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HomeMy WebLinkAbout97-01018 " "-,-' 'f' , . .. . ~. ....... ~ ~ ! . I 0 z ' ' LLI ~ '.) .; /' , 1::1/11/1' '!It.:/(,~,.I,! t'h' <!t" /k,,:;r;/1,u/ (1/.\'0/..-1/(11\'11 a.\' . I)I':'I'ITION I''ON "NOIIA'!'E Ilnd (;I~ANT ()Ii LETTENS ~J.q?~/Olg No, 1'0; , /)('('('(/,\'('(/, So('illl Sl'<'IIrilY No. ,.2c' .\" .,< 'i': /.. ..~i"1 I<q!illl'lol WillI 1'01 llil' ('Ollllly 01 CIJllb-:,rlillJtl ill the ('OIIl1110IlWl'illlh of Pt.-'lIllsylvuniu Tlli..' Ill'lilioll 01" llu' IIIHll'l~il-!l1l'd t'l''iIll'l'lrllll~' rl'j1ll''il'lll'i HI,I!: YOUlIWliliolll'I'(\). who i\,nrl' I H Yl'ilt\ (II Hgl' Plllkh,-'I alll"t' l'\l'VIlI'.~ IlIlh,' 11I'llI'ill of 11"'lIhole <ll'l...<I"III, <llIled /,J/7dtC'" /....!c" ulld eodil'ii(q dlll,'<I IIl1l11ed _,,19.,<i'~ n_._____r.__.___._~ \'lall.' tl'k~iltl! l'lll'llfl1\I,llli'l"', l',,', Il'll\llh'iati,\II, ,kill II lllnl.'l'ull1l, l"l',) ..._-----'-....._'_.,._....~....... I)w"lId"il/ Ilill domil'ikd 1I1 delllh ill-<)"fi?:'d(',t('~""'1 du.. ('OI/IIIY, Pennsylvania, with h~..< I'l'l fumily' 1lI1'Iilll'q~.l"idl'I1l'" 1I1 . /~.'./7!(h":7'(2,. ~'(',.,.,.,.~__,_.....~..__.. ..- .t'--tt-".,.p )1///,,4, /1"/IE1,-:";' /';"'?f'::'~4~"'Z'..~' ' (II,,! ,li-l'\'I, Illltllhl'1 Hlld 1I11111dp:illI\'I IJl'l'9,Il~'IlI. Illl'~_ <),.' Y'l'lIr' "I "pl'. \lll'<I 2)l"'i'.ei?'1,twZ~ u/ ~_.____, IL22_u, all,\:c,r(~h:;t:'(:.(~'j:.ll;;;i'~,~~~I~~,~ ,Iil""l'l'd alld did ""1 hllll' a ~i;~;ill;\;:;;-~;'adori~(i nfll'l" L',\\.\:tlll011 olthe \\jll uffcn:d 1'01' prohate; W~I.'; !lul thl' \'klilll of II killing lIlld wa~ never adjudicated 1111.'()tllPl'll'lll; _____on' ..______ ...~_____ Ikn.'ndl'llt at i.lL-i1ll1 0\\'1Ied ProPl'II~' will1l'~lilllllll'd \'11111('\ it" follows: (If d~'l1kiled ill I'a.) Ail pl'I'Sllllal P"'pl'rtl (II' lIot dOlllkikd ill PH,) 1'('1'\011<11 pf'(lpcl'ly llll'enn\yl\'<lnla (II lIot dOIllIl'ih:d in I'a.} 1'1'1'\onn1Ili\lpl.rt,\' ill ('oullty VUllh,' nl' l'l'all''ilaIL' ill 1'L'I1I1'.yl\'ul1ia "lillllill'l.l \1\ 1'0110\\-<": $Jt0~'e.(.':~~~ $-.........,---.-.- $ ."._---'~._-_.- $____,.._...._.__. . ...__.__.._~_...~.- .' ~_._._----,-~---- \\IILI<I.I'()kl.., P"lIiiolll'r(1) le'pcl"lull\, Il'qllo'I(.\) Ihl' proball' of Ihl' lusl will and codlciJ(s) prl"l'lIll'd 1I('I','\\ilh alld till' ~r"nl or It'IIl'I' 'festCll11entary_.. ..,___ .'__"_'''_.'__'_ ~_c. ..~'_.____~_____._~. thl'IOII. (ll'~lilllll'lltal'; ,1dlllilli\lrHllllI1l',I:H,j administration d.h,Il.('.I.n.) , .0 " ~:: J .. ~M ~,;; :1':: ~/~~-- c2'; ,r-4/?~n(/~# ~f'}d" ~'7-Fy:' AI" 11/ /--::;, /?p II .......--.___-O~....__.___.__ "._.._--.-......._._----,-~._~----<---- '~_....~__n..~~~~ _...,---------...,,~-.~._----~_.._---.- .. --. ,- ~-------. -.-.---,-. ,....._~_~u.__________._ ,!, '7 .,.._____.__ 'h.__...._~.............__~______ ,._,~-~-=;:.;.;:::,~:r-"== OATH 01' ..EI~SONAL IU<:I)NESENTATlVE COl\1MO,II,iWMI.TII or I'ENNSYI.V ANIA I COl ~T\' OF Cumberlcmd r H" Thl' IWlilionl'r(q ahll\l' llarlll'd ',\\,\,.11'(\) or allirlJ\(~) lhal till' \(Hll'IllL'111', ill 1l1l' foregoing pCliliol1 nr(' Il'Ill' <Iud l'llfll'l..'[ [oIIH' he'd \.II I Ill' ~!I(l\\ll'd).!l' and hl'lil'f or IWliliolll'l'(o,,) and lhal a.... personal I'cpl'cscn- lilli\'l.'(<,) (if till' ahon: dl'\\'dl'1l1 pl'lilHHll'l'(o,,) will well~} [rill,\' adlllllli\ll.-'I' thL' t..'slalc ul.'cording to Inw, S\\O'il "I 01 '.111;';1')(\1 iflld ""h""'''.'.l'<I I M1.411!'/okf/....--.--. ~ hl'l\ll'l' !Ill' till'. ...../.) da\. ul . I' ~ (]1..P'iq~1n~h>,Y,. ., 11)n ;Y.';I' ~ Il'la~,<,,/ ',.(..UtiL{.:1;/:/~t.:d_IJ.7;u;.' ~l'i.;f.'tcj ~ ~ry c. Lewis N('I!/\/I'I' .' tJ B' IS" ,};( /-g . N 21-97-1018 O. _....---~_._.--....~..---..~--~----. Estllle of _'-' CICLC!.Y VIOLE:'!' l\QEI'MlI\'L....-.--....--"" Uecellsed J)F:CREE 01<' PRORATE ANI> (.IRANT (W U:Tn:RS AND NOW._l;J~!3r:g231 . 1997. ,Ill ~nllsiuerlllion or lhe pclltlon on the levelse slue herenl'. Sllllsl'lI~tury pwnl' hllVill~ b~cll pre,ellll'd ndure Ille. IT IS DECIWED Ihal the illstrumellt(s) ullleu- tMl<GH 8119~Q..., ..,.--~.-......-..__.. deseribe(\ thelelll be l,umitted to pwbate lIud riled ul' re~oru lIS the 111.,1 will or... ....-.-,..--------. CICELY VIOl,E'I' HOF\WIN --.--' -..,.. ......'.. .."-....-...'...' ...--".......-,..... --.." -' -.-" ......_,.....-.-...._-~.., lIlId Letters ....__- .. .._..1IDll.Ji,MeNIAR"i.......:--......-...... ...-' ..,........" -' ,.. ..,..-.--...-'- llle heleby glllnleU to _.....-GArm-I.~~,!:I~~~..,_....,.."".''''.'''.__'''' ....,.. -.----.-,..-...-..,-,----,--.........'---..--'..--'-..-............-- ---,..._-------'--- .----~--_._~._._---..__..-~-_. ~--- . 9l/~.~y.u~~!~1Llfltifl -.--.-- () K,giltor of Wills MARY C. LEWIS ?1 fEFS plobate, Lettels, Et~. . . . , , . . .. $...llO..Q.\L ShOlt Celtiflcates! J.) ".",.... L,.,3.0~ Renunciation ,...."....,..,' $ x~Pages (1) 3.00 JCP ,--'''- $-.CO-' TOTAL __ L_~..?..- Flied . p'~,E;~. ~~,I,~9?7..,.~. .~~1,..qq. ____..---r---. ,-- ATToKNt'\' (Stlp. n \.D. No.) -_..--~ ADDRESS , --~---_. PHONE i~) (" MAILEDLETl'ERS AND ORDER 'lQ EXF..curRIX ON J.2-24-1997. Thi\ bi to n'nih' that till' il\l~l!-lll.llillll lint' gi\'I'11 i\ \(llrl'lli~' lllpi,'d rl11111 ,\11 11liglll,d I vl'ldil;lIr 01 d,',lth dlth' I1lnl with Illl' ;I~ 1,{H,d l\l'gi\tl.H.'Thl' migitl~d ,ndlil,ltl' wdll1t' 1;i1'\\\lIlkd III ll\l ,\1.11(' \'Il,d I\l'([jlll, (1111,\, I1I1 P('III1.II\I'I.I filii!!', WARNING; Ills IIlagallo dupllcotllthls copy by photostat or pholograph, No. _'i;llii:(~\'W 'ij('PI4>~';~,' ;i$',' -4:~\ if'il' -.,' '-(.:.\\ I!"'!~'~\I ~'i3".. ! ~"!b.1 (.J" 'd, l,' \ .'. "-' ,_;' it ,~.. \, d-'- ,- ,,-{.,// ~, ,;S,.,;::' ,. "fft, ..*-'r,. "'.2"MINl ~\ ;""", ~-'~~~'!c:'(!I!I!'!I!!1 t2. ~- j ,:r-') r;", ., ~"'~;,~, ,"~'I(:';::':r::'I(,""~"~Ct.... I,',' 1(11- Ihl\ Ci'ndk,lll', "",',Ill) 4889848 me I (j I'HII' IJ,HI' CPMMONWEALTH OF PENNSVLVANIA, OEPARTMENT OF HEALTIl' VITAL REOOROS CERTIFICATE OF DEATH '1IM~ Fllf ~II,MlIIUl 'I"Mfi)f'OECf6iNTif;;;M;;;;;;~I.R"._.'-----'----".,-,---, ~~.- - .- ~ - -- - -- ['~~- - -- ~-~-.a-'A.l-'i1:( iiiiliYiiliMii~--I~if{,i:Ar'l ~~. .it."i-:;; "~-;-,. .!..CJcely.__ Vlolel .110[[11.111 ..........._ .........._..____ _......, '..! "l1nJp_I', ./!~l~-.:. 2..!......::.! 581 _illfCErt1Ct~ I'll A(ll:lld'\lU<lIdlf) r UNOfA I 'l'l'.AH lJNO~A1DAV -.' OAlf0f8.IfHII ] 811ll11'IAC,t,':,r,.,",j PIMEOffll"ll~.flh"'I. ,,' _'....-;;I"i." ~~..i~1Ol1 --- __R__ -"';;nlh,. r 6.y.- 11m,'. "1 "'W'~'" ".1,,"'10 11.., 'U'''I il...",. ''''''_'1'' L """." tl.)SPlfAI - - !OIHER- .- '(Jclobm' i'i' II '1"",'11 ,'~~f "(I ,,, I I"I\~I'N EI!iO"'IOlI Wnl t I rlOA II'm~ [I n.,.., ,." I , ,[ I L.L . L.'J!!.BUf.tlJar.'.!.l'l\ ".. "'" COlJ"!!Y ('If ~,ijlt - ---. . - --- ---CiTY_ -i>Q IV< . ".t'.Il' .iCii'ny NAMi:71~~.1 ,,~.,....t. ,c,tJ~.';-'I"'l!I;' '~"';;!;;;~. -. '.'. - ...'... ----- -I~i De. "'llfijf~iPi;;ICOiiiOim-I:~i..Ci~Am.;~. ;.'.fI<~~r\. ii;'i~w':;.~7-' < \ \ ~ C'p () 'J I . . I ""lO< ..I I"," ...""..." '.."'" Cumbur.l Clnd Kl_~L4 ~_~..:.l,~~OI'~..__!!!. nQ~~. _.;"). .!J\!l .\0-,:.0. ,! lsL. ___~m ~~~:'~.l~~_~~\nl\':_ _... 10 WI Ii I C- . Ot:\.eOENT'allS\!Al'occur~f1oV ~1_'-!QQf~~If!lfll~'l!I!H~I!1l!~_'!: l....M;DI(;iA[rI1[~[IIIN[. ()r.,c(.r)[~.r'SW('CAIII)'1 .r '''. ".I~l ;'l!"".l-'S'M~II'>f<l I - SUR'>'IVI/...:l'iMi.lSi..4.----- -, -'!fG;i::i;;-i;" .';;~:~;e;M--r;;i';,;;,.." \J ~ AII~[O F<lR<;f'il _. _ wH.,r,,! '. l:jJl~!t J'l!--''1'' fr'\ '~!.~:Il 'II.., ~I"..<J, W~IQ"", ," A"" f',. '''...",,' r;""WI QI-...Jl~'1>Q ~1II, dlJ 001 '.... ,&",..J I y~. I I flu Kl: E ..r"'''14,~~~7'onoj~_,~ L ,C;I'I:r, I ' (),.o'e,,",' 1$1'...:,1,1 " Ik)/lL~m:lkcr 1111 _l\)u):,'sl ic U II J /, u ~vldowecl I OECi~~;-~I~~~:~O{)~ri~s~:~';;;-l:.'(I'I".." ~I.." "i,"G:;i ." f~!~~~:,re ~ -l-,.~:,~"~--i;-~~~~;~-y l~~~;l-~----~~~~,~!..~---...---- ;;~.kl ~" :'~~:~':~-~,~~~'L. PennslJol:U._ L""""""'" '''''''. I' Cnmp Ili'll, ['^ 1701] ~~':'~__..!!!.~'~~1I111)C!IID.nd '''''''I~'~I I,,,[)::::~~~~,~,~~.~IM __-._._ _ _________._"11"1/11011> 'Al~I(~i~,ij;jEIf~:;;-~i:";.;l~:,jt----~ ..mTi"lfl\~Mf:-,I-;:;~h!:;,(;;;.~';-;jI- -----------.-- .!L..,~"o. .gl.~ri..]"~~[),,-,-,..:.-,.,Il4',,,' 't.UL__........_ ..----..------~._.~._..________~_,____'". t!......L!ll~,aJ.L_illldl<~~J.:.c._~.,____.___ INfOR.."" ",i:il7! - , INfORMANT S"'''llIN().I.(1IlIlfS~I~''''''1 l,I,I1o",,1I :)L.ld l'I'(,'~I"1 ....,(:".lll~.li."._ ..lJQ.f.fImn..----.-..'..'.I"--- . ----..-........'..- _....J;,., laUUJkl. UJl(L. ".Llnc.' ,.~.i:i.Illt:L.tU'.l.l~l'b...11 !JU,.._,__~. MUtl6O'i51'OiSffiSll!ON i).l.If. Of OI~lI'OSIII()1oj l'I.l.Cf Of OI5f'(l~ITI0f4' N.~" <JlC.r"'I"Y!;I.!".IO<y lOCATION. \.~ylT,,,,,, StJI. 1.pCooJl 8~Il'IU CrI"'.!"", I_I lI''''''''~Ir~,~sl~l.l.l f I ,""'~,I" 1'., )\'10 ~'()1f>otr 1'1." Ho 11 i ng (;r8E::/1 I, __OI~"I:"'~"f~.__,__.___~____~~_ WtJ~~:p~!!~LllLJ.~2Z__ tIc, ~k\l!!..!)'iill PElrk______~_ 2ld I{)YiQ.L_ltUQ.[L~_11L.h_ SK)~~u== ~~~~ OAPEA~;:.I,SSUC~___."R__. ..I~;:~~;~:~\I~;i~_~1~_t~._.._.._..~._. ;;c~lll~:/)~OI:~~~ ~,43'1:.J~3fttl8Hgbf.1 ~Wt~r~l )k/li~~~___. Com~1f ,t,,", n.,t <lnl,.. .1r1,rW"l 101,.. bill "I "I,' ,"""I"dy", .I~~IU ""..'11<1 J( '~"''''' ,j~11 Jr"l pi.... "....I llel N'.il NlIlHlEfl 01fE110NEO pIly,"..n""~"J'I4Ib1"llom IIlIIJI~lfJ '~'\l"''''''.JJ.II'''''1 i~I,",I~ II.., '..W, <lIhlyU""<I'",.,h " ]WEAE -'-UR1PSV fl,ir;itj(~-- l,lANTifiloTilu..rij-' A""'IIAIII~ Pflltll\!O ~~~~~t~~(JNOf( AII~E Hlh...J 11 .I,.:,"J.,..I II rl'{ I I",) 'Id I~,,,,',I<I I ;j.b ~_!...__ e.liij~il";6...,-,,.,,-;:;; 'C''''IFYIHQf'IIYIICIAt4,''I,,,,,,,,,,-,,,,'I,'''I''h;'''' '",',1'1- """,',1'" """"'"." """,I'L,',.r-..;_.,~;I,'t''''". TQ 1M blut 01 ~" ~f\Q"""gl. IInlh ,,,,<<111", d~ IIlI~1 CI"..I'I'"l! ",'"n.1 ~~ _1.1,11 ~Jb, , 11I,lECi'm'Ai!i--".. '" '-..-- -[iiij{;-;;iONii\mct1iO(AOli.rr":i~Rl\~~-~---- ~uqEflTFEnn~(Ji(rr.Jft5ICAl7~c IIOHER1 ___, _..__ 11.. .C\',"c~':)..C~". ",bEt;.~~I-iOC~,_\'i,jS1.1,.._..._ ,,_...., .....'.'..:.~___~__._.., ~1 ",In I, ~,::~:.:~,,~:~~~ ::;:'::~.~,I,,~''''~I''.'><I''l "n,d' c.ull<.llnl Ll1!~ln Ilo; '''1' ~",~r I~I "''''II "I ,l~'"" 1L.'h~" ".I,.~ m rtlll"JI"" .".,1 II'K~ '" 11W' IJ,ru't ! ~,\~'rl~I~"~~~~rHI~ PART If: ~:I~~'~:%~~~:I:'~;I=,':;,~'~~~'~~~L:~I~~~ . O!L""I.rklJ<tllh , , , .,- , , , , , , , I , , n~r~rn'-I;Viiii"v" m_-liWOfiIIJUflV INJU!\V..., WORK?. [OifSCRlflE 1100 INJU1lVOl..cufiiliio-- -, LI.II'III'II"'." I I v., II ',011 II Il~91 lQ!f '~"!~l ~!.'!L.__~ I'".M ..'I l>II d..II'[P,,,.,1 ::,I,;~~,~q O~~tl;'~i~'~~II\~1 /10"" I,ll", llrldl, 1~~I"'V, IIf1>1:~ 1,"'.'''.I<1''4I<;U,* C.I"I".." lldl'll ~,~, , H,(iI;Aiu~it\iihf~(UWiIif,l--?T{l----------- '''<,,',',1'','''-1_1' ('I ~.) /1 I \...-.... ,l'~. ~- \ ll!t ~ '.. _ J. _ I . . U(,f'hE IlliMIl[fI , " o~rE SIONED')"'''"' """ '11.1I1 I'RO"!OIlIojCltlCl A/jlH':UHI'VINn PtlV'ICIAN..' ", ,I'!. 'I " , /"" ",,,,,,), ,,!I, 1"li, ."_,,1.J,,,"" I \ l!~ J"_" ~)_ ;")1 iV'" ~ r Il, ,J1t_ _I_l ,I ~'t 1_\ 7._ '"Ih. ~.l 01 m, ~""""dlll, "ul~ """~".d II Ihl tlml, dll. ..." pl"'I, Ill" d,," 1<1 1111 CllI"l'll<Ul "'~I"\,l.~ II_I,,, /I.1,Mf AlIIJ A[10n~$S()f HilSON W!tO COMf'I nf,[1 C.USl Of Of AlII "I. ., .'/1 rf~'" <II 1'''''1 ~_I\. ,_ (i. \ /\ L.4.'<,J \-(_j ~I'\\ L ~L' ,-, I J' ~'~.'-.' .{ .' "I '-' \' _~~.. _.~~:'..:i..}_.__. d j ( {;. ,il~: l C'uf. -'(:l~4i Af~i:( F;LL)L ,{ ~l~~ vl,' /'I ( ,"j \' j, I [)lIt-jOII:lI-AS ~ ",,';1.(,,1['/(:[ I'll .Iv' ('j J 'I,' ! I" .. 0(....(' /'\1\,4 ( ~n:' ._~-- .. ,:AiS PIlI: 10,'4' ~!; ~I'<)I".I.(I,,[lIL:l (ill I!I'I"'",,", l't."J"'ljl"'''''''I_II''H' 'MllllCAl E _AMINfHICOflON~R On 11111 b..l, 01 U'''III''lIon 'nd/or +n~nIlQJtloH, In Ill~ <11>11'111(\, dUlh "~~IU"II ~I I"'1I1!;1I, <I~l., ~"d plf~~, .,ul <lilt h.llh. ,.uUI.j.nd IIIlnn.,.. $I.I~d , '" -,iiiiii5TIi'Ail ~; ~I(iij~1 (jiii-' '~i!1 ililj~ill ii E,tJ~/'Z-1~~;t~ f>l (~n I " iiAi"ff-lll:fi,i:i "", " A)~ /CJ /1<1)- , " ,,' , I , , , I I I I I I, " ! I , i I Ill!,' " , , , i i 'I 'ii, , " , I'll, , 1'1; :11 j, ~ , i " 21...97...10[8 I:', ':1!11 !,' I: "II ,: 1:1', "I' ',: 0 S D . ~ i I .~ :J ~ ~ > g ~J:l J >- " ~ ~ ~ ~ ~ .( ~ ~ .~ H I ~ ~ c:i !;; ~ 3 g d .~ -, · '" m ~ ~ :r ~ u H ~ ~ H U 7. REGISTER 01<' WILLS 01<' -- COUNTY OATH OF SUBSCRIBING WITNESS ------~-----_._.-,--~._--_.-----'_......_._.- .....----. ----'~ ___-I codicil (each) a subscribing witness to the will presented herewith, (each) being duly qualified according to law, depose(s) and say(s) that _.,- ______----.' "resent and saw --- the testat_-, sign the same and thai ___-------- signed as a witness at the request of testat_, in h____ presence and (in the presence of each other) (In the presence of the other subscribing witness(es)), -_.._-~.----_._---_._-_.~___--._I Sworn to or affirmed and subscribed before me this -- day of __ 19_ .--------- (Name) -------- (Addrcss) ----~-.- -- Register (Name) , ., (Address) REGISTER OF WILLS OF CUMBERLAND COUNTY OATH OF NON-SUBSCRIBING WITNESS .___--- / ' - G b . . " /' '.. (-1). .... ~j()H/LJ J . LA-I ej'l, ,1_EJ.-JL:--V L~:< (each) a subscriber ~er.~to, (ea h) being duly qualified aecordingJ9,law; depos (s)tn~~at .. .' I , It! F- l=t K.L . lamlhar With the signature 01 .LL~~ . IFf((\f~ ~. codicil ('will that . ) presented herewith and codicil \.>-..) (' . __ believe' the signature on lhe(wi!fjis in the handwriting of ('j:(;~~_ \J-,--_~d CJI~L:.lJ.\L______-' . to the best of acJ2-._j knowledge and belieI'. 1 -' Sworn to or affirmed and suh,cribed before (~<.S'~' I ;~{L..!!:..!.(,_ me lhl's 23 d I" 01' ~ /' IN/(/I"r~) '7) . ~-", ~"~;.~. '~t~~'dL (~ ('c1~..!&.,l'" 1'./0'13 MARY /, . L IS I' 7,1, ('" ,,'/ .\ v rJlter "- ../'" A.. A. ....,. ~..-' , ~-\ \c:.' " S' l~(/~ '::''I;j(t (iVY\..-\\\.:."' ~'0 - (Address) \ I '" \ J teslaUlllL of (lIIIIlKx~(ldllCxx~ witnesses to) the Qou/ HV.I500 EKt 1'.9"1 I 5 - l~ ;;;.. I - J (J fOR DAIIS Of DIAIH AnlR 12/31/91 CHICK HIU ~~:~~:9l\ INHERITANCE TAX RETURN ~o~:::'ru~:~D'rl'cLAIMID II ~JIl.... RESIDENT DECEDENT fill NUMIIII COMMONWtAlHlm"'''''''VA'',^ (TO BE fiLED IN DUPLICATE Stilt" !.l-97-11IIH ilf.P^~fMfNf m ~EV[NU[ .IlA!~I~fJ:UXJI~:"O.Olmn ..'oV'TH REGISTER OF WILLS) . . COUNTYCODfl9Y7YfAR OIOIIlNll~m ofcfim~I'S N~MfliAn,'ii'~""MnnAiliIJiriN'T'-^n-"-'-'--"'-"----_.~,..---.....- f)t7.Ii,i~lr~ cOMpilifAfioiiEr...--.-...-----------.________._... 1I0JlJlNAN CICELY V 101.1-:'1' /I] "" I<l.dgl' ehll t "1l11 8 ,.i:iIA..i.ii~:U',i,.i.':.V.MiTi..... -................ '''''.---." ... '/".. A.'., '.'''''O[.A''. ~-- 111^ i.' Of "'''''-.' i.:~!fII:.~().1 '.:71' I ~,.al.].X . 1 7 (.1l.1 .. _ j .... ";~:.;=~~l,,,,",,,..,, ""..l;"~.'.::,iJ 'I"'''' ,?";t:~", . "l;;::::I',~&!~':ll,'""..:" . "-_m l.liI I. Original R,'vrn 1'1 2, S'ppl.n"n,,,1 ROI"". [ J J. Ro","I"d.r Ro'"n {for dahl\ of d.olh prior 1012.13.821 [J., lImit.d E"o'. 1.1 40, F,r"o In'....' Comp,omi.o I] 5 f.d"ol Ella" la, R.'u,n R.q"l,ed ('or duhn 01 death of lor 12.12.82) [x"l 6, OflC"dMI Died 1el1oto LJ 7. DflClldtlnl Mointuined {I livlr\g TrUll (AIIClch copy of WillI (Attach copy of TrulIl -~--- ALL CORRESPONDENCE AND CONFIDENTIAL TAXINFORMATIONSHOULDBi'DIRECrWTO, U .i~;'"~:r:,~,:;;:~~'- - ~~~~I;::r:.~i:;',:F;~;:II---' ~. .. -~- 1. R.ol E.ro'. (Sch.dulo A) ( I I . 2, S'ock. ond Bond. ISch.d"l. BI I 2 i 3, Closely Held Stock/Porlnenhip InltHIHI j5chodule q I J ) ___ 4, Morlgogfu ond Nott" Receivoble 15chedulo DJ (4 ) 5. Cash, Bank DOPOlils & Miscellclnoout Porsonol Properly 15 I ISch.d,le EI 6. Jolnlly Owned Propflrly l$cl1odlllo f) 7. Transfer, (Schedule G) (Schedule l) O. Tolol Gran Atiltl! (fotulUnes 1.71 Q, Funeral hpentos, Administrative Co!ls, Miscellanoous Expo.... 15ch.dul. H) 10, D.b,., Morlgog. liobllitl.., lien. ISch.d,lo I) (10) _.._"_....~_..___.._...._,_..,"_ II. Tolol D.du"lono (rolollin., 9 & 101 (II) ----..J5..1l~_._____." 12, N., Volu. 01 EIIo'.lli" B minoo Un. III (17.1 -,2iti..9.L5...0L,... 13, Choritobl. and Goy"nm.nrnl B'q'.", ISchod"lo I) (13) _.__...._QQ...Q,~_.. .__... 14, N., Volue Subloc' 10 len (lIn. 12 mln".Un. 131 (141 ..,---.25.6,.'lli..Oil......__.___. ----~--- --~'-_._-~.,~.._-_.__.~'-_..__.__._._-_.----.__._-_.----------..._--~--~-------- 1.5. Spousal Tronden {for doles (If death ofter 6.30.941 See InstrucHon. for Applicable Percentage on Roverse Side. (Indud. values from Sthedule I( or Schedule M.J 16. Amount of line 1.4 taxable 01 6% rote (Indude values from Schedule K or Schedulo M.l 17, Amount of Une 1.4 1011 obI, at 15% role jlnclude voluo5 from Schedule K or Schedule M.I 18. Prlnclpallox. due (Add to)( from Une, 15, 16 and 17.) 19. Crodill Spousal Poverty Credit Prior Poyrnonlt w >- ..:!::(,I) ....[" ~o9 u~CQ -- 8. T 0101 Number of Sof. Depolll 80.... ..U70J852,?[) ....-----..-.---..-- I j\ z C> r:: :s '" t: ~ ~, w '" lL7]~..,02 (6) 17) . '1 "I .u___~.. _.~_~.." ~__,_,,__.___ ____.. (91 -.._.-.l5.&(i_9..J.!L.._~_ I B) _~_4.U.,j81l...u....... 1151 "~"-'''------'---..-..-".~._,W,___. ~-+---_..._--_._---"-._---- (161 ---.~?,'i(i,.9.lic04",__._..w ,06 .-..."J5J~I~..,..9L z C> '" ~ i IE C> .... S (17) ,..---_...)( .15 Q --,-_,_QO.,lJO DiICol1nt IIBI.-.1.5,414.9.I 21. If line 1811 greater than line 19, enlflr the difforence em Uno 21. Thll i, tho TAX DUE. (21) A. Enler tIle Intertut on lhe bolcmce due on line 21 A, 121A) B, Enl" 'h. '0'01 ollln. 21 and 21 A on line 21B, nl. II Ih. BALANCE DUE, 121BI.. iI. ,61j4, 16 "--_____. Ma.k!.C_~,,-~.~..v_a.bl..to.I_R!g.l'~ra-'W,"-,,_Al!"nl ..... . ... . ...,.. ... ....____,..___..._._. , ._~____,____ ~ ~ BE SURE TO-ANSWER ALL QUESTIONS oN-iiEvERsEsfDE-MiDroRECHEcK MATH .('.';,(_.__ ~fh~~,.~~!~~c.r ~n~0;i'~~I~I~9~:I~;~I~:~~~n~~~;;;:,~~~:'~~:~~~~7~~::,1:j~~;,~~~:I~~~~~,g '~;I~:d~:~I~;~,;~~'~r'~~~n~:;j ~~h~~;'I~;~I'h: ;~, ~~~~I:~j,'.~~~O~I~i~;i; baled on alllnformollon of which prflporer hOI on)' knowledge. ftoNMURf PI "so~r Rf sromijlCi6-';iiiNc""iflU~N-" ..-----'Af)D'Rik~---. _..._ . .~_ _.....___ -, !fONA "m\'~~~i:r.&N R ~/,fiuH ,iE_ 20. If line 19 II greater thon line lA, enter the difference on line 20. Thl' is the OVERPAYMENT, II O~'II"'~"'I']'.'III."J1'I!I'J-III'II...rnlTl':l'l'n_'I'lll.'I.'I:III~'I:I"'Jil + ----.....--..---.., t -JZO.,]5 Intorel' -._____h___.__ (19) ,_".._. 710.15 1201 ,,-- ._._,-~ .......--. ]4,6411,16 . J()(1J.Ni\I'~eLi> ~ reqt. . (:/lJJlI' III I L l'I\I}O.1J OAIf 11.?~(t... to !tJ~ OAIf --r- JIJ..:U~~L11f .. ~NTA'ivi' Cl.:'i",.1",....___ --....35 j'nl'mholl"e .1,[ltle,..CIlIJlPI/III, Pi\l)lI.1J ......-- ~[if!ii["s ~-~--'" ----'. ---. Act '48 of 1994 provIde. for the reduction of the tOK rot.. Impoltd on the nel value of tran.feu to or for Ihe u.. of the .pou," The rat.. a. pr..crlbed by Ihe .talute will bll e 3'10 (.03\ will be appllcoble for ..tot.. 01 decedenll dying on or alter 711'94 and before 1/1/96 e 2'10 (,02\ will be applicable for ..tot.. 01 decedenll dying on or after 1/"96 and bel ore 1/1/97 e 1'10 (,01\ will be applicable for ..tal" of d.c.dent. dying on or alter 1/"97 and b.lore ,"/98 . Spou.al tron.fen occurring on or altt! ",/98 will be uempt from Inheritance tOK. PLEASE ANSWER tHE FOLLOWING QUESTIONS BY PLACING A CHECK MARK (V') IN THE APPROPRIATE BLOCKS. 1, Old decedent make a transler and: a. retain the use ar Income 01 the property transferred, ""'"'''''''''''''''''' ,,""" " "" " " " ""'" ,,, b. retain the right 10 designate who shall use the property transferred or Its Income, '"''',''',,''' c. retain a reversionary Interest; or ,,,,,,,, """" " " " " ,,, " """'''''''''''''''''''''''''''''''''''''''''''''''' d, receive the promise for IIle 01 either payments, benefits or care~ """"""""",,,,,,,,,.,,"'"'''' 2. 11 death occurred on or bel ore December 12, 1982, did decedent within two years preceding dealh transler property without receiving adequate considerallon~ 11 death occurred alter December 12, 1982, did decedent Iransler property within one year 01 death without receiving adequate conslderatlon~ "",,,,,,,,,..,,,,,,,,,,,,,,,,,,,,,,,,"',.,'''''''''',.,,'''''''''' ,.""",,,..,,,,,,,,"""" 3. Old decedent own an 'In Irust lor' bank account al his or her death"-.""."...."""'..".."'''''..'' m. J~Q. IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART Of THE RETURN. K K '.'V,I$lI '.', 1""~1 ~t SCHEDULI1 tI (~~l;~ FUNERAL EXPENSES, ~OMMONW[AIIII Of rummvANIA ADMINISTRATIVE COSTS AND INI~I:::~~,~ln~~~,n~i::R" MISCELLANEOUS F.XPENSES PIOhl. P,lnt 0' Tv,," I1fAfiF7.,W.---...---.. .,,. -...~~===="'~~~~==-="c,=====~'.'='~='fll~ 'f.j()MiiiA-=""~- CIClil.Y VIOl.E'!' 1I01'l"NAN 21-97-1018 ITEM NUMBER ____~_T_" .~----------"""--"ri'~"~"_."-~_~_'_.""'_""___.___~_'~n.'uK..._u_....___...._.... .__~__ OESCRIPTlON -';::-"-". 'F~;;-. ,.;jE-;;~;~;;;~.."_.. ."-- ..,...----....... ....,...........-..-- .._- ........,....-..........--..... 1. l'nrthomore Funerul 1I0me, I.nc. 'frnd:ltiollul StJrvlcc..................,.............,.., ,.,. Steel Caskot....,.............................,........... B. I I I I I I 4, C, 1. 2, 3, 4, 5, 6. 7. 0, 9. 2. Clergy, flowers, orgnni" t, hili rdro9ger, dellCon nnd denth cortiflcllteFl............,..,........ .-. ,..,........... Rolling Green Come lcry. . . . . . . , . . . . . , . . . , . '.' . . . , , . . . . . . .. . . . I . . . . 1. Admlnlllrallvo COIl" P."onal RoplOlonlatlvo COllllllllllon. Social Socurlty Numbo, of Po"onal Rop,o.o"lallvol ,,__~_~-:...__ YOClr COlllmllll011l paid 00___..."' 2, Allornoy FoOl 3, Family E.ompllan Clallllanl _._______.__.__ Rolalla","I" Addro" 01 Clalmanl 01 doco,lo,,". doal" Slrool Add,oll -~-_.._.---------~............. ----------.__..~-_.._-----._--...........~~ CHy .._--,_..-_,__51"10 ZIp Code P'Dbale Foo. Cumberland County Register of Wills.. ..'~.~...ttt,~j.~..f~...;.~.. MlluUaneou. Expon.o" Short Certificates..................... II..... t "" ~ ~.... f"'" The Apothecary NCS - drugs "' , . I . . . . t . . -. . " ~.~ Ii i.' . t. . . , . . , , . . .. '.' . nlue Ridge Chateau....., ".0.. ....,...... .,..... Ii Ii t... .'~~ If. t f... Bell Atlnntic - phone..... t" .... ~... ~..,. i Ii"" f. ...." f,..... ~ Bell Atlantic Credit Carcl..... I..... . ... ~ ....... ... ~... ~..~.... The Patriot - News (Newspapcr)........"........t,..~..i......~... Cumberland Law JO\lrnal (Estate Advcrtising),~...".~ .......... APOTHECARY NCS..........."........................ ~ . . . . , . . . ~ . . The Patriot - News (Estate Advertising)........................ "------..-.- TOTAL IAI.o onlor on IIno 9, Rocapilolatlonl (If 010.0 'I'nco II no.dod, /rll.rl o"dlllonal ,/r.oll 0' ,,,,". "'0,1 AMOUNT 3,611,60 2,550,00 1,25,20 745,00 NONE 4,000.00 NONE 281,00 12,00 " 266,l2 762.00 19,76 434.35 9,70 60,00 223,51 74,4', S CONTINUED ~ ; ~ " ~ g "d\>J ~ ~ i ~ ~ i q ;0 f I (J) f} ~ ~ I ~ f"" i I, 0 ~ 0 ~ ~,. nI !l: ~ i~ i I !: ~ ~ 11> rt '1 l1> ~ PI e:I< ,. ..... IT 15 rcq f1l ! . ~. n !l .. ~ m 8 *' ~ '0 'iil 'j;: i - - - ~ r~fJlO~ 0 l.: Ql 0. iril~~~ ~ g a. 'tl' g ~h f~ ~ g a !to .. c ~ ~ to [ ~ S ~l)> ~ ~ ~ ~,Z ~ ' ~' 5 2, ~ S, il' ~ ;r z ~ .:i! ,M ~ ~ [ p .. 0 I ~ :t 1" a a r .. 1 j: (J) a .. CD .. CD t'lq: b eo ~ !: 3 ." , ? i 'tl .. Gl ft E~~ Q .. ,~ 0 f'1 g ;-l "0 c -< .. )> ~ :J: ~ :g g ..~~ ~ ~[l ~ " i .. 11> .. :J: .. " t 2 ~ i .. POlU01 .. .. 1m .. gg!:l88 8 "'0> ~ g ll: '" .....,.~- ---..-_...,_....-,""'..~..-..-,...- -, '~; ~ I,: f ,. ~:; / 21-97,-.1018 LAST Wl.LL ANI) 'msTAHgNT 0[1 ". ,~ CICI;I,Y VlOLI;'f 1I0Fl'HAN il: If )' 1, CICELY VIOLET 1I0I/[1HAN, 0 f the llorollgh 0 f New cumbedand. Cumberland CO\\\\t'l. PennsylvanIa, beinl\ of Bound ml,lId, '"ol\1ory alld u.id6rstandillg, do hereby make. I'Ub1iBh alld declare thIs as uud fOl' my l.IH,t HIll. and 'testament hereby revoking and making voId any and all other wIlts by me at any time heretofore made, I. ,", ,1 diroct that my Ex.ecutor horeill"rLor lIamed shall pay Illl 'Ill' JURt dohtH alld rlllloral OXpOIlHOS ae HOOIl IIH convallielll:ly may ho dOlle after my decoaso. , " 11, All the rest, residue IInd t'e\',llIilldcr of 1\\)' ostate, whether real, !,'!r- sonal 01 mixed, and wheresoever sItuate, I hereby give, devise and hequoal:h unto my husband, CLARENCE C. 1I0FH1I\N, if he survIves ",e by a per iod of thIrty -(30) days, If 1\\'1 said husband docs not survive me by a perIod of thirty (30) days, then th'is gIft l:o h'il\\ shall be divested, and I then, give, devise and bequeath my ontIre estllta, 'including real esl:ata alld personal property, unte my SOilS, Garth E, Hoffman of Camp hill, Pennsylvania, Jon P. lIoffman of Ellen- vllle, New York, and Charles ll. Hoffman of pi.ttsburgh, Pennsylvania, 1n equal shar(~a . ., " " Ill. I hereby nom111ate, constItute and app01nt my son, GARTH E. HOFF~IAN, as Excc~.tor of this, my LilHl: WIll and Testnl1lCnt, IN \HTNESS \,llEru,;OF, I, Cieely Violet lIoffman. l:he TestatrIx, have unto this, my Lllst Hill and Testament, set my hand and seal this ,f{!!l- day of ;In! (I, , A. D., 1966. , \~~ C~,~~(~1-(X \ \ ~\\\:~~(Sl , lt1 r.~~ (I<l"~ ~0.'i t ~fl ',1 '\':;' "1", Page ol\e of t\/o Pag09 " )'1 'iii.'h".J " 'l~]"t '... .,. I \"\'IJ~ '"'' ~ . Iii' b"'i~"I'l~.it\I" II'! "'1 f' ',' " k, ~.;I\:r: 'l'~ t' , l " .., ",' , t\\~t1. ,.:,.rl!I.4t", 4' itft\'. ~. ,t. J f,t"1~1"'1l."",(",'1'0'1;'''Y,,,/ ,;.. ' 111,f;f~~\~~'I~~:"l~""f'I'" : " I!'rl~'l ~ .it-f:'\"l (I ,hi" j '.. Ii '1"~"I~ tl~':"!"\~'.."~(""" .. ''', '\1" J'~\~iql ,I', ~I.'\" " 4t:~~"~~1~ ~\tJ'\',d I Iii' ,!f~"~lt~.J~': j" .~.'lti';1i\~' . , . .-",-<,-,., ,.", 'j SIGNED, SF..ALED, rUIILlSllED and DECLARED by Cieel>, Violet lloffman, the ,above.nllm~d 'l'eatatrix, aa and fur her Laa t WI,l1 and 'l'estament ill the presence of ua, who have hOl'cunto subscribod our names as witne'dsea at her request, in the pres~nce of the said Testatrix and of caeh othcr. "i,' %f~~ c?!~#I .-..irW-f)- A,k (./, <, ,-,-, ( , , ! i~ 1 ,,~ I '\~ \ Ii,: ,\ ',:r;: ';. .. ~.:~!: :' I i , I i I I 1 I I , I rage two of two Pages i'-" ~:, \-;tW';:,~' 'i\':",,~ i ':~;,.~ / ,,/...:.<. ,,>>'-:':'~+\'(I:i;~~I' I' ,1l~""J;,\\~\.t' I, ,~,. "~', 1",'""'1",;",.,, ";"",:,,,3',1'.~"~"" 'l!~M\#',1ii.!, I\'H. ~'!:"',U';I;I,.~iJ"'~,:.,'n:~,~~.:\,~I,,;t'..'i".\, .!!f. lf~It.~f~t . .n t:i....,,"ll1.. .'.*"",I.',!,b,!'.i...".',,..J;nIo':loU It; ~JJ.l.1.Io\~ . '..'W".lI'YrtW~~ ~~1i:J..,." ' . ".".11.,..'..... ".." .,.- ..,.",...... , r ;-', ~.'<\>~" .~. ~ ..,'" ~.' .',,; . \, ,"' """ ~~~'l Ii' ,L l 1-1... ~,\ .' '.!( .. /r I , ' 'J 'In ..~ ',J' \ '1' r ;, 'h """y' 1-" '" COMMONW.ALTH OF '.NNSYLVANIA COUNTY OF CUM'.RLAND III (11\1\'1'11 E. 1I0l'fMAN bel nil duly Bworn . ~ccordlng 10 low, dopo.o. ond uy. Ihol he iA tho Executor of Iho E.lel. of . GicelY.Uo,LQt. iI.ol'.f:mnn. . lole of Camp Hi II , CumborlMd Counly, Po" d.ce..od end thel the wllhln II on Invenlory mode by U/lrth E, Haffm!\!1 __, Iho !Old Exec.tltor of the ontlro ..1010 of ..Id dec.donl, con.l.tlng of oil Iho porsonol prop.rly ond rool ..Ioto, excopt rool o"elo ouhlde tho Commonwoollh of Penn.ylvenla, and Ihol tho flguro. oppo.llo ooch Itom of Iho Inventory ropro.onl II'. folr volue u of tho dolo of doced.nl'. dooth, 5iJi (!:!:J...__,._.__ end .ub.cribod be for. mo, ~/ ~7' ,~r;t7j~.<, . ~~-, Eucu or . A~~trlto, Gurth E. HoffmAn )J Farm Ilollse Lane ___.!I 21..f~,S--__..__..- 19 fJE'._- , _~'",..._II i' Ct,/_f'l:-__ I Dote of Dealh . , NOTARIAL SEAL WII.LiAM ^ YOCUM, Notary Public "liP Hili I'ln,o, CUrHDerlnnd Coulltv Il!il"i',jn!1 I )',plun ,IUflO n, n)(')o ilj"--'-'-' --,-----'" o'v C!\mp HiP,I'^ 170l.!___ Add,... .. \.2, . Month 1997 ..-.., -. -.,,~.-.....--.-.-------.-.--.,..- ..._,..,.-------,---~~-----..~ Vu, INSTRUCTIONS I. An Invenlory mu.I bo flied within Ihr.e monlh. .ftor .ppolnlmont of porsonol ropr..ontotlve, 2. A .upplomont Invenlory mu.I bo filed within Ihirly doy. of di.covory of eddltlonol 0"011, 3, Addlllono,.hoets moy be ettoched o. 10 personolty or roo'Iy 4, Soe Arllcle IV, Flduclerles Acl of 1949, @ ~ -c:I UJ . ~ ~ ~ ~. m 0 ~ 0.. tIl ~ . ~ UJ 0 0 tlI ~ '" w f-< .... :. II ;!: 0.. o.L W .... .; E ...j ...l 'H 0 o.L ...j ~ 0 0 p:j 0.. ~ W 0 ~ H i: ~ '" :>- ~ 0 Cl >- 0 , VI Z r;J u 0 0 '" U Z w <( I; ... 0.. H ." U 0 m ... -;: 0 Jj 1: ... ~ E 0 m , if .g ...j U '3, PrudentIal Life Insurance procepds of $1,281,37, the Holy ~pirit Hospital refund of an overpayment of $23,90 and the AARP Account refund of $126,75 have been placed in the Estate Account to be utilized for payment of estate billa, 4. It is acknowledged that Decedent owned securities, reflected on a letter attached hereto from ,John V. Thomas dated January 15, 1998, which were valued at date of death at $270,852,20 which will be distributed or expended as follows: (a) The Executor, GARTH E, HOFFMAN, redeemed 100 shares of Bell South, 34 shares of NCR and 296 shares of US West Media Croup on January 8, 1998 and placed the net proceeds derived therefrom of $14,825.63 in the Estate Account, Subsequently, he sold 1972 shares of Pru Mtg Inc Funds, 2123 shares of Govt Ine Fund and 2366 shares of Pru High Yield Fund and on March 6, L998 deposited the net proceeds derived therefrom of $69,333,95 into the Estate Account for the payment of bills, On March 9, 1998 he deposited three dividend checks totalling $113,94 in that account. (b) Ownership of the follOWing shares of stock wU1 be re-registered to designated beneficiaries in the following manner and the broker shall be instructed to transfer the accounts a this earUest convenience: GARTH ,JON CHARLES Shares E. p, D, Security now held HOFFMAN !!~ HOFFMAN -- AT&T 226 76 75 75 Ameritech 888 296 296 296 Bell. Atlantic 523 171, 174 175 Bell. South 316 105 106 105 Lucent: Tech 176 58 59 59 SBC 660 220 220 220 USW Comm 296 99 98 99 3,085 T;(i28 - 1,029 total 1,028 Page Two of Four Pages If the above transfers have been effectuated on or be[nr" thl! date of this Agreement. the parties hereto ratify those transferll. (c) The Executor shall be authorized to retllin the 11\1111 of $1,000,00 in escrow to satisfy unpaid bills, if any, inc1udillf\, hut not 1II1IItud to, the payment of Fidicuiary Taxes, other taxes, if "1'1'11,,"hll1, IOKII\ f'!(I1l und accountant's fees, Beneficiaries hereunder, shall I'" """I'nllfdhlo rot' UI\Y tllxon relating to and incurred after the in-kind dIntrlhutl(lu or flhHt'Ufl rn Ihllll1 frllm the estate. (d) Unspent escrow and contingency fUlldH /llId uuy IIdd1llnllul. ,'atllto income, which have not been utilized or resel'v,,,1 fnr l'uYl1llll\1 (If 1>111a, flhllll be distributed in three equal shares to the IWl\cf'Il'lllrIIlR Iwrllllndor III II dlllo on or before six months after the date of thI. ^groumunt, (e) It is acknowledged that the Executor oxpondcd, 01' will (lXPlllHI the sum of $15,669.18 for funeral expenses, udl1linlstl'lltlvlO ,'nabl ulld I1Ilacolll1ncolls expenses on behalf of the Estate as set forth nn Sclwdlll11 II ,,1' IhlllnhorJtHnCe Tax Return filooMarch6. 1998 and pHid an Inlwrltllnc(' TIIX or $lli,(,I,li.lfl for tho Estate on that date and those payments lire herehy Hpprovod, 5, Each party waives his right to t'"q\l:It'(! thl' E'xI"'\ltOI', t:^R'I'1I 1(, HOFFMAN, to file a First and Final Mc()unt IInd propofll'd Stll!lllll"l1t or IJIHtributl,on in the Court of Common Pleas of Cumherland CO\lnty. 6. The parties heretn, therefore, huv" rumlfled, rullluflPd, qultclllilllOd that forever discharged. and hy th"Al' pn'fll'l\tfl, ror !\wlIII1f1\oI VHHi t1Hd r IndrH, executors and administrator". do n'mIH" nollJ/""', <jllllelllllll IIl\d r''''llVl11' IllHchLlrgo each other. of and from all, and 1\11 IIl1lll1H!r M IH'! 1111\ I\lId 1\1'1 ("nn, ('I\Ufll' IInd PI\I\" 'I'hnHI 01 1'0111' l'II>I(lH ClQMttWULTH Of Pt:NNIVlVANIA OtPARlMf:Nl or Mf.VENUE BUREAU Of INDIVIDUAL l..(1 DEPl, Z'''601 HA.MlnURO, PA 1712l~0601 *' INFORMATION NOTICE AND TAXPAYER RESPONSE l~ FILE NO. 21 91-1018 ACN 98115849 OAT! 04-14"98 TYPE OF ACCOUNT o S~VINGS [Xl CHECKING o TINIT ~J cum , GARTH E HOFFMAN 35 FARM HOUSE LN CAMP HILL PA 17011 REHIT P~V"EHT AHD FORKS TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE. PA 17015 O~UPHIH DEPOSIT a~HI( I TRUST h.. pro.lded ."" ....,..on. ,I\h tho Inlor..tlon 1I..od ..,.. whl.h hot ..on u.od In ..,.ul.tlnt .ho po.ontl., t.. duo, Tholr r...rd. Ind'.'" ,h.. ft' ."" ....h 01 .ho ..... __to .ou .... . Joint .-.orl...../I.I." .1 .nh ...aun" 1/ you 1..1 .hl. Inlor..lIon I. lnoorr"" pl.... ob..I. .rlt.on .orr..tlon 1'00 ,ho IIn...I.1 In.tltutlon, .ll..h . ...y .. tnh lor. ond r.turn 1\ .. ,h. ..... ....r..., Ihl. ...aun' h ...obl. In ....r..... .lIh tho 1..,.1'1..... To. l.... 0' tho <_Ith of Penr,Yl'f~l. (\"",tl"". ",,,y Mi ,."",I.ullll1 toll' MIl tnv 1711\ 111."521. COMPLITE PART 1 BILOW . . . SII RIVIRSE SIDI FOR FILING AND PAYMINT IN8TRUCTIONS ~o..unl Ho. 45328741 Dote 07-05-67 Eatobll.hod .....\lUII"'O,'" EST, OF CICELV V HOFFMAN 5,5, NO, 208-24-1581 DATE OF DEATH 12-14-91 COUNTY CUMBERLAND To In.ur. prop.r Ill'.dlt to your MlC~t. two (2') copl.. of thl. noHal lIU.t nccoepMlY your ply.-nt to t~ RI9I.tlr of Wtll.. "ek. c~k ply.t)l. tOI "A-ehtlr of will., Agtmt" , 5.175,28 50,000 2.587.64 ,06 155.26 TAXPAYER RESPONSE .FAlLURI ,.0. ".....i::WXLL 11M T: III AM: C1fflSCIAL .,.AX A.....IIIKT PII. CMI ,",I' NDTICI Account a.lenee P.rcent r.)(eble ~-.nl Subj..1 10 T.)( R.t. Potonllo1 To. Duo Ta. NCHEI If tilt ply.."t. .rl .1IdI lflthln thr" (:5,) I!Onth' of thl cMcMtent'. net. of death. you MY dedUCt . !t:< ahcount of thl tll( ctul. Any Inhlr!t1lnC1 tllC due will blICl~ deUnquent nine (9) .onth' eftlr thl det. of delth, K K PART ill A. ThI 8bo\ll Infor..Uon .nd taM dUe 11 ClorrtlOt. 1. '{OU ..'1' choa'. to r..1t ply.."t to thl R-vl.t.r of wlilt with two cop 1.. of thll noUo. to obtlln I dhcount or IlIotd tnt.r..t, or ~ou ..y aMck bolt "A" WId r.turn ttll. notlel to the A..ht.r of WIU. end WI offlclll ........"t w111 bl luuecl by thll P. OeJotrt...,t of R.v""" ., 0 'ho obo.. ....t h.. __ .r .111 .. roportod """ t.. p.'. .lth .ho p."n..,...I. Inh..It.... T.. ro.urn to be filed by the deeldent" repr..entattvI. C. 0 ThI M)OVI Infor.Uun I~ncorrect end/or dlbtl IW"Id deduCtion. ....n PIld by YClU, 'Iou MI.t ClMlPtltl PANT ~ end.Ior PART 0 below. [CHECK J ONE BLOCK ONL Y - If you lndlc.te . dlfflrent t.x r.t., pl.... .t.t. your roloUonohlp 10 d..o_l: .; ,. . OFFICIAL USE aNt. y 0 flAF' 'A DEPARTMENT. Of 1l~',f~NUE :; JOINT/TRUST ACCOUNTS '::\.::':\,,:/::',:::_:;': PAD '. """'.,.~..,.,.' '::::;:::i' ;:~:_, ...,,:f' ,...;:~ .. ',:, ..;: ". ~ -- i~ PART ~ TAX RETURN - COMPUTATION OF TAX ON LJ.rh: ~. u.i. tltllDiilnaci 1_ 2. Aeoount ..lance 2 5. P.rcent r.Kabl. S ~ 4, AMunI Subjocl 10 To. i" s. Cobh ond DacJuoUon. S 6. AMunI T..oblo 6 7, To. Rolo 7 K a. To. Duo a DilTS AND DEDUCTIONS CLAIMED P~RT [!] DATE PAID PAYEE DESCRIPTION TOTAL (Entar on Lin. 5 of T.~ CG~t.tlon) ;::';'::\~:':;1:::,;~/,::):" :.,'", ::':":";':::::;:;i~ .::';:: --',,""":' , ,i::;::.:.: ,i:::::!:i :[:!i!: 1: i~i !:i :'i: :~:,:!: -:': ':':':'::;:.,::;':::'::::::;:: ',-;-'it '" ,::,<::::::'::;:::<:)~" ',', :-";':": ~ .-,""",'-'-',""",,'-" ~ ,:' ,..,..~ ,....,' ,-",-,,',' '''i ~tl ~I ~ AMOUNT PAID ..": o "" ,:,. . - Under peneltl.. of perjury, I declare that tha f.ct. COMPlete to the b..t of .y knowledge end belief. TA~A'?1i~;rt'M:I1{ Ah/~/>.' .' c'j/' C" I hlva r.ported .boye are truel correct and ~OME (":/, ')) -) ~.I t.,,,,-':) WORK ( ) TELEPHONE NUMBER GENERAL INFORMATION I, 'o\ILU~e TO AU~OIIII NUL ~ElULT IN AN OffiCIAL TAN AIIUIHENT _Ith _11...1. In'''''' ...eeI... In,.,..lion .ubtlltt.. b\l tht flMMI_1 In.tltut1on, t. Inhlrlt~. till beclMtl' deltnquM\t nlM "H'!th. aft., thl _..-.nt', data of ....th, I. A Joint ItClcount It taMllIbl, IYiN1 thoulh thlll ~.d"lt" n.. ..I' ,"fUN .1 . .IUlr of ciHlv-enlen4ll, 4. Accounh (InGll1dl"t tho,. held hat"",, hu.b.-nd and "If., Mhlr.h h,. dlHJldent flut III Jnl,,' n.... ..lthl" OM Yllr prior to ...th '1'" 'ul h tllC_le .. trAnI'lIr., S. Ac!count. ut.e.ll.hlld jolntlv batWHn huthltnd IIhd wlf. IMlf' th., OfM W.., Ilriot tl) dfi,th Itr. /11'1~ "ubi., .. AClGounh Mid by. deClI..,t "In trult for" IlInQth.r or nther. an t.Iil..lla full", REPORTING INSTRUCTIONS - PART TAXPAVER RESPONSE 1. 'LOCt( A v If the Infor..Unn and ClotlPut..tlon In ,.,. M)tlcll IIrl carr-ad and d-.tfutltloo. '1'" IlOt iMine 011.IHd, pa.. In "'C" In blo~k "Aft of Part 1 of the "hMPIYII' R..pOft.... lactlon, Sign two r.oplu IHld 1\1bII1t thM with your ehec:k fu,. ttM -.nt of taM to tM Register of Will. of the oounty Indicated, '~PA Pepen.eflt Ilf ".\I~ will I..u. ., \lUlel" .....lMnt (for. REV.1SltI EX) upon receipt of tM r.turn frOll the R"htlr of Wllh, l. ILDCK I - If the ....t ,pefllfl.d on thit notlcl hi' tMlWl or will b. r4ttlorted and tlllC ,IIIld with the Ve",,.vlv.,l. Inherit"'"" IBM Afllturn fUN by trn. d.e.d,nt', repr..'nt.tl",., pllc, an "X" In block "II" of fllIrt I of thl "hlO.pflVIr N..pon.... .~tlon, Sign Of~ cOPy end r.turn to thl PA Dlp"rt.,nt of A.",.nUll. lure., of Indlvldullll '''"II, n~t ZeotJOI. fl.rrhbl.lrll. 11. I11ZI'0601 In the Mv.lop. pro...ldId, :S, BLOU C - If tM notice Infor..Uen II {noon.elt andlor deduction.. fI,. kNlln, elhlMd. check block "C" IInd c<<*pl.t. Part. Z ~ S ICIClordl", tl) t"" In.tructlons b.low, Sign two copt.. WId eublllt t~ with vour chic"'. fo,' t.. .-ount of t.1C payabl. to thl Jt..ht.r of WJ1h Q~ thit .:........,ti li...i.lullt.J. Tl... p,:. ~....., .t-W.. lJ1 ll..v........ will I...... !WI oHlclal ......lIIMt lfor. Jlt'J'h"tll tAl ~ "Melpt of the r.turn frCNI the R.,hter of WIlh. TAX RETURN - PART 2 - TAX COMPUTATION llHE 1. Enter tM d.t. the ItClcouot orlglnllh "'I' ..tablhhld or tJUttd In the "''lMr .ltllting .t dltl of dI.th, HOTEl for I .ced.nt dyln, 11ft.,. lZ/lZ/8Z: A~count. -.hlch thl dtc~t put In jollnt 11"" ",Ithln Cll~ (I) 't.." of d..th .,.. ta~able fully". tran.f.,." tlo",.",er, thare I. an I)(clu.'on not to I)(c.ed B,OOD p.r t"M,f.r.. r*rdl... of thll ",.IUII of thlt IICcOWlt or tlw ~.,. of .ccounh held. If . double a.t.,.ltk (lut) "PP..r. b.fo,.. yoy,. fI,.,t n_ In the .Cldr... PO,.tlM o~ thh I"Otlc.. thl 15.000 l)(cluIlon alr.ady hat been cMduCltld f,.OIl tn. account balMC' III ,.eported by thl flnancl.1 In.tltutlon. 2. Ent.r the total balanc. of thl account Jnc:iudlng Int.r...t IIClcrUld to the dlta of d.,ath. 1. Th. pareant of thl eccnunt that It tllCMll. for .lIClh su,.",lvor It dltt.,..lnid atI follow'l A. TN pa,.eant taxabl. fnr Jolnt ....t. ..tablllttad lOr. th'llW'l one y.er prlO,. to thl dlc:ldant'. eM.thl 1 DIVIDED IV TOUl NLMIEA OF JOIN1 OWNERS E~..,I.1 A Jolnt ....t r-ol.tared DIVIDED IV TOTAL HUH~A Of X 100 . PERCENT TAKAlLE SURVIVlNO JOINT OWNERS In the n__ of thl dIfl..,t and two ot"r plrton,. I OIVIDED BY l (JOINT CWHERS) DIVIDED IV 1. (SUAYlVOM) . .161 X 100 . 16,1:( <TAXAllE fOR EACH SlRVIVOA) I. ThI pa,.elM\t taMabl. fa,. ....tt er..tad within ana VI.,. of thl ~lMfant'. cMftth or ec:COo.rItt owned by thQ dMldant but held In tru.t fo,. another IndlvlduaUI) (tru.t hlntflcl.rtu): 1 DIV.tDED IV TOTAL HlIHIEA Of SURVIVING JOINT OWNERS OR TRUST IOIEFlCIAAIES X 100 . PERCEMT TAXABLE Ex..,l.1 joint ICOCltA1t ,.oght.,.ed In the nMII of the dltcadant .-.I two othl,. parton, and ..tabllthad lllthln OM y..,. of "ath tJy thl dtc:.adant. 1 DIVIDED ItV Z (SLIIVIVORS) . .50 K 100 . 50:( <TAKABLE FOR EACH SUAYIYORl 4, The MOUI1t .ubJNt to tlM Olna 4) It detar.lnN by IlUltlllhlno thl account bIIlane. (llna l) by the perc:tnt taxlhl. (lIna J). 5. Ental' the tot.1 of t.. debtl ~ deduction. Iltted In Part l. 6. ThI MOUnt taxllbl. (llne 6) It det.ralned by .ubt,.tCltlng thl dabtl end dadUClt10nt (lIna 5) f,.OIl thrl IICM.f'It fUbJlClt to t.M (1lna 4), 7. Ent.r the ...,.op,.lata taM rlt. (11M 11 .... dlt.,..IMd M1MO. A. For dat., of dMlttl OClcurrJng Ift.r 6130/M, the taM ,.It.. fat' tr."f.,.. to 1fIOU'" e,.. .. follow'l 1. Dlt.. of death on 0,. aft.r 7/1/94 and bafor. 1/1/.5 the rat. It 3~. 2. Dat.. of dNth on 0,. Ift.r 1/1/95 tr....f.,.. to I9OUII. will be tilled .t o:c till rat.. Not.l For ~ta' of dMth prior to Ul/lMo tr....f.r. to Ipoull&i ar. taxabll It 6~, .. Tr..'f.'" to lInNl ..e....," Includlne fethlr, tIOthlr. .on, dlught.r. ,,.anck:ttl1dran, ton-In-I.., dlutht.r-In-l.... .tlftChl1d and thll,. hi~ '1" t8~IbI. at t1M pe,.cent 16:<1. C. TrM\.f.r. to IU othert lnoludlr'lll b,.athlr. tl,t.r. ~I., .unt, ~ and nlac. a,.. ta~lbl. .t flftMn pa,.cant O!M). D. If YOU chIntt 1hl taJC ,.It., pl.... .ptlClh your r.laUonanlp to the dtetdent In the er.ft pro",lded. I. The 8Ml.I\t of taJC due; 01,... IJ II datlr.lned by ...ltlpJylnu the -.a'lt taxlbl. Ulne 6) by thl tlJC rat. (11". 7), CLAIMED DEDUCTIONS - PART 3 DEiTS AND DEDUCTI ONS Cl.AIMED AlllMfMl. dlbtt and dtduotlon. .r. dtt.,.alnad .. follrMfll A. You I...lly a,.. r..pon.lbl. for PlYMI1t, 0,. thl ..tatl IUbJact to ftdalnlttrttlon by I pa,..anal rlflr..entltlwl 11 InlUffl(11M\t to pay tlw dltduCltlbl. It.... .. You acttalh paid the liMbh aft.r death of the Mcedtnt Wid can fu,.nl'h proof of P'YHnt. C. Dabtl belfl1 clallltcl Wtt be !t..bad fully In Part, S, If Ilddltlonal ,pac. II nMCNd. UI. JllIln p.,.r. lIZ" II 11". P,.oof of paPlnt ..y be raqua.tad by the PA Dep.rt.."t of R.v...... i...Y....<<<< '. .../ "'.'..,, T AXPAVER. ..ASSI STANtE' . ,. ,. .,..". '.,.,.... ",. .. IP/YOU, NEEDF'URTHER INFORMATION OR ASSISTANCE. CONTACT ANV </ ...,. ... REGUTER OF WILLS. PA DEPARTMENT OF REVENUE DUTRItT OFFICE / OR CAll THE BUREAU OF INDIVIDUAL TAXES. TAXPAYER UIQUIRV UNIT IN IlAItRISJURGAT(717l 787-8~27 ,/TPD'",.(7.17) 772-2252 tHEARING IMPAIRED ONlV) . ,...,_.,.... ,.. . .... ,""',-,:,:,:,;,:,,,:,:"_',',:,:,i COMMONWEALTH OF PENNSVLVANIA DEPARTMENT OF REVENUE IS. )-J-/ ....3 lURE AU OF INDIVIDUAL TAKES INHERITANCE TAK OIVISION DEPT. ze,0601 HARRISBURG, PA 11128-0601 NOTICE DF INHERITANCE rAK APPRAISE"ENT. ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESS"ENT OF TAK 05-25"98 HOFFMAN 12-14-97 21 97.1018 CUMBERLAND 101 f..._.~==~~~~~.:~",~~=~d~:~_~:=j MAKE CHECK PAYABLE AND REMli PAYMENT TO: REGISTER OF WIllS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE .. RETAIN LOWER PORTION FOR YOUR RECORDS ~ R 'Eli: is7iji' E if -Ai: p - (eiF 97"1" Neir i c r 'oF - YNHi:iii i' ANc E' 'fAx" iippiliii S EilEN'r-; - AL. l"owAiic E - OR - -........ - -... - - - ........ DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX CICHY V FILE NO, 21 97-1018 ACN 101 DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN WILLIAM A VOCUM 3001 MARKET ST CAMP HIll, PA 17011 ESTATE OF HOFFMAN TAM RETURN WAS, ( ) ACCEPTED AS FILED RESERVATION CONCERNING FUTURE INTEREST . SEE REVERSE APPRAISED VALUE OF RETURN BASED ONI ORIGINAL RETURN 1. R..I e..t.t. (Schedule A,) 2. Stock. and Bond a (Schedule 8>> 3. Clos.ly Held stock/Partner.hip Interelt (Sr.hadula C) 4. Hartg.g.s/Not.. R.~.iy~bl. (Schedule 0) S, Cash/Bank Deposits/Hilc. Parsonal Prop.rty (Sohadula E) 6. Jointly Owned Property (Schedule F) 7. Tranlf.r. (Schedule OJ 8. Total A...t. ( X I CNANGED SEE III 121 (31 141 (51 (61 (7) ,00 270,852,20 ,00 ,00 450,65 ,00 ,00 (BI APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Fun.ral Expansas/Ad". Costs/Misc. Expense. ($ch.dula H) 10. Dabt./Ho~tlaga Liabilities/Lian. (Schedul. 1) 11. Tot.1 D.ductlons 12, N.t Value of Tax R.turn 13. Charitable/GovernMental Beque.ts) NonR.I.cted 9115 Trults (Schedule J) 14. Net Value of eat.t. Subject to Tex If .n ......m.nt w.. i.su.d pr.viou.ly. lin.. 14. 15 .nd/or 16. 17 .nd 18 will ~.fl.ct figur.. th.t includ. the tot.l of ~ r.turn. .......d to dat., ASSESSMENT OF TAXI IS. Alftount of Li.,. 14 .t Spou.al r.t. 16, AMount of Lin. 14 taxable .t Lin..l/Clal. A ...t. 17. AMount of Lin. 14 taxable at Collat.ral/CI.I' 8 ~at. la. Principal Tax Dua TAX CREDITS I PAY"ENT DATE 03-06-98 03-06-98 NOTE: RECEIPT NU"DER AA269817 AA269818 DISCOUNT ('1 INTEREST/P~N PAID (-I 4 02:"32 364,58 15.669,18 ,00 (111 1121 113) 114) 191 110) IlS)__~~ K'OO. 1I61 255.633,67 K ,06._ 1171 ,00 K' 15. liB) --__----....00..... .... '_1 A"OUNT PAID ----.-'..'7-:644 , 16--- 7,000,00 4 (- * _'HW II If' 1I',HI CICEl V v DATE ATTACtlED 05"25-98 NOT! CE NOTEI To 1nlur. p~op.r cr.dit to your account, .ub~1t the upper portio~ of thh fo~" with )lOU~ tax pay",.nt. 271 ,302,85 1 ~ ..6.~9 18 255.633.67 ,00 255.633,67 ,00 15,338,02 ,00 15,338,02 .. TOTA~-iAX---CREDIT:t'_- '-_=~_~5, 411. 06 BALANCE OF TAX DUE 73.04CR --~---_._-.~~~ INTEREST AND PEN. ,00 -. -~-~~_._--- TOTAL DUE 73 , 04CR ,-------------- - -~_.---~- . IF PAID AFTER DATE INDICATED, SEE REVERSE FDR CALCULATION DF ADDITIONAL INTEREST. IF TOTAL DUE IS LESS THAN 'I, NO PAY"ENT IS REQUIRED. IF TOTAL DUE IS RHLECTED AS A "CREDIT" (CRI, YOU "AY IE DUE A REFUND, SEE REVERSE SIDE OF THIS FDR" FOR INSTRUCTIDNS,) , "ElIERYATlONI Elhtt. of dlClldlMII dYing on or b.fore nlUtblr 12, 191" ~- If any futl4t. Jnter... in thl ..tet. 11 trlN'll'.rr" tn PO...ulon or'nJOYllllnt to Clln . (coUatereU bln'fichrl,. of the doc:edtnt aft.r the IHpll'.Uon of any ..tUII for 11ft or for y..r., the Co.-now,.lth hereby .MPr"'lY t".tv.. the rloht to Ippral.. end ,..... trlO".r Innerltanc. T.~.. at the lawfUl till" a ((lOUltllral) rlllt, on any 'lIeh future Int.r..t. P\J!li!OSE OF HOTlCEI To fUlfill the r~qutr...nh of Section Zl40 of the lnneribn.::. and Eltet, Tal( Aot. Act 21 of 199!i. 172 P,S, Stctlon 9140), PAYHfHT I O'tlloh the top portJon cl thh NoUce and .ub.1t wJth your pay",ent to the Rlght,r of WHIt: pr~nhd on the rev.r.. ,Ide, hHah chick or lIon.y order Pl'lyabl, tOI REGISTER OF MILLS, AGENT REFUND (eA) I · r.'und of fI tllll: c,..dH, which wa. r.ot r.qu..ted on the Tall: R.turn, IlIlY b. r.qu'lIhd by coepl.tlng an "Appllclltlon for R.fund of Plnnlylvanla [nherltanc. .,nd htate Tax" CREV-1313). AppJJcatJons ar. IIvaJ1ftblt nt the Olflc, of the R.glstlr of ~lll., any of the 13 Revenu. DI.trlct Offlc.., or by call1n~ the 'p.c1ftl Z4-hour anlw.rlng s.,.vltl nU.h.r. for forll. ord.rln~l In Penn'Ylvanla l-aOO-36Z-10S0, out.id. P1nnsylvDnle and wlth'n local ttarrhburg ftrea (111) 737-a094, lDOI (117) 71Z-ZZSZ (Hearing Iepalrld Only). OBJECTIONSI Any Pllrty In Int.,...t not .atl.fJld with the .ppral....nt, allowancl or dl.allow.nc. of d.ductlon., or a.",slI.nt Qf hll: (IncludJng dhcount or lnt.re.t! .. shown on thh Hotlce .u.t object within sll(ty (60) day. of r,cllpt 0' this Notlco bYI AIlltIN nfftaTlVE Cllflilt!CHONS. nwrltt.n prot..t to the PA O.pa,.t..nt of R.v.nu., Board of ApP.al., Dapt. ZaIOZI, tlllrrhburg, P* 17IZa-lOli, OR ..'I.ctloo to hili' the Ilathr d.terlllnad at lIudJt of the lIceount of the per'OMI r.prlluntatlvl, OR "~appalll to the Orphan.' Court. DlseMf, f~ctual .1'1'01" dl.col/lr.d on thl. 1I.......nt .hould b. add"'s.ed In writing tOI PA D,part..nt of R,vMnu., Bur,.uM Individual Tall:.., ATTNI POlt Au.....nt R.vl.w UnB, O.pt, 21\0601, tlarrlsburg, PA 11124~0601 phon. (717) 747~6S05. S.. Pagl 5 of the bookl.t "In.tructlon. for Inh.,.itaflCI hx "_turn for a ".lIdent O,c'd.nt" (REV~1501) for an ,~planatlon of ad.inl.trativ.ly corrlctabl. .,.,.or.. If 'ny tall: due I. paid within thr.. (]) callndar lonthl Iftlr the d.cod.nt's dlath, It flvl p.rt.nt 15;0 dhcount of tha tll( p.ld I, .llowad. PENAL TV, Tha 15% till: alltll.tv non~plrtlc (patlon p'nalty 11 co.put.d on thl total uf the tllll: and Intlre.t .u....d, and not P.ld before JanUh,.y 18, 1996, the 'Irlt day .ft.r tha Ind 0' the t.~ a.na.ty period. lhl. non-participation p.nal,y is app.al.bl. In thl .... .annl,. and In the the s... tl.. p.rlod .. YOU would app.al the ta~ and 'ntlr..t that h.s b..n ....I..d a. Indlcatld on thl. notice. INTEREST I Int''''llt I. chlll,.g.d b.. Inning with first day of d.llnqu.ncy, or nlnl (9) 1I0nth. and on. II) day froll th. date of o..th, to the data of PIY"nt. Ta~.. which b~"e d'linquent b.fore Janu.ry I, 1981 b..r Int.,...t at the rata of .IM (6%) p.,.cant plr annul celculat.d at . dally rat. of ,000164. All ta~I' which b.ca.. dellnqu.nt on and a't'r Janu.rt 1, 1982 will baa,. Jnter..t at a rate which will v.ry fro. cal.ndar v.er to !:al.ndar Y.flr with th_t rltl ennouncld by the PA Departll.nt of Rev.nu.. Th. appllcabl. Int.r..t r.ta. for 1982 through 1998 ar'l ~ Int.r..t '!!l! Dilly Interest factor ~ Inter..t Mnt. Dally Intlr..t ractor 1912 20% _000541 1911 9% ,000147 1913 16% .000458 19la~I'I91 11% .000301 1984 11% .000."'1 1992 9% .000247 1915 15% .000356 1991~I"'" 7% .000192 1986 10% .000Z14 1'.I9S-199a 9% ,000l47 ~~Inta"..t It calculat.d .. folloWl1 INT~R~ST = BALANC~ OF TAX UNPAID X NU"B~R OF DAYS D~LINQU~NT X DAILY INT~REST FACTOR -~Any Notlc. 1.~UId Ift.r the taM bICOM.. dallnqu.nt will rafl.ct an Intlr..t calculation to flft..n liS) dlY. b,yond the det. of the ........"t. If p'YIl.nt Is .ade aft.r tM Int.r..t co.putatlon dati .hown an the Hotlcl, 'ddltlon~1 Int.r..t .u.t b. ~.Ioul.tld. , 00 ~1f' 'e:l.!ll R ,- ill~ a; '."1 O~?; .-L ~ 0 ri! >- t~ Hl i!l. {; !tl ~(i .:- o \....") ..:J Ii&! ~ ~,t; do {" '" 15". ,2,).' ~,5 JUREAU OF INDIVIDUAl. TAKES INHERllANCE 'AM DIVISION MPl. 2'''0' HARtU'BURO, PA 11111-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMEN" OF REVENUE INHERITANCE TAX STATEMENT OF ACCOUNT ., ( --) . IH.IU,U UP C1I4"1 WILLIAM A VOCUM 3001 MARKET ST CAMP HILL PA 17011 DATE 07-14-1998 ES1'ATE OF HOFFMAN CICEl V V DATE OF DUTH 12-14"1997 FILE NUHlER 21 97-1018 COUNTY CUMBERLAND ACN 101 E___~:~- R~ltt.~'----l MAKE CHECK PAYABLE AND REMIT PAYMENT TOI REGISTER OF WillS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 NOTE I To In'u~. proper oredit to your .coo~~tJ lub.it the upper portion of thil forM with your t.~ p.y.ent. CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS .... itllj:il,oi-EX--AFP-lo;;:9'rj'------.iiij-iNHERiTANCE--YAX--STATEMEtWoF"-AI:ciiriNf""i.-..--------------------- ESTATE OF HOFFMAN CICELY V FILE NO. 21 97-1018 ACN 101 DATE 07-14-1998 THIS STATEMENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE HAHED ESTATE. SHOWN BELOW IS A SUNHARY OF THE PRINCIPAL TAX DUE, APPLICATION OF All PAYMENTS, THE CURRENT BALANCE, AND, IF APPLICABLE, A PRDJEC!~D INTEREST FIGURE. DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT, 05-18-1998 PRINCIPAL TAX DUE, 15,338.02 PAYMENTS (TAX CREDITS), PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (- ) 03-06-1998 AA269811 (,02,32 1,644,16 03-06-1998 AA269818 364, ,58 7,000,00 06-15-1998 REFUND .00 73,04- 0, 1/",1 '-~ - ~l '6; ..., :,::::: a:J N =1 ''') (.J (;} ':JCJ: 0: . r.o P\ u '._ f::. ~S --'-0' . IF PAID AFTER THIS DATE, SEE REVERSE SIDE FOR CALCULATION OF ADDITIONAL INTEREST. I IF TOTAL DUE IS lESS THAN 'I, HO PAYMENT IS RE~IRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" ICRI, YDU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. I TOTAL TAX CREDIT , BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE 15,338.02 .00 .00 ,00 PAYlII1NI, Dttaoh ,the top portllHl of thh HoUo. IJnd lubllJt with ~our p.~..nt .ackt payable to t.... '""" itnd acWr... printed DO the rav.r.. .Ide. If RESIDENT DECEDfNT II.. check or Ilona~ ordclr payablo tOI REGISTER OF WILLS, AGENT. If NoN-RESIDENT DEC€DENT .aka chIck or IIOI..Y or.r payabh to: COHttONWEAL TU OF PENNSYLVANI.... REfUND (CAll A refund of . ta)( credit, Nhich Na. IIot tuqua.tad on the Tal( Return. II"Y ba requasted b)' oOllplaUnQ In "AppUcaUofl filt Refund of Pann'Yhan1e Inherltanc. and E.ht. Tal<" (REY.UUJ. App!JcaUon. ara .".Uabl. at thtl OfficI of the Aaoht.r of NUll, IInY of the 23 Ravenue DhtrJct Offi08s or 'rOIl the n..rt..nt', 24"hour IInIN.rlng ..,.vlcl OUIltHtr. fer for.. orderJnSII In Pennsylvania l-aOO-362~lOSO, outside Pafl!lly!vanl. and ..Uhln local HlItrhbura .r.. (717) 787-8094. TODt (717) nZ-ZZ!i~ Wearing Iapaired only). REPLY '01 Q\M.tlon. r."arding arro:1II cClntaln.d 011 this notlclI .hould be ItddrellSed tOI PA Depart.ent of R_venu., Bur.au of Indivlduell lIlMtll, AnN: po.t .hlenMent Revillw Unit, nept. 28OM1, Harrisburg, PA 17128-0601, phon. (71"/) 787~6!iOS. DISCOUNT I If any hx due Is paid within thrllll (31 calendar Montha aftllr the dllilcedent's death, It f)l.IlIil perCl.nt (5%) discount of the taM paid I. aIION.d. PENALTY 1 The 15% taM -.na.ty non~p.rtlolpatlon p.nalty Is co.puted on ~hII total of the taM and Inter..t ..s....d, .od not paid b.fore J8fll,I.ry 18, 1996, the +lrllt day flfter the end of the IBM lIIIn.sty p.rlod. INTEREST 1 Inter..t hi ch.rged beginning with Ur.t day bf delinqullncy, or nlnll (9) .onths and one ()) day f,.o. the d.t. of death, to the datil of p.y..nt. TaMU which bllca.e delinquent before January 1, 1982 tJ.ar Int.r..t .t the rate of .IM (6%) p.rnant p.r amI... calcul.tlld at It dally rflte of .000164. All taMlls which bllC"1I delinquent on and after Jenuary 1, 1982 wIll baar Interllst at a ratll whlch wll! vary fro~ call1ndar y.ar to calend.r YII.r with thet ret. ~~.d by thll PA O~.rl"nt ~f RIIYllnulI. The appllcablll Intllrost ratllS for 1982 through 1998 a,.. I 't.ar Int.r..t Rat. Dally Intllrett Faotor Y.a,~ Intllrll.t Rat. n~lly Inter..t F.ctor 1982 20;: .000548 1987 9X .000247 1983 16% .000438 1988~1991 11% .000301 1914 11% .000301 1992 9% .000247 1985 13% .000356 1993-1994 7% .000192 1986 10" .000274 1995o-1998 9% .000247 --Int.r..t 1& calcul.tad .. follow'l INTEREST = BALANCE OF TAX UNPAID X NUNBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR --Any HotlG~ i'IIU11d aft.r tha t.x bllco... dlllinquent will refl.ct en lnt.r..t calcuiation to flft-.n (15) dly. b.yond the data of the ........nt. If p.y..nt Is ...dt after the tn't.rut co..putatlon date .hown on the NoUca, addltJon.l tnt,er..t ault b. o.l~ulat.d. \ \ i \ I'IJII'OSE Of _ntE' pft"..."11 ~f\IMU (eMll OflJEC110MS\ ,\llIIM' lS1RftllVE CottttEtlloMS' I,' I' 'llEl \l\~'\ 1', ~ t \ '~,l j\ .Gll'l nU\\" " " M"" ~ .~,,_." ~... ".. .. .. .-'- - "..".. ." .. .. ., .".. '" .... 5ttO,\0" 4nQ01. .... ~.. ~.~..." .". - -" .....~ ...... ~ .."..., ."" ...~' ~ rev.r.. _,de. · ._ M'" .hO" 0' ..>no. 0''''' .....1. \,0' ~EOISlE> Of MILlS, .OEM', . ..- .. . .. .~", .,. .. .. .-... . .. .. ..... ~ . .-.. . -...,. . ...."... ....~.. -"." .-"'" p ".... ..' ...."".. -"."" - ....~..., - .,,~.. .. .."..,. "".. ~., ~,,~- "...", ......... ..,,~ ~ -" ...- -~ ~... _.,. ... .M'.'" .-.'-" ......~., ."'. -"." - ..." ..., "O,,\lbU'. .... (7\1> 7.7.....' ,"01 ('1\11172"'" W..rln. l..ol..d On"" - .'" ,. "..." .., ....... .'" ", _..,_., ."._. . ...n_ .. -.... · ....... " - n."~"- · .,_.... · - · "n .... .. .... ..." ."" ,.. ....' -". " "". MotlC:8 byl ...,... ...... .. ~ .. -.-' ., ~. .... .' ....., -'. ......, ........ ., .......... " .......~ . ... ~ .... ....... ., .. p" " .. ...... .. .. ~..., ....-"'..... " ~pepp..l to t\WI Or\lhtll\l' tourt D\SCQUMl \ ,.._' .... ....... . ... ._...... _n. -.... ,. .,,~.. .. --' .. ..-. .....' '."'_' ,.... n'" .., ...._. ..'. .n, .... -., ...,_." ""..... _"." .._" .......... _", ....~n- .. .-"- ., ."" ." · ...... oo..aon" ,>EV-ISOll 10' on ...I.n.'lon 01 ....lnl.".'I..,. .0".o'ObI0 .,'0'" n _,.,,"." .,,,"~.. ". ..,..., .... .n' .. -... .....". ~... ... d,.cOUll\ of tMi ia'll. fle\d 't all.oW.d. .. .. .. _" ...",...n. .-'" ,. -.' .. .. .". ., ~ .. - .-... ....... - - .... ~_ - ... .~. .. "... .. .n. ~ ~ .. - .. _... ~.,. .". __n._n. .....W ., _... .. - ._ - p .. .. - - n. ~.. .. .. -" -' .. .. p ....." 'h" hOt b..n .......d .. Indlc.'.d on 'hI. no'\c', PEMlll" ........ ,. -.. --,. ... ..... .. ., ........' . .,. ... .-' - - ". .. .... -.... -". . -.. . ....". .- .,. - ..-. .- ,..... .. ... - ..-..., - ....,. .. ".. ...., - - ....... ". .", ... ., ...... ....... .... - .n_" .". -.." ". .n. - ..-"...... .... .....- ,- .- -. . .'- .., .,. -. .... -'" - .. -.-' ., -_. - -'''.'' In""" ,.,.. 10' ,.., 'h,OUgh I". .,., tM1ERES1, ~..f ~tef..t Ra~ Da~ \y lotenst f.C~ '1.ar lflUr.'J\ 'Rata D.n')' lot.rest fllOtor - - - - - - - 'It&t ZO'l. ,0001)46 1.961 1)'1. .OOOl4tl 19n 16'/. .OOO4~a 19&&.\991 \1'1. ,QOOM1 I'M 1\'1. .oOO!lOl \CflJ'Z q'l. .000l41 llJft" 1"'1. .aoU~ lCJlJ'!.~\qlJ4 1'/. .000192 \lJI6 \0'1. .000l14 lqq~-\qqa CJ'l. ,000241 __lnUr.,t \1 cal.cUlatad .. fono"': ...- . ..,"'" ~ ... ..... , ...g ~ .." ",,- ' ..... ,..- ,- .... .n......... _.. -. .n_' .". ..."... ",.., ........" .,,-""- - ~ .... ., - ..--" ".-.".... .". .. ....... -.'" ... - . - ..."co, odd",....1 In'or'" ou., b' c..O\,I.tod,