslulo Ullless rC(lulrcd hy In\\"
. ,
II, QUAIU>JANI /"'/'
!lIlheeyon(t shllll 1I,Ie lIS the S IllPllre1,II of mll1or.\lklf(fren,lhen IIlPIKJil1~
" , OS Olllll)lllllf bf SlIld minor Clttmren, If this mlllled
Ollllrdlon I~ Unable IIIIWllllllg 10 Rerve ell I uppoll\l. / /'
os 1I1lomu\e au un, .
III.
III~QUESTSI
followlngl
/. '" A /J .' I) Cb' :<7'//0"'(1 n(."-ICc./l. 1:.-:-
a '. ~Ct.,'-;',I\ ~(;'t~.\4-'/~ ?t, 1.-"...e..,/'I.<..(2.,,.( r;; .....I.tL('.c.~" ,:-~1r I' i..~' J'
'-Cd -(.J!.,l..t........,J ~~" /~v~.J, I~~,,/;/-:..~:~ ....,./- ,1V'[1.t~.J ~.:~ ~.t-(/7; -..J
....i(7) t€~..tJ.~ ""''1YJ...r../~-+.~",.L !&jA~,.) ,-.4"'';'' tt<~ """,-eLf ',1~- \
" Ll ' ,/': I~'-\ 1 t' " .} J ,d- ., /~ ,.#1/:,1..1;; ~.#"'"
~ ".....~.~(";;':- -n ~'~-j.:~,p~...4,'~/v:<'"1 !:1v: (!;J!,~,'" .",::f
--"'~, ,~~~. '-,-("'l.~~"'~':rA--'~4 ~~--f...~ " , <(J--c!:fl-
o-...J 1/L'f/C"1~..Xd.L...vl.?I, cc-t."~.iCl l..(1 ,tii ~.4.~ 'e_,
,,..~, 1t"'~:;';'l. ;, ,to dl-'''oj~k;) _t9-,1.(!..tl'c~"
<'-?/1(' (t,.:.J II ,I ~
r" ..(,4- . I ../..
Cl ....;.:.I.~rI.{..J.j ,
~/':? 17} ..~c..tI\'d'<;;'2r ;; ((!r1-,..J!(z;:;j -1!J""~' /~'
t-1Jl,...t,;;ut. -".. o.-'~...:j.tld ~''''~,1 . ,.{1' . I!
~1- --? 1 ,,, ~i..l:4/l'-"'.A.-"-";) CLx.,!-;JAI-:Q,
"Ii I' ,C.~j1 ~A!!& ~_~..v _ (~,,-() .d~~
e,F,../J ' J!1.../i.,,,'-tIC--.j /l e:",; , It.
, ,,/ : -t:;:)
('(It ~.1--r.f~" / .
ct ~/}"""'J /'z,€,,,''-(f..t_'<-""''{j , .
I: (/
I dlroct IhuI nfterpllymenl of 1111 my JUsI dehls, my properly be bequMlhcd IlIlhe manllor
o ~m~ m~~ s
/ ;; " .1".< ~,....e. J
CJ~1+ ' ,Att"'JIJ
.~ &,..j/"~ r t V tJ'
21"97"918
ImmS'I'Im OIr WII,Uil ()Ir ._.putlBltIUJAND___ COUNT\'
oATil Oil S\JIISCItIUINO WITN~SS
~T""""';---"'--"'-------"'-
___._.__.__.m.'__--- ,9)}EJ~~ i.<!!\!:\~JI.! _\'LI!Hf.l~~1!----_.--.~------...--
MlltNl\'.
(oneh) n RllhRcrlhlllg WIlIlORR to thc 11'111 tHCRented herewith, (eneh) helng dlll~ I!nnl\f\ed neeohlh\8 to
IlIw,de(l\l~o(R) I\lId RnY(A) Ihnt_'_n__...u._.~J1,~_:~a~,._u_'_--_.._n_-n_._--C IneRellt IItHI RnIY
__..........ny.le_E... . La'lo lla_I"LI5.L~.1t'.1~L Lgyelle -----,
Ihe leRlnlrix ._, Rlgn Ihe RIIIIlC 1\l1\1I1II1!,._"nllh~~.._,,",n_..__n_ AlgnedMn wllneRR nl,the
requeRI or tCRtlllJ'.ix..ln h...e.r....preReuee 1\1\11 (inlhc plQRence or oneh olher) (in the (lroRonCe or lhe
olher R\lhRcrlhhlg wllncRR(cR)).
(j~, ,....,...,', .~ ~.J
Sworn 10 or nrrlrllled nllll RuhR,:rlhcd herme '-Cfiui'tt1~-.- -<-ir- -', ,r , ",,-,,-
lIle IhlR _~ls_t..__n,.-_m..'.._ dl~ or r s t anna I~nl gner '
~1;:~;,,~~..90' .!!.._M""~:,.;;,;~M"'h.ni"bUi9b,\A
", ' I/cnl,!,f1/ r; __'L' ,.. ..n__.__n_.______.~___'__
(Nam!!)
n.'._____~..<T. _..__u._________...__._..............._._........___.
(II ddrcss)
"
j-";
;;){""
Imms'l'lrilt Olr WILLS 011 _emmERT-AND COUNT\'
oATH OF NON-sunSCIU1UNG WITNl~SS
{'-..J
, ;!
,___J.alliLL,.,...E::Ln.ch..---..-~- ~.___l
(cnch) n. RUbRcrlbcr herelo, (ench)hclllg dul~ qunllrlctl. nccordlng loinII'. dC(loRc(R) nnd A~Y(A) thA(
, she is, '. (nmlllnr wllh \hplgnnlurc of __ Nvl~ E. LaveJ.I'e a/kill NY'le Lavelle
. ,:' lelldtoll ' , , ,
tCRllI1 rix or (onc or the RllbAerlhln8 wltne~RcR 10) the 11'111 pre!cntCQ herewith, nnd
. . 'tOOtH,
thnt she , ;.. believeR Ihe Rlgnnture onlhc 11'111 IR In the hAndwriting or
teSlnlJ:.ix... bellevc! Iho slQllllturc or the 11'111 IlrcRelHcd hcrewlth nnd lhnl she .
xlKdlotbt '
bellevcR Ihe Rlgllnture on thc 11'11\ IR In ihe hnndwtltlng or ___,lCJ.1e ~._...LaVR] le.liLlVa/ Nyle TJilVE'llla
tothc beRI, or her __ kllowledge III1tI beller. '" '
sworlll,fl or nfrtrlllcd cnd SI,'""""" ...ro<, 2:2" ~~/~~'~C--?' .
Ille thlR ' ?ist, dllY of ~~e.. ' ncl}Namc)
~mbe(r.--'-~' ,,19..~L, , _~?,' 20_~_Li8bthous~.J:lf!9~ South Riding, VA
~~ ~~ -"'7-/r.t,(~~- (Addrc.!,!) 20152
, "17, RI'Rf.!IC1IJlijt--- - ----. --n--'yN;,~~;'~--------..---
-.............,;---------.................,.-.--~'
(lIt/tim,!)
"~"""'illll ~*
~ .
COMMONW .A, 1 P NN8YLVANIA
OCPARTMENT or RCVENUE
OOI'I.1IlOOO1
IS'". .;( I '-I ..3
REV-1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
'li,'.I1l \'I'i.'nlli (
;U HUMleR
2 1 9 7
.... MIl""wrx
L A V I~ L L It N y L It II
"
d~ITYNlJ.IB'R PATIOfDE.\lII D"JEUf'P1fml
1 6 2 .. 2 4 . 1 6 6 6 11/0 3/ 1 9 9 7 f) 8/ 2
I c
'11
MurrBl R. lvRl tarR I I II , !tall;
, 697-'4650
.
.
o 2, Supplemenlal Retum
o 4e, Fulure InI0I8IICompruml8el~~dI""''''''111
o 7, Deoedenl Maintained e ~Mng Tl1illl!l.ch cop, ~ I"",
o 10, Spoueal Poye CrvdllljJO ~ tit.. ""'/.11'11 Old Hili
f) ,9 1 8
, T
RIIOISTIIR OP WI~~8
54 E:nat Mnin S~l:'aat
t1echanicaburR I 'PA 17055
(1)
(2)
(3)
(4)
(6) .
(S)
(7)
I'
o I .~
( "
1 1 7 0 '1. !I'8 I)
o !'
i i...
1, Reel eltale (Schedule A)
2, Stockund Bonde (Schedule B)
3, CloIe~ Held CO!JlOrellon;Paf1nellhlp or SOIe,ProPr1etOllhlp
( Morlgag.. & Nol.. Rece~able (Schedul8 OJ
6, Oalll, ~nk PePPll18 & Ml$(lellaneoul PellOnal Properly
(Schedule S)
6, Jointly Owned Properly (SchedUle FI
7,lnler.v1Yoa Tranllell &Ml8cellaneoua Non,Probale Properly
(Schedule G 1lI ~I
S, To.~1 Gton An.tl (Iotal ~In.. 1.7)
9, Funelll Slpen..UAdmlnl8trellYl Co.l8 (Schedule HI (9)
10, Oebts 01 PlCedenl, Mortgage ~l8blllllea, & llenl (Schedule I) (10)'"
,11, To~1 Peduotl~h'(loial ~In.. 9& 10)
2 1 1 6 Il
0, \')
L)
, (
2. ':a'i/8
OJ )5~
o '
.
I ..
(S) )
9 1. 7 4
6 7. 5 6
(11)
(12)
(13)
,I
(14)
(16)
(16)
(17)
(18)
9 ,5
,9
12, Nel V,'u. 01 &I~t. (~I~ 8 mlnUI Line 1'1)
13, OIlMftable and Govemmental SIQuealslSeo0113,Trults lor which en eleoUon to tal hOI nol bIen
me~ (Schedule J)
14, Nfl VelUe Subjtot to Tex (~Ine 12 mlnua llllt 13)
6, Ameunlo IIn. taxeb
ellheepoulallel rele 1 I X ,0
See 'nllruollonl on ,.yertlalda lor applloe~1e /I<llOehlege
18, Ameunlorllne 14 texable .' 1 2 8? 5 4 8 x
aI6",.18 " _ " ,06
11, Ameuntofllna l(taxeble
.116,. ,.Ie , x ,16
16, tax DUt
19,
a
Plaoe
20152
PA 17055
I~
I
I:
!;.;.
110
I~
I
2
(~,", :1(fIM' t1lil ~
(n ~.
,"i1' /.1
uti',:
~':;. \. ;-;
_1":/"-
...-:.---
~~1\1
VIsa.
3 13.8 4 . 7 8
1 0 ,5 5 9 , 3 0
,
1 2 , 8 2 5'. 4 8
1 2 ,8 2 '5. 4 8
I 7 6 9'1,5 3
,769.53
(3)
(4)
I~) 769.53
"'- ...----.....-----
(eA)
eA 8T80 IOQ TOB
BY PLAOINO AN "X" IN THe APPROPRIATe BI.OOKB
1, Old decedent make e tranefer end: Yos
e, retain the uee or Inoome olthe properly transferred; ....,......,....,..........,..,................,....,....,.., ~
b, reteln the right to deslgnele who ehell use the property trsnsferred pr IIslnoomei ....:........,..
0, retain ,a reverslonery Interesti or ,.. ,....,...... ................ ,.. ''''.' ..,...."";;,",,. ,,,,,,. '"'',''''''''''' """," ",.t
d, reoelve tM promlae ,for IIfs of either paymenta, benefits or oere? ..............,..,.."......,............
2. If deathocQurred on or befor~,Deoember 1:1, 1982, did deoedent within two yeare
preceding death tranafer proparly wllhout reoelvlng edequate consideration? If death ooourred
efter Deoember 12, 1982, did deoedent tranafer property within one year,of qeath without
receiving .a~equBte co"aldera'lon7 '''' ,.."", ,.;, ",,,.,,,,,,,,,,,,.,,,~ ",,,,,,,,,,,',,,,,,,,,,. ,,,,',,, oj., " " "H"" ,Ii'" '" 0
3, Old deoedent own en "In trust for' or paYable upon deeth bank aocount or aecurlty
4 ,~tl~'I::;e~~n~~~~:'~' 'I~divjd~~i ';~ii;~~~'~i '~~~~~~i:' ~~~~iiv: '~;' ~ii;~~' ~~~~'~';~b~'i~' ';;;~;;~rty?:::: 8
11' THE ANSWER TO ANY OF THE ABOVE QUI!BTIONS IS YES,
you MIlST OOMPL.I!TSSOHI!DUL.B 0 AND FILB IT AB PART OF THI! RBTURN
72 .B. 19116 (a)(1, 1)(1) provide .for \hs ro uotlon ollhe ta~ rate Impoaed on tenet value o!tranura to or or the uae 0 the
aurvlvlng apouse from 6% to 3% for dotos of deoth on or after July 1, 1994 end before Jllnllary 1, 1996,
72 P,B, 19116,(e) (1.1)(11) provided for the reduotlon of, the rate 1r11Poaed on the net veluo ollransfera to or for the uae of the surviving
apoUae from 3% to 0% fordeles of death on or efter January 1, 1996, The statute ~oea not e~emot e tranafer to e eurvlvlng apouae
from ta~, and the atetutory requlramenta for dlsoloaure of aaaeta end filing ate~ return are sllll applloable even If theeurvlvlng spouse
la the only benefiolary, .
Decedent'_8 complete Addres8:
GlIlF.r:r Il{)RF. S 335 \" 1 h i
,Ofl, a" lIt' va
OilY
Sf 1: rA
l.'PP055
Machnnioabur.
Tax Payments and Oredlt,,:
1, Tax Due (Paga 1llne 18)
2, CredllslPaY\llanls
II. Spoussl Pove~y Clodll
B, Prior Payments
C. Dlscounl
(1)
--
--
TolOI ClodllS (lit B t C) (2)
3, IntsrasVPoRslly if appllcabls
D,lnlerast
e, Penally
4.
6,
\
769.53
Ni
lJll
B
FOA DA T88 OF DBA TH ON OR AFTeR JANUARY 1, 1998. please answer the following question by plaolng an "~' In the
approprl~te epeO\!,
Old the dooedent oreate 8 trust or Ilmllsr Irrangement whloh II lolely for the eurvlvlng epouse'l beneflt for hie or her entire
lifetime? Yee 0 No[] ,.
If you ansWered yes 10 the above question, the to~ on the trust or e,lmllar arrangement Is poatponed until the death of the aecond
spouse, at whloh time 11 wlHbe fUlly ta~ab\e at tho rate(s),applloable to the remainder benafiolary(les), l:!nter the value of Ihe truat on
Soh\!dUle J, Part II, In orller to remove 11 from the oalculatlon of the ta~ due In this eetate, You may wlah \0 flIe BoheduleO In order to
make the eleotlon available under Bectlon 9113, If the eleotlon 18 made,the truet or almlle! arrangement Is ta~ad In the eatete of the
"rst decedent aPouae, the portion of the trust or elmll\!r arrangement whloh benefits tha surviving spouaa lata~ed at th.e zero ta~ r~ta,
and the remainder la ta~ed atlhe rate(a) applicable to the remelnder bene"olory(les), If you ohoos~ to meke the eleotlon, you muat
atlaoh Bohedule 0 to a tlmely.flIed la~ return, elong wllh Sohedule(') K andlor M In order to show Ihe epportlonment of the trust or
almllar arrangement between the surviving spouse and Ihe remainder bene"olary(les). . .
;.y.I.,,'II.fI O.,A,
.k
cllM\l<ltlWl!M.lIlOl' Nilltl8YlV^IlI^
INIIIRII^tlCe I^X RP,lUlltl
Lavelle, Nyle E, 2197-0918
,
Indudl UI' ~004l.,J1 01 Utlgullon I"d Ihl'dllllhU prOO4lldl WIIO 10000lvod by Iho 111010, ^" V10PIIIY Jolnlly,o\Yl1ld wllh \llt ,Ighl ollUNlvOllhlV IllU,!1 bl dltolo"d on tohldUl1 F,
1 ' T
NUMBeR oeaCRIP liON or PeA 111
1. Pel:son!\l pl:oner.tv - net saie nrice b"
Chuck Bl:iCKer., Auctioneel: 135,00
j1'lll:nit:Ul:e ., per appraiBa1bv Chuc\~ Bricker,
Auctioneer
2,
3.
4.
5.
6.
7 .
B,
.9.
10,
11.
12.
"
>'i
. SOHEDULES
OASH, BANKPI!POSITS, & MISO,
PERSONAL PROPERTY
640,00
Bethany 'rowers . resirlential rent r.llJ:um\
Cloister Water. Service . refund
Plluphin Pepos~t Ban\~ 1/5/1522013
Dauphin DenosH Bank nZ136?50
Harris SaVil1gs 1/300110B495
FNC BanK 01010915
Blue Croas/Blue Shielrl . medical t'efund
MiddletOWn Home - refund
Et'ie Insut'ance - t'ental insut'nnce r.ef.und
Pinnacle Health - medical t'er:und
17.57
11.85
2,928,,93
1,95~.8~
14,735.33
918.42
24.30
301. 52
5,00
9.1B
TOTAL (^lkO enlel on line 6, Recapitulation) $
(1I1\101n AII!I"nl' n,,"'h!d, In,mlll'ioIillnnnl .hl'nl. (lflho AOllln AIIO)
21,682,98
(s ,)/(/-::'
BURHAU OF INOIVIDUAL TAMHS
U*lEAlTANCE TAK DIYISIOM
IlEPI, IS...I
HARRIS8U110. PA 111IS-'.'1
OO""ONNIA~TH OP PINN8Y~VANIA
DIPARTHINT OP RIVINUI
(~\
-......
'*
NDTICH OF IHHHRITANCH TAM
APPRAISSHHNT, ALLOWANCH OR DIBALLDWANCH
OF DBDUCTIONB ANO ABSHBBHHNT OF TAM
ny."., ..", I"""
MURRilL R WALTERS
114 E MAIN ST
MI!CHANICSBURa
III I!SQ
PA 1701111
DATI
18TAn OP
DATI OP DIATH
PILI NUHIIR
COUNTY
ACN
08.03-1998
LAVf!LLE
11.03-1997
21 97"0918
'C;:UMBERLAND
101
AJloun'1 ~s..1 Uecj
NYLI!
E
J
MAKI CHICK PAYA.~I AND RIHIT PAYMINT TOI
REaISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLIS~I!..PA 17013 .
CUT AI.OND THI8 I.INI ~ RITAIN 1.0NIR PORTION POR YOUR RICCRD8 ~
ilW': l.ltylll'l/"~~lI".r&9:"T.AoYfan\'..lliHllt"ff~1l6'i"Y"'X"A'jiPRiifUlliilr"At,t.lI'li~ll6'i''b'W''.''.'''.~'. .....
, DXsA~1.0WANO~ OP DIDUOTIONs AND ASSlssHINT OP TAX
18TATI OP ~AVE~LI!' NY~E E PX~I NO. 21 97-0918 AON 101 DAn 08.03-199~
TAM SHTURN WAS I I X) ACCIPTHD AB PILID I I CHANGHD
RI81RVATION OONCIRNING PUTURI ,XNTIRI8T .. SII RIVIRS.
APPRAXSID VAI.UI OPRITURN BASID ONI ORlaINA~ RETURN
1. Reel Istete ISohsd~le Al
e. stook. end Sond. ISohs~ls .)
I. ClosllY Held Stook/Pertnsrshlp Interaat IS.hed~le CI
~. Horteesss/Hotss R..elylbl1 IS.hed~ls DI
B. Cesh/Sank DsP.slts/Hls.. psr..nsl Propsrty IS.hsd~ls H) ,
6. Jointly Owned Propsrty IS.hed~ls ~I
7. Tran.fsra IS.hBd~l. 0)
, e. Totsl A...h
11)
Ie)
II)
I~)
lSI
161
17)
.00
1.701.80
.00
.00
21,682.98
.00
.00
eel
HOTI', To Insure pr.p.r
orsdAt to y.ur ....unt,
a~b..1t the IIPpsr p.rllon
of this f.re HUh~.ur
tSN pay...nt,
23.384 j 78
APPROVID,DIDUCTION8 ANP IXIHPTXON81
9. F~nsrel SHpah.ea/A~, Cost./HI.., SHPsns.s IS.hsduls HI (9)
lq.Dsbt./l1orte.g. Llabllltles/Llsns ISoh.d~h II (10) 967.86
11. T.tal Dsdu.Uon. (11) , 0 . BRQ M
12. Nst ValUl1 of Till( R.t~rn (12) 12,8211,48
11~ Charltabi'/GoYSrn~.nt.i .Sq~..t'l Non-shotad 9111 Tru.h'C/loheduls JI la) .00
l~. IIBt V"lUl1 of htst. Subje.t t. T.H 11~) 12,828 , 48
NOTlI If.n ......m.nt "'II b.ued pr.v:L\lu.1YI 1:I.n81 14, IS .nd/a, r 16, 17 and 18 ~~u.
reflll1t,f:LgUr" that :Lnc~ud. 'thl tat.l of ~ raturn. .......d to d.te.
A8818SHINT OP TAXI
11" A~oUllt of Lln. 1~ et Spou..lr.t. (11) .00 M .00. .00
16, A~.unt of Llns 1~ b..ble et qns.lICls81 A, rate C161 12 .825,48 M .06. 769 , sa
17. AIIO~nt of Llns 1~ t_H.bls.t C.l1.tar.l/Cl.s. B ra~a (17) .00 M .15. ,00
18. Prllloipall"., D~s us I 769 , 53
TAX CRIPIT81
PAYNENT
DATE
9,591,74
RSCEIPT
NUHBaR
DIBCOUNT C+)
INTS"18T/PaH PAlO I.)
AHOUIIT PAID
TOTAL TAX CRIDIT
BALANCI OP TAX DUI
INTIRI8T'AND PIN.
TOTA~ PUI
769,113
,00
,00
.00
>( IF PAID A~TaR DATB INDICATED I SIB RIVBRSE
FOR CALCULATION OF AODITIONAL INTIREST,
( IF TOTAL DUH IS LESS THAN .1, NO PAYHENT IS RSQUIRHD,
IF TOTAL DUE IB RSFLECTED AS A "CRHDIT" ICR), YOU HAY BE DUE
A REFUND. SEH REVERSE SIDH OF THIS FORH FOR INSTRUCTIONS,)