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HomeMy WebLinkAbout97-01006 Oatil of Pursonal i'leprosonlativo Commonwoalth of PonnsylvDnia Count y of ~~lI1lJH~~ CUMBERLAND Tho !'ollliollu,!,1 lIuovu'IIl1ll1ud "wua,I,,) ,lIl1i 1111 ill "I ,;I Ihaltllll "Ialll""""" III tlllllulll\1ui"\Il'lItititlll .lIl1lll1l1ll1."" G()[II'GIIU thu hosl ultho kllowluu\Ju alld Iwllo! oll'Oliliollur(HIIIIlIi IIII.\' II" 1'1IIH,,"al IIIIHlIHulltllllvlIlHlul Ihllllll"",hlll\' Potilluf\Ul'tsl will wnll (11Id truly adlHilllslnr tlHl oHlUtn accOIdll1\llo law. Swurn to 1I11l1 uffil'lllml alld 5ub!iClihod pm,,;cc~t l</, ?:yy- hulor" 1110 IhiH ._.__~~_____ day ul ':rjf;:T~~' ,~E:, .,;: 'M~1 ffbtJ;n--- tf MARY C WJlS __.._LL-'----------- ... ------_..,.-_.--_.~._-' _.-..---~...__._.,..,..~-_.. . ___,..___.....,. .._..._____.____.._' ,. __.__M'___~'" _" ..-.--.......-- DEe nEE OF nrGI~;TEII ESl1l\IJ of _.B.WR]~.1<YNti..XOL'(!!_..... DUCUilsod 1,,,. _ZL~-9? _-JO_Q6. fllso known flS __'__'_'___~'________'_'___'_'_ _..______ ..___.__.___..OM.__. .,~ Social Su<;urlty No: .-1.?l-.4.f::..42Q\l IJlI{(lullJoalh:...U/13/~7, AND NOW. ~ __..J)~.~IMJ3PL.1.9 ,.. 1 !l97 ,Ill t:IIl1nidlll ;llillll 01 11111 I'otilillll 011 tho rovurSll 51do hereon. salislacloly pfoollwvill\J bOl1l1 prosul1llld IwlollJ 1110, IT IS DECREED tl\ill Lollors 1'-1 Toslilllll11llllfY IX! 01 Adlllil1l~;Irt1liol1 ....' _....-.~.-- I.'" ,I!."" 1""."""-1..,.",,,...,,,,,,.,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, lIfO 110reby UranllJu to MICHAEL w...YOI.,TE.__..._________. .-~.\-,-I..'~...'...-.,-"".I "'. --- ....._-.~, .._,...~--- ill tho above e~:.lalo and Ihal Iho inslruIllOnl(s). illlny, da\ou .------.-------.-----..-----~. doSCriullU In 1110 Potition Ilo ndlllillnd 10 prolHtIO illlll IIlnd 1111111:0ld Ill, 11111 11I!i1 Will 01 i)O(;Odol1l. ..~----------_...........- Short COIliflcu!B(s).J4),.. ~. 12.0L_ 'AX') c.. (C/,. 1)..11"" ,W"'"hL\J!lm. .(Ji-..':R1i, - .:;t:.:.... I u M~~~'~"l~:;SW r:/'O FEES LollO!'!)""". ..., .""."".,.", ~ 25.00 ROlllll1cilllion................" $ Affidavit ( I...........".... ExtrD PDUUS ( I....,....,.. Codicil"""....,.......""..., $ __..._.___.u_--~ $ 'rOTAL., ,.,.,. ...."" All,UlllIlY :~.... J.gl.1n. .I'l.". ~2D",X.1(J_h.L ,l.'J!351'!.!E.e,~.._ I. D,No:__...!JlJi)_L__._______~.._..__.___,_ Ad(ho~s:~__.~9.4..s.t_i'! t9_,fJ.t.~oot ___ .________._. .___________JJ!lrr jsbl\!:9J _ [> l'J_ __J_UOJ..__,P, .. . T olopllOl1o :__lli: 19_Q9.,____________...____.__. DATE FILCI): DECEMBER 19, 1997 ,,' ... MAILED LETTERS AND ORDER TO ATTORNEY ON 12-19-97. ,. " -~.-----............. 111I1i"ltory & Tax Forms... Otl.UI.."."......",.."",..... $ 5.00 $ Jet> Faa"...""...."".."", $ ---.......----'""' $ 42.00 - IlW-7o rlll\ Is III ~-l'n;f\' dl;l! dll' illhlllll.llillll IH'I\' !',I\Tll I' I Iii I('llh ,1,\\1(\1 IIlI]11 ;[11 (llll',IILII ,<"Ililh ,\II (II dc,11I1 dllh likd \\'Ill! I\k ;1;. 11l\..IlI';q,,\~\r;\r.'TIlt' nlll',iIWI \l'llill,_.IIl' \\d\ II( !rll\\,.lIlkd Iii (Ill' 'd.!\(- \ II,d l\!"'llil lllll" 1;11 \11'111\,111\'111 lihlll', WARNING: It Is IlIogallo dupllcato this copy by photostat or photograph. NIl. ililt'~\f\i\'Of'Pj}'-,',: l\'~'\. - . -, -_If,I<'~~ it"" .I)... li ~ f/,'\\ I~' 1."~'l\ I <=:i, . -" \."'... ,Ifl , .... ,i ; .. '_ . \. SI . &.'.~,iJ ..1J<> ,....:-:,l. ., '19'''\'''", "~~~-,-:',~/fNl ~\ ~~,_\"" ~tt!{df'1!!(\'!-- , a~ //2. ;a:;:.w-.A"r1~?Ji:' " .'. ..~~' 1 'l< ,d 1\( ghl!.11 . h'e lot' lid" (l'ndic,llt,. ",~ {HI 4614797 NOV 1 7 1997 I-);l!\' OOMMONWEALTH OP PtiNNSVLVANI4' OtiP4RTM~NT OF HEALTH' VIT4L RECOROS CERTIFICATE OF DEATH "^" "l~ fojUlo4Nfl t,''"'~ DEC~~I~';; ":'~I~~' f 0 f tz ~~=:~,=-~~~~.=:.~===: ~j '11;,:~~::J:T2'i~:;~~~~~~~__4 ~~~=n~~~"'0_~;-7~1 '1-.-.. "OIE(II..6~lhlol~1 [~~{~~~ --~~r!~.- '~:'~~'~~~~I I ~::~::~~,I~~'~;;I 1:6~~JIf'~rJ(~lti~'~:~~"'~'~:<t ~"-'~'~'-1-"--!'~''''-''!:!'-~1-:~ 6hiffi-" I I- . [ . 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It_ TQltltljtuWtl, I.A "/0056 ' "'" 1'''"1 . ~ 11~ ~~,~ ~!:: ~~~_~~~~: 11(> 't (~II'<l"""'''' II.l ) ~::',,:.~lqt _~I~.3~~.~JQt~L_.__._._.;..;~~,._ fAlltrA'SNAIoIf.lfH' M.-;;;;-l~;f-------'~~- ~ws j;.i.loIf;f ,,,-i:k",,-~I"""'-;-;:;-;::;;'-;;;--- , Cr_c-if SIWdl'.1t It AtOI Z llIllII(''tIWUI :"".if~~"1ilg;1Fcic'tJ;r-tz_=:~~~~=_~ . __~___.___,,_u,_______ ';;;i>>f'r~tr"~:~l~~~!;i'~~(';:;";J~~:~711;~I;~~~~J~~-' ~~~s~=:___ ____ ~"ftlOOOFOI!I"'06mON DiIl'i.7ifDIsMllilf.----- I'IAl;EOfOISI'\1SlTION N.n..oIC'r~"I'Y t""'I""~ }t)(:""ON Cof}'''-' SW' h'C,.. 8"'''I[.Il;r_llQI'l~fl'm<l'II~umSlII,1 ) [111.l<"'N~~J7,~llHIJj 18 1997 <l,Ol~"It('C'l.rmat(lJtl SO('{l!.(11 (In ().,...q'ij.,~ll_____.._________~___ _ --- It 'I~ ,,^ ('H'ma((J~!1 If f{(HJr.(~~U~(j "A 1"/109 At:Of'UNE lMRViCi'~!iE~-r"ER-- -:ii"Housuci. - ~--lliCEilfiNUilD[j,------' -~- 'It.jAI.l~AJiOAoDf1i~"()fi.<<:illfy~~j(i TOti~(~r~,~()t--Prllji ~rlf~r:til (Zi- . un - )' "___. _ ___.Jm______________ __~_. ,.,illdJ2Q tJQ1Kli.Q12tUS_\"l\L1!{LU.u LJ~A_UlV,L__. Co.."~I'~lml ~o<tl "'"C""ty,"9 rc;t,,,~~m~_"""lo<~ ,II,",<)<;(u"..III'/IIII1" ,W,"<><lI~I(,""'",1 1<(;1'l',1 WH,lOIH DATE IOlltD pfll'1Il:'8II.M<l ~ twit I,m. old...!".., L~"""'e..~I!'~1 ",",.", (),I, .....1 ~-.r\1l'f tI,," 01 h _~_' ___ _","___ ~.~:!(:."~i= ~~:r'"'n7t73J';i~") ~ _= ---~= ~ffif'i!i'"'<O-"'~.I:~'r-~ij;Nffi< llL1il;---~- If ""I'l'l Ell'" In. "'"1'" "'I""" '" (Qmplo:lh.ml..~~Il(Il'll<Iln, (lolll1 IkI IlCl I"'" 11.. n~1<,," ,,1.1,.,'11 """ U Ul.(JoI( 0' '.II"'''~'Y .,,"1 IIW)l.1 oJ 1"111 I. ~'" I ~Il.~;;;.it~ ~A"'11 01"., ...",IIo;Wll C<)(\<.....;;;;:;.-W.'II...-...~_. . . l,lIo""..."'CI"'''''''cI,''" t.~'NWbt- r.{'II,...Ill.l9IlI...""'...,,"'''_lfwon..WJ\lr ,~,r1d,lIo1h I :?,'(({S , i I , , . i ______ - .. ____ __~ _. -1- . (lATE Of INJW\Y .-T',',,"'..."". '~JUR'..._ (M....-~' 01, y...l II II (:,)ojkl "'~ l>oI '",11,,,,,,.1<1 (_ I m.Cf. Of IN,jlJn~ AI ""'n" II,m 11/.11 !tCloll'J oll-;' l',,'""'ol lIe :'",!jI,_~,l ~. .Qv.1l Q; (\,.rJ . . (lA.N c...c [<.,., IflilJlml(~I.I..~"r()'Nll')fNC[''f) \ :'-- "''''~-..:;;Atj1Of>AYJ-'''~-' r" I"(A'O,.Mlnl ,tMAjt....I[Pllk>nm C.OMPUi110NOfCAU& \/1 Of Pf-AHI1 Nil"''' "" "'r""'~ I 1 Nd ~[l ""'~ S.,ull II _ ~~_ __ ~_ ._~_ l!.__ __._ CI"'tiilit'I:;"~; ""', .,,~I 'Ct"Il',(~ 'Hy.ItIAN If'I,-," ",,, ,_..~,,-.,., ,_.",,;.j 'Iu"- .,...-- .;....1"" 1~"..._,.,.N' I'.d".',...i "".,i I. ....1Ietl1. '"~ ~1llI.~. dtllt!GCclInld'IM" 1M ~1-\l'lm''''' ml1'~I1III1~ltd riilt; -ml~l ~~ .i;Ulfl'>fOll( '~:l-iiii-- 5iii 101(111"''; Ato.i!;[iili{t~Cf ,-ii '..IOICAl UAMINtA/COrlONI" On Ih. Holo ollllllllnlllon onctlOlln~ntllllllon.I', ml olplnlon, dUlt! o<.wrtd 'I lilt 11m.. dl", .nd pl."., Ind du. 1111h. ~,u"I'I.nd mltnn.,u.llloG. 311 _ _ .n..~.._.._______._.______ -.- ii(O~RAJfi ~lniiAf~f\nNI-}ij\i'R !!ann "/~ ~.I.p(,1/1A .. ':'''[.:~:~'I~T~t~,~lil,~V~---~--- ~K1k"IN'>;j....';~f'~'..''''''I.1 (' I Itly(;,:C(RilFifA'~i\A"3--.._._-- I I ~~: J~t~ z '1 ~- 1;~:",Sf1'I~fr ,.~"'r Arm .('I00f5SOI-.l'fll~ONwllo<".n..."lllf(lC"il5.E j 'JfA~~ ",,,. '!RJf~r"'t:~ A.{; J''<V !IHifA~!ti;iftJ~ {_qr.l'i:d'?t~ 0"'( ~Ol [lJi~ ,~, ,,,,. ""'; r ..](,rv /7{ 19'17._ Ib".:o<II ~'''''''f>\I'''''''''''''''''' ,1'-,I',_...'ll~""<l't.."n; ',MNOOHCIMO "NUt;,-"U,yiNQflllYI1C1""'lf1-...-.II.I.--'I' "." ..," '-'l.l",';f ,1;-,1, ",_rl"~' ,.. ~J"i<I.-1 de.n.1 101M ....'01 IIll ~""".....' d'l11h teC..u.... .11hI tll\<ll. '.1._ 1M pi"., 1,1<1 ",.. ,..I'" ~1"1~1111'<d ml"~" I' 1111'" tf':"UOOE)(.lle1)~ COMMON~,(LVANIA Dl:PARTMf:NT OF REVENUE [JEffT 280601 HAHRlSflUfHi PA 17 \28-0001 /fJ-- &, REV -1500 INHERITANCE TAX RETURN RESIDENT DECEDENT ~l!!i !2 II! ~ o .. OfFICIAL tlSCONI.Y (1 ,> FilE NUMBER ~ I l) 7 II l;WtotyC(j()( 1,Q1 II II .-. /I ~ W Q W U W Q Of:Cf:Of.NTS NAME (lAST, Fins I, MlO MIDDlf: INITIAL) U56 a blnllr block III sopilfalo W()(~<; I' () I. T I. S II I': R I. Y N N SOCiAl. SECURITY NUMBER [JA1EOf[lFATH 7 7 -4 2 -4 ) II K /1 .1 / I 'I 'I 7 tlA 11 OF [~I!i III 1I .1 /2 ) /1 'I , II (IF APflllCAm.f:jSURVr.J\NGf,rOUSFSNN,U:(LAf,l FIRSfANOMIDDlE INIlIAl) SOCiAl Sf:ClIHlIYNUI,llWll HilS HHUHN MUST nr FILm IN OlJPUCAH WITH TIl!: MICIIAEI. W. FOI.TZ II 7 -4 II -4 4 II 1I REGISTER OF WILLS ~ 1. Original Roturn 0 2 Supplemental Return 0 1 Remainder Reltlrn (d~leof~~alhpr""\o 12,1]82) o 4. Limlled El\late 0 4a f:lIlllre Interest Comprornise (dolliiofrle.lltl ,l"er \2,'2-811 0 5 FedAral Estate Ta)l, Return Required o 6, Decedent Died Toslate IAtlill1hcopyolWill) 0 7_ Docedent Maintained a liYlng TrusIIMiV;hCOpYOIIILI,n ~ 8 Tolal Number of Sale Deposit Bo~es o fj, litigation Proceeds Receiycd 0 10 Spousal Poyerly Credill(1.1t'lO(!ltl,lthMMclllll2lt.91 ,l~r) 1-1-0:,) 0 11. Eleclionlo t&~ under Sec 9113(A) lM...;hS~hO) ECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAl. AX INFORMA TION SHOULD BE DIRECTED TO: COMrlJTf MAiliNG A[)[1RfS~, 204 State Slreet 12. Net Value 01 e.tatelUne B minus Line 11} 13. Charitable and Goyernmenlal BaCluesls/Sec 9113 Trusts for which an election to ta~ has nol been made (Schedule J) . 14. Net Vatu. Sublectto T.. (Une12 minus Une13) 15. Amount o! line 14 t"able 2 7 at the spousal laK rate , , See InstructJons on reverse side lor aopliCilble porcenlaQc 16. Amounl olli"e 14te"ble al6%rale 17. Amount 01 line 14laKable al15%rate i i o 1. Real E.k,leISchedule A) 2. Stock. a"d Bond, (Schedule B) 3, Closoly Held Corporalion, Partnership or Sole-Proprielorship (3) z o i= :5 ::J l- ii: ol( u W 0:: 4, Mortgages & Notes Recelyable (Schedule 0) 5, Cash, Bank Doposlls & Miscellaneous Personal Property ISchedule E) 6. Jointly OWnod Property (Schedule F) 7, Inler.Viyos Transfers & Miscellaneous Non-Probate Property (Schedule G or L) B Tolal Gross Asset, (total line. 1.7} 9. Funeral EKpenses & Admlnlslratiye Costs (Schedule H) 10 Debts 01 Decedent, Mortgage liabilities. & Uens (Schedule I) 1,. Tolat Deductions (total Line. 9 & 10) z o 1= ~g 1-'0. 2 o u 18. Ta)( Due 19. Ilarrisblll'l..!, PA 17101 OFFlC1Al use ONLY 11) (2) ,K 9 /I . 7 II (4) (5) (6) (7) 1 , 7 g 1 . K 'I , I ) 9 .4 0 t <) g 4 , 7 2 (61 7 /I 7 ) 0 II 1 0 0 ) ) (II) 112) (13) 2 7 4 4 ) 6 3 7 g 2 4 ,7 (9) (IO) o /I K 0 , , 4 4 (14) 2 7 ,I 4 4 ,5 /I X .0 115) 0 () 0 X 06 116) 0 () 0 X 15 (17) 2 1 ,'> (16) 2 1 'I << DATEIt// 1710'1 ,/, 1(/ 1'1 DilJ . 0t, I'A 1710 I -:' /0 t_ ) II 5 9 4 0 D~ced6nt" Complete Addrell: STnEET ADORESS 6402 ClIlIlIOllllril'c CITY . Mccllillllcshurg ~ J 'PA lIP 170)~ Tax Payment. and Credit.: 1. Tax Due (Page 1 Una 18) 2. Credits/Payments A. Spousal Poverty Credit 8. Prior Payments C. Discount (1) 23.91 Tolal Credlls (A + 8 + C) (2) 3. InteresUPenallY if applicahle D.lnteresl E. Penally O.HJ 4. Total Interest/Penalty ( D + E) II line 21s greater than line 1 + line 3. onler Iho differellce. This Is tho OVERPAYMENT. Check box on Pago 1 L1l1e 1910 requost a refund If line 1 + Ilno 3 Is greater than line 2, enler the dilference. This Is the TAX DUF.. (31 (4) (5) O.HJ 5 24.74 A Enter Ihe IlIleresl olllhe lax due. (5AI B. Enter the tolal of Line 5 + 5A This Is the BALANCE DUE. (581 24.74 Make Check Payable to: REGISTER OF WILLS. AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a Iransfer and: Yes No a. retain the use or Income of the property transferred; , .. ,.,., ,.......... .0 [)9 b. retain the right to designate who shalt use the property transferred or lis Income; , .... 0 [Zl c. retain a reversionary Interest; or . .....,0 [Zl d. receive the promise for life of ellher payments, benefits or care7 ..................., 0 [Zl 2. If death occurred on or before December 12, 1982, did decedent within two years preceding death transfer property without receiving adequate consideration? If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? ....... . 0 [Zl 3. Did decedent own an "In trust for" or payable upon death bank accounl or security at his or her death? ......................................,.. .0 [g] 4. Did decedent own an individual retirement account, annuity, or other non-probate property7. .. [Zl 0 IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN 72 P.s. ~9116 (a) (1.1) (I) provided for the reduction of the tax rate imposed on the net value of transfers to or for the use of the surviving spouse from 6% to 3% for dates of death on or after July 1, 1994 and before January 1, 199r.. 72 P.S. fi9116 (a) (1.1) (II) provided for the reduction of the fate imposed on the net value of transfers to or for the use of the surviving spouse from 3% to 0% for dates of death on or after January 1, 1995. The staMe does not ex~J a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even If the surviving spouse Is the only beneficiary. FOR DATES OF DEATH ON OR AFTER JANUARY 1, 1995. Please answer the following queslion by placing an "x" in lhe appropriate space. Old the decedent create a trust or slmllsr arrangement which's soley for the surviving spouse's benefit for his or her entire IIfetlme'/ Yes 0 No ~ If you answered yes to the above question, the tax on the trust or similar arrangement Is postponed until the death of lhe second spouse, at which time It will be fully taxable at the rate(s) aprllcable to the remainder beneflclary(ies). Enter the value of the trust on Schedule J, Part II, In order to ramove it from the calculallon of the tax due In Ihis estale. You may wish to file Schedule 0 In order to make the election available under Section 9113. If the elecllon is mado, the Irust or similar arrangement is taxed in tile estate of the first decedent spouse, the portion of the trusl or similar arrangement which benefits the survivin9 spouse is taxed allhe zero tax rate, and the remainder is taxed at the rato(s) applicable to the remainder beneficiary(les). If you choose to make the oloctlon, you must attach Schedule 0 to a timely-filed lax return, along with Schedulo(s) K and/or M In order to show the apportlonmont of the trust or similar arrangement between the surviving spouse and the remainder beneflcimy(les). ~STATE OF SHEIU LYNN FOLTZ SERIES E - $50.00 BONDS Issue MonthlYear Serial Number !hte of Death Valu$ May - 1974 LlO43738343E 194,76 September. 1974 LI043738580E 189.52 December. 1974 L 1 084285036E 186.24 March - 1975 L I084285252E 186.22 April . 1975 LlO84285380E 186.22 June . 1975 L2002624039E 182.96 July - 1975 L2002624138E 182.94 September. 1975 L2002624236E 182.94 October - 1975 L2002624504E 182.94 December " 1975 L2002624795E 179.76 February " 1976 L2002624847E 179,78 March . 1976 L2018187126E 179~ 78 May . 1976 L2018187310E 181.48 September . 1976 L2018187585E 176.56 October . 1976 L2038998068E 176.56 January 1977 L2038998411 E 173.58 February 1977 L2038998505E 173.58 March . 1977 L2038998753E 173.58 May . 1977 L2067967972E 175.30 June . 1977 L2056706005E 170.54 August . 1977 L2078343759E 170.52 November . 1977 L2087265707E 156.38 SERIES E - $75.00 BOND Issue Month/Year Serial Number Date of Death ~ November . 1974 K \ 00450826E 287.01 ~ES E . $200 BONDS November- .1974 November . 1974 R I 02450590E R 1 023623 78E 765.36 765,36 ~ERIES E. S1.00IlBOND November - 1974 Ml03245865E 3,a26.8Q SERIES EE . $7,00 BONDS September . 1992 R85927924EE 134.40. September . 1992 R85927925EE. 134.40. September . 1992 R85927926EE 134.40. September . 1992 R85927927EE .134,40. September . 1992 R85927928EE 134.40. SEJUES EE . $500 BONDS September . 1992 D3Q862Q48EE 336,0.0. September. 1992 D3C862Q49EE 336.00 September . 1992 D30862Q5QEE 336,0.0. Septemb~r . 1992 D30862Q51 EE 336:0.0. ;5--,):)0 -" BUREAU OF INDIVIDUAL TAMES INHERITANCE TAX DIVISION Df:PT. 2110601 HARRISBURG, PA 11128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE ,I C NOTICE OF INHERITANCE TAM APPRAISEHENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSHENT DF TAK DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN GREGORY S CHELAP ESQ SKARLATOS 8 ZONARICH 204 STATE ST l.: HBG PA irliOl 02"23-1999 FOLTZ 11-13-1997 21 9"-1006 CUMBERLAND 101 A""unt R..l ited * If.V.IUI U '" U4.'1, SHERI l l 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 ..... iiE'v: iS4"i" EX "AFji - iiiF97Y"iiiii''iCE- OF" "fNHEiiifilNC E - T"A'ii"A'pjiiiA'isEMEiir; -ALl"liwilNcE -iiR --" - ---" --- -" -" -- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF FOLTZ SHERI l FILE NO. 21 97-1006 ACN 101 DATE 02-23-1999 TAK RETURN WAS: (X) ACCEPTED AS FILED RESERVATION CONCERNING FUTURE INTEREST " SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1, Reel Estete (Schedule A) 2. Stocks end Bonds (Schedule B) 3. Closely Held Stoak/Partnernhip Interest ISQhedulo Cl 4. Korte.g../Not.. Receivable (Schedule OJ 5. C..h/8ank o.posits/"ilc. Parsonal Property (Schedule E) 6. Jointly Owned Property (Schodule F) 7. Transfars (Schedule G) a. Total Auat. 11) (2J. (3) (4) (5) (6) (7J ) CHANGED ,00 11,896,70 ,00 .00 13.783.89 159 , 40 11.984,72 la) APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expan.../Adn. Costs/"isc. Expan..s (Schedule H) 10, Debts/Hortgege Llebilltie./Llens (Schedule I) 11. Totel Deductions 12. Net Value of Tax Return 13. Charitable/GovernMental Bequasts, Nonaelaotad 9113 Trusts (Sch.dul~ J) 14. N.t Velue of E.tet. Subject to Te. If an a.......nt was i..u.d previou.ly. lineB 14. 15 and/or 16. 17 and 18 refl.ct figur.. that includ. the total of ~ r.turns a..e..ed to dat.. ASSESSMENT OF TAX: IS. AMOunt of lina 14 at Spou.al rata (IS) 16. AMount of Lln. 14 taKable at Lin.al/Clas. A rat. (16) 17. Aaount of Lina 14 taxabl. at Collat.ral/Class 8 rat. (17) 18. Principal TaK Due TAX CREDITS I PAYHENT DATE 12-17-1998 12-17-1998 NOTE: RECEIPT HUlfBER AA324407 AA324408 DISCDUNT (t) INTEREST/PEN rAID (-J ,74- .00 (9) (10) 7,675,00 3.005,15 Ill) (12) (13) 114) 26.985,16 K .00. ,00 K ,06. 159.40 x' 15= (111) AHDUNT PAID 24,74 24,74 TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE . IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. NOTE I Tu insure proper credit to your account, lub..! t the uppa,' port Ion Qf thl~ forM with your tax pay...nt. 37,824.71 1n .680 11; 27.144.56 .00 27,144.56 will ,00 .00 23,91 23,91 48,74 24.83CR ,00 24.83CR ( IF TOTAL DUE IS LESS THAN '1, NO PAYHENT IS REQUIRED, IF TOTAL DUE IS REFLECTED AS A "CREDIT" ICR). YOU HAY BE DUE A REFUND, SEE REVERSE SIDE OF THIS FORH FDR INSTRUCTIONS,) RESERYATlOtf! E,tlt,. of _..,," dvint 00 Qf I",fa'-. Ih~G""er Uf IIf., " If .w f~tur. tnt.r..t In thli ..t.t. I. tr..,ferred In poue'llon 0" IflJovont hi ca.., I hwUet,r.1 j b.n.flfllerl.. of ~t. rito.dlnt _ft.t UWI 'MPirltlon of ..,y ..t.t, for lif, 0" for !f""'1 the CQM(M.....lth h.Htllv u",-...h r"~r"''' t.. rit.ht tll I'PfIrlh. 11M ...... tr"'U.r lnh4litltanal TI)CI. .t the a_wI CI,.. . (nuU.te"IoIII !'nt. un Inv luoh fulutl Illtlrlltt. PUIlPOSE OF MOncEI PAYNEHTl MFUHD ((~A) I Tu fulfill tlMl t...ult.'Htuh of o.d IlIn 1114\0 ut the Inhnlt""C}. And [It,.t, Tal( Act, Act 21 of 1995, (72 P,S aecUon 91ftO I, bft'.oh thl tOfI flllrUOfI III ihh HIll hi' ,md IUhfllt with VItOI' "'V,,"t to the M.,ht.r af Wllh print... on the r.vlr.1 .1de. U4~' (Ih'lllt LlI MflfHlV OIt'" ,'.vl.hl. tUI InOISTER or IULLB_ AGENT A f,.fund 01 III tlllll tlrMtIt. .hl"h WI'" nut 1'.I~I..tllltl un tlHI Ii'll( M.hlrl\, '1'1'1 h. r.quest.d bv ClOllpleUng an '"Applicltion for R.fund of 1)..WlIylullill Illh.dt.,a. ..Nt I..t.t. h~" IRLV-Ul.\)' 411plicIIUcma .r. avalllthl. .t ttt. Offio. of the Jt..htllr of NUlt, any "' thft i'J, "'.v.nu. IIhtJlut OU'en. ",' b... c.1l1ng the 'fl.clal Z4"hour In....rtng .,,,'vlo. IMlIlh.... Int- fur.. urMllnel In II"W"lylv..~la l-aoO'J62:~1050. out.lde Penn.ylvanl. IIOd wHhln 10aal Itlttrhh"r,.,,-.. (/111 IA/-'O"", tnlll (1111 In-us? IUe.rl", htPolrlld Only), oaJECTlOHSI Any party It! lnt.rut not ..U.fled with ",,' ftllll,nlt"ltltnl, nllowRnflll or di..llow.no. of daduCltlcnl1 or ........nt of taM (t"Clludinll dllcount fll ~flt....t, ,n 'hown nn thl. Nutl!)e II\I.t obj.ct IIIlthllllSIMty (601 d..... of rlto.lpt of thh Hotlo. ItVI AIlItIN ISTRATlVf CORiCECtJOHS. DISCOUNT I PE_l TY I INTrRfIT' ......rlHItI prnt..t to Ih. I'" 1"llItl't..,lt nf MeV.IlI", IlIard {If 4'111..,,11, Dept, ZIHOZI, Hltrrhhurg, P4 1112&-1021, OR "~al.(IUolI 10 hav. tlWt ....... dataraln.d Itt ItIKllt of the .ocHlunt 01 the p.r.onal r.pr...ntaUv., OR --'appeltl 10 U.. Offllll'''' Cou.I. facltual error. "'Itlllv.r.d 011 Ihl. ........"t .hflllld II_ .dtt"....d In writing tOI "" Oep.rt.ent of Rav.nua, Bur.au of IndJ V Idll" , '.IIU, AI UtI I'o.t Ali....III.nt fhlYh.w U"it. lI.pt. laottOl. tbrrltburg, flA 171Z6~0601 pttonll (1171 7.'~6!iOh. S.. .'.... ~ n' the hOllttl.t ''In.trueHon. for lnh4tr jt..nc. 1811 Return for a Ruldent o.o.dant" (IttY-I'OII '01' IIIMI .1I"lIlflaUtHl of 1td.lnht".Uv.1y carr.ctabl. .1'1'01'1. If ..,~ tak du. It "1I11i wllhln th.... (:\1 fI.l.ndlll- 1I0nth. .ft.t the d.udant', dellth, II flv. parcent (5:0 dhcount of thlt ta)( paid h allo.d. The IIX taM .."a,ty Ilftn"p.,"t hdlltlt Ion It4HlIIU!i h oOflJluted on the tot.1 (If th. t.1I IInd Int.r..t .......d, .,ld not paid hIIforll Jlhtlllry II, 19"1, the U,.t dllv IIft.r U" end uf Ute tIll; Mnll,t!i pllrtod. Thh non-pertlcip.tlon PlIOIIltV I. ....,..lIlhl. In the ~.. ....IfNtr .nt' in tiNt the .... tilt. pedod .. Vou Mould appllal the t.)! and lntlrltlt that ha' lMlttl ......ad It. Indlcat.d Qfl thhl notltl.. Int."..t it ohll"..d "1.I!lIlt"", with first day flf dllUnqu.ncy, or "in. (9) 1I0nth. and 0,", (1) dav frail the date of M.thl hI th. data of II.VHOI, hll" which hllU.1I dalillqullnt b.for. J"luar!ll 1, 19Ai! hlat Int.r..t at th. r.t. of .hI (6X) fllI,'o.nt ..." "lnUIII oahuhtt... At II 11,,11'1 rah, (If ,000164. All tell" which b.e.... dallnquent on Met aU.r JIIflI,..r~ I, 19.2 ",UI b.ar Int.,...t at a "at. which will ....ry frOll cal.ndar ye.r to calendar y..r with that rat. IIfWllMNMllld hv th. "A D~.rt..nt of M.v""",,, , TII. a'lplloetlle Inter..t r.te' for 1982 throuttl 1~99 are, 'tilt lnt."a.t Mlltl! 0111 hi Inte"..t I'.otur ~ Intorelll Milt. DaUy Jnt.t..t factor 1.81 lO)C ,0005". 198ft '19fJI 11% .GOOlOI nl! lI,): .000"J8 1991 9% .000247 19"4 11>: .OOUOI 199]-1994 n .000192 .'a5 1!1 .OOOJ!t6 1995"1998 9% .OG021t1 ..... lOiI' ,OOO1l4 11199 7% .000192 .../ 91 .0001'" ~hll1t.r..t It (I.'cull_tld .. 10U".1 INTEREST . BALANCE Of TAM UNPAID K NUHBER OF DAYS DELI~QUENT K DAILY INTEREST fACTOR u.nv Netthltt hlued aft.r th. tAA I"Qo... dltllnqu.nt wtll tefl.ct .n In-;:"r.s;t calcul.tion to flftun (is) deYI bt\tlwwl tlNt II.t. (If th. ......""t, If plly..nt It It.de .fter the 1'lt'lf'..t ClMtPut.tlon date shown on thlt Huttfle, ""1110"111 Int.,.... .IIt b. aaloul.t.d,