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HomeMy WebLinkAbout97-01027 -',- '. . E . & . ~ ~ N Q - c.!.. '0 } E A , G) e c - '"' 15E I . 0 1;; ~ z .ra :J ,. ,. ANOll \10l' "llfl91 i' /." .~_-'tI1() ~I(;~HS l\l"'IE~ --.IO""ltlON(IlI~N.~--- 1 "J11.p ..~:'i91L_luJL,,-.!..~'Ll HAl'" "HO.l.DOflnsor'IIt~W'tlOtOt,l'~E1IDC.l.UIIOfOUtH ,"~""II\'1~(II'HnI1().,';~1-I 1 (:.,.,.."1'1,1/.,,, ""(I U ' tj" 0 .",,,, j,.,vvr ,,~rr'lI'i If") u. (~~_L..1.J..!::.!.f:._..1..A-!.'" I 3 O.l.1( "lto ....~.. "I, ..', _ ....____.])~~j~'h- 1'1' 11i"" '" n."ih. Iii." ,h.. 1111"11I1.";"11 hCI'.I'';V''II;' ,,,,,ntl,. "'1';'.'\ ,,"11' .ill "",'.111,'\ "."Iii,.",. ,,\ ,\.-."h ,I"h lil...1 ""I, ,,,,. .1' I ,,,.11 Rq~I"LII..lh. ",i,~;ll,,1 ,..,,11;,,".. willlw ,,,'II,I,,lnl',, 1\". "1.111 '.iI.lI \(,. ,,'.\. I III,,, I", 1"."","".11' Iii",,' WARNING: 1119 Illegal to dupllcille Ihls copy by photosl..t 01 photograph. h:l' Itll' Ih\\ n'nilk;lll,,~.',.1I0 "II!I(~\jW'of'pi;~>:. l"#-, "'J'j\ I'.~'_. ~ <:~\\. E\' '(1. .~IJ '\ . ,. " .,' ,~ .. <il; ~,"/ '1t. '1>''' "-, ~;,~fMfN' \\~ ~~,/" ''r.!'!/I!!!!fu/jll. lli. ~:'~~"'~I~~ Ill! , \!J\I'I 4705642 1)1\1' .._._.._~ __.~.__n_o'~__~~'__' -. Nil. "'O$lo!JR..vt7 COMMONW!AL.lH OP PENNSVLVANIA' DEPARTMENT OF HEALTH' VI'TAl. ReCORDS CERTIFICATE OF OEATH O"l OiWiiiU;;;;;'C;;;.~.;;,-""--'-.-. ..Dec. I~, 1997 '''It'''IW'''M'~ -.-.--~-- :';:m:l~J"t7~"':"~"t =-~; ,"II.lt1'lJ,ct,(I.,.A,' "\.Al'.~(II!)(.!t1r(,~""rNj"""._,,"".""f"''1'''''-'''-' S Jn~ldT~to~'1 lio!iP'fil-. _..-- - -. -----. Cumb C P ,.,,""0' Kl Elllo..<t'oI"'''' Cl DOo\ [J !.....---,-. 0./ A II! '.C1L1,......."'~,'I""~..'".......I)"..tllHlV<l""...-' 11I1"''' ilHT '" 1I1"'~~PfCIOI..,.,I'\1 "'<<I' ."1 Ella M. Ol_ ---, ,51*~IL.J , IO.Il~''''''''~ll lIHO\:III"Ll1'1 -loIOI..... 01" 88 .. " ~, CIN, I#<I'!\HO woo. I~",~__" Carlisle Hospital ~~~~~~i~i .....0 ~~ t,lAAltll.' ....lIT'I4 N_!,l",*,.~, 1)toOfeIrd~"'1 . Widowed "..00 .......r.edIlIIMll., Carlisle ~\ cunt>erland 11::r," CU' U'<l" (ol~~':::O"="::~~ Cook _ estau ant llliCIDtwt-"""'.......lMO...OOU"~..".C-fy"-' ~ toC",,",,1 ocelO'''I'.' 154 Brockwood Drive ~i~~t.\tCE Carlislel PA 17013 '~;:'~~7." N. 11 11 \"..!;,",._-RL------~ Cod ,,*""'" ~.. 'q<oo"It,ojl1 _jlOrl,u.c___wtd ,ltl__......-tol--.- - "'OO'EW!ltll"'f,~""'" J,N "'A.~$o.'o"""'l , Mary Raudabau<Jh _--- ,..;O"iii:ll"" S"'"llIOOIt'OMUISl'. <:","""""$lII,,lOCoo.l 154 BrooKWood Dr.. Carlisle, PA 17013 pl.lCE751Oi'ip(l~ITo(VI-;-;W;:;;~I''1r;''''lttf'l l "'",C....~,.IIl.IClCIVll o,~....,P..(. Moncoe Twp 1997 Mt. Zion Cemetery ,!;'\!!lil!rl nd'Co., PA ",,,.,,;0",...- - .-- -,,,,,,,,,.,,,,,,,,,,,,,.,,'" Ik;ffman-Roth~'1 Home 010343-1. . _lue. IlQlUlr...5t......r... .J101 I"" IIlI""'t_"""''''' ,,,,""'1 Ik. ,,""'"' I"" Illl(."...., ~lCf..n"Ul,lllf~ .I111C11110 "~!L"" Q", --e.~ (IA-V ,;~\'1CI J.. -..... 'l,lEDrOEIlII .---:-l5.'IlIt,..(JNOl'..CEODU-O",'.~'!h \~'.. 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I !lli,lliilll:llilt,W111::'illi 11':111 :.'\III,;iiiii1i!!; Iii '"llil!ll:ill: :ii11111i :IIII,llill' liillll!,',III!', " ;:IIIIII!:II'IIIII'I il :'I'liiIIIIHItII':lill,lli': .:'11i li.:ii iiili:i.,l!l! :.IIII::j11lill;'II,I.III,IIII(1 i ..il ::, :...:1.1.'1 :::11.1.....1 1::11[1111. .,.:.1'11'1'1'111. :.:I...II:,II:.::I...!I' I :.II..II..::i T..I;"!, : . . ,I: 1,1" '., d. ,.';',' 1"1'1' ,01,,11 '.' , '11,1; I; :':',.Iil' 'liil::::1 111::11"11 1"1111:;". ' .1..'... !'.' il..... I' '.' i. II':'. "I,' '.'.1. II.'! !.III':.'. . ,I '.1'1. I'. , , .1 " , "'1 I'.' il':: :; ,1-', \ 111I,! ,! I I,l' jl I ,'II,' 'I I , ,:;, I - 'I ,'~ :! I '; -, !! 1 i I I - I"'; i , i 'I'!' 'I' : ! I'! ;'.' } :'1 ,.,1.':1'11::.1.' '111,..".:'1' . ; !, 'I, Iii::: !'_: ,', ':1 Ii, L .j ! ,Ii), III ' , , -I I" 1,1:' - i ' , .... I " ,: ..... I ~ i .. t$ 1,; 1I1 a = - - ,.. I 1: = * trt\ ."1 c} r"-); " ,,j ~,l {j(, -\, {- ~, ' '" . ~ mast RJill nub mtBtumtnf of ELLA M. MoCLAIN I, ELLA M. McCLAIN, of 532 West Penn street, Borough of Carlisle, Cumberland county, Pennsylvania, being of sound and disposing mind, memory and understanding, do hereby make, publish and declare this as and for my Last will and Testament, hereby revoking any and all other wills and codicils heretofore made by me. FIRS'l'. I dire0t that all TIll' junt debts Mid .funei"al expenses be paid from my estate as soon after my death as practically and conveniently may be done. SECOND. I direct that my remains be interred within my family'S burial plot located in Mt. Zion cemetery, Churchtown, Pennsylvania beside my beloved first husband, Ray Shurghart. THIRD. I authorize my personal representative to expend funds from my estate, in such amounts as my personal representative shall consider necessary and desirable for the purchase, erection and inscript.ion of a suitable marker for my grave. FOURTH. I give, devise and bequeath my jewelry unto my granddaughters, Cheryl Ann Hankey and Caryl Sue Dickman, ane! my daughters-in-law, Barbara McClain, Almeta McClain, Betty McClain and Mary shughart, in equal shares per stirpes. FIFTH. I give, devise and bequeath my cherry bedroom suite to my son, Blair McClain. SIXTH. I give, devise and bequeath any and all tangible personal property owned by me at the t.ime of my death unto my son, George shughart, and my step-sons, Blair McClain, Earl McClain, and Gail McClain, in equal shares per stirpes. SEVENTH. I give, devise and bequeath any and all real estate owned by me at the time of my death, unto my son, George Shughart, and my step-sons, Blair McClain, Earl McClain, and Gail McClain, in equal sh,\res per stirpes. EIGHTHT. I give, devise and bequeath all the rest, residue and remainder of my estate unt.o my son, George Shughart, and my step-sons, Blair McClain, Earl McClain, and Gail McClain, ill equal shares per stirpes. ~" CERTIFICATION OF NOTICE UNDER RULE ,.Hill Name of Decedent I ElllI N. NcCllIln Date of Death: Oecumber 19, 1997 Will No. 2197-lon Admin. No. To the Register! I certify that notice of beneficial interest required by Rule 5.6(a) of the Orphans' Court Rules was served on or mailed to the following beneficiaries of the above-captioned estate on 1-8-98 I ~ Address Ellrl McClllin Stllr Route 2 Box 9 Waterfllll. PA 16689 Blair McClain 154 Brookwood Drive Cllrlisle, PA 17013 Gail McClain HCR 75 Box 184 NcConnellsburg, PA 17233 Cheryl Hankey Box 125 Elderton, PA 15736 Caryl Sue Dickman Box 125 Elderton, PA 15736 Notice has now been given to all persons entitled thereto under Rule 5.6(a) except none Datel (- f J} I sdlc/{!-/l,'t1iat{ N William A. Duncan, Esquire ame Address I Irvine Row Carlisle, PA 17013 Telephone( 717) 249-7780 Capaci.ty: '_""IF",I '"),,,-.i :{X Personal Representative Counsel for personal represen ta t i ve z o i= ~;! I-'~ :E o o /1'1 ;),.1 I I"V'too(".I'"I~ C()MM(tNW~VIV"'tM nU'Afl'MrNf Of IfrVnMI; OWl :l8OIMI' tlARHlSUUHO "'" "1;l80fl0l OECIOE""SHN.llt"'l, 'If(!l, AHDMlODl.I.lfrlllWj 1M ....btect I. ........ REV -1500 INHERITANCE TAX RETURN RESIDENT DECEDENT I ~ MCCLA N ELI. A M 9 Olo.U' Of 0111111 o 2 II OfflClAt UU(,'NlY ~(iniijiiiilit...' 2 I 9 .;"" '.'.".""';.'..";;."'.~""..;"'.".I socw SECUfWY HUtMI[R DMEOf OfA1H 2/09/19 7 ~ I!! il~ 1XI1 Of~,",' Relum o 4 lIm,ted E.I.le IXI 6 Decedenl D,ed le.lole ,18"'",,, ""I o 9 l'llfllIlK>I1 P,oceeda Race.ad o ') SLWlo!menlal Refuln o 4a F utUhJ Inlolcst Comprotnlso (d.. of ~ lAir 1].11-11) o 7 Oecedonl Maintained a lIVIng r fust (Nt"" ,.,. 01 'MIl OIDSp00'3.IPO\IOIIyCre<lI'........_l1"."...'.,,,, o II 9 () 9 TltIS RElURN MUST !IE FII.ED IN IKIPlICAIE WIIH ~ REGISTER OF WILLS o J RomalOder Relurn (""""wID 1l.I~UI o 5 reo".l Eslalo h. Relul'O Re~med _ II T .Iel Numbet 01 Sa'" Oepos,tllox.. o II E~~t""lctlXundCfs.c 9113IA)/IOl.....cl ~ OFFICIAL USE ONLY 18) 7 7 4 12 HotV.IUIof Em Ie (lllleBmlOusL,ne11) 13 ChRfilable and Govelnmenlal8cquoslslSec 9113 ifusts for which an elechon 10 18)( has nol been made lS<hocIJle J) 14 NeI V.lu. Subjocllo Tu (Une 12 m,nu.l,ne 13) - 15 Amount oil,.. 14 I""able ,"1M! spcusalllX ,ale . . See insl,uchons on 'everne~lde.fof ,app!ic.ab!e p6fC~18gEl 16 Amount 01 I,ne 141""obIe 6 0 5 4 4 9 8 eI6%'ele , ' , '. 17 AmounlolllOel41""obIe 'I 15%IIle 7 9-. - 2 . J J III) . J I ,.7 6 (12) 6 0 5 4 4 ..9 K (13) . 114) (, 0 ,5 4 4 .9 8 (15) , . (16) J ,6 3 2 ',7 0 (17) liB) 3 ,6 3 2 .7 0 COMPlETE MllINO AOORESS I IRVINE ROW CARLISLE. PA 1701J , ; 3 x .0 x 06 X 15 .7 6 ).>> III S A 81 ANDRECHECKMA'fH e:e: LInder ponlliBtot pe?ry,1 decln !hilI hMe~lIIMled thi, relllTl, incw.ng 1CCM1*'l~ SC~BS end 'taMmenls, lWld b!he 1:851 or my knowbd!1t tnd bellm, IllS llUe, oomlCt m ~l!kI 0ec1lr1llY\ 01 P"PMf ohI thll'1lheD8l'SONI~i'u.dm.lnbmalooof"'dI~ h.lI'1ikf'lO'llkdatl SI TURE OF PERSON RESPONSIBII fOR filiNG RETURN ADOHESS .\, t ~., ) q 1(" S ClNATURE OF PREf'ARm Of HER THANRfPHESENTATlVE AODRESS IIF APftlCMl.LI SUftI/MNG !iPOVSf'SNN IlA9f, fiRST, AlIDIlIODtE IH"~,1 SOCW, 5FCUlUfY HIMIER . NA'*- WILLIAM A DUNCAN fiRMNA,*- (~Appk;IbII) DUNCAN & alTO P.C. IELEPHONE NUMBER 717 49.7780 1 Real E'lalelS<hocIJle A) II) 2 Slock, and Bonds {Schedule B) (2) 3 Clo.c~ Hold COlpo<'l~n. Parlnar,hl' 0' S~o.ProplleIOi.hip (3) ~ 3 j:! ~ ~ 4. MOilgeg" & NoI.. ReceivalJlo (Sche<t.J!e 0) 14) 5 C..h. Bank Depos,l. & MISc..ne0U5 POI.ona, p,operIy (5) (Schedule E) 6 JOInl~ OWned Property ISc,"""le f) 16) 7 Inle,.VNos Tlen.f". & M"c.leneoo. Non.P'roale P'ope'ly (I) (Schedule G Oil) 8 TolIl Groll Allot. 1101,1 Unes 1-7) 9 fu..,,1 ['pen.o. & AdmlO"",livo Co.ts ISchoo,,!e H) 19) 10 0001. of DOCedelll, MOilgago liab,lille'. & lIOn. ISchedule I) (10) ".. 11 TolIl Deduction. (lol,ll,ne, 9 & 10) 18 TuDu. 19 , ,(' 1 /!IJ' (;4;2 L~ DATE 1 .n Y.r DATE Decedent's Complete Address: Slam ADOaESS I RIVINE ROW arv -- CARLISLE J S1A1E PA f2iP I 70 L1 TIX Plyments Ind Credits: 1 Tax Due (Page 1 L1"e 18) 2. CredllslPaymenls A. SpolJl8l POI/arty Credit 6 Prior Payments C.Dlscounl (1)_ 3.632.70 --..---- 3. InteresVPenel1y If lIflpI~eble D.lnlllfl$l E. Penelly Total Credits (A + 6. C) (2) T otsllnleresllPenelly ( 0 + E ) (3) 4. !fllne 21,,,ealer than line 1 + line 3, enler the dilfllfence. Th','sthe OVERPAVMENT. Chock box on Page 111n. 1910 requ... a rofund (4) 6. !fllne 1 + line 31s l1ealer Ihan line 2, enler Iheli"erence. This Is the TAX DUE. (6) __3.632.70 A Enter the Interesl on the tax due. (SA) 6. Enter the tolel 0' Line 6 + SA. This Is Ihe BALANCE DUE. (56) 3,632.70 Make Check PJab1e 10: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BV PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Old decedent make a transfer and: Ves No a. retain the use or Income of the property transferred; ..... ................ ..............0 0 b. retain the right to designate who shall use the property trensferred or Its Income; ...............0 0 c. retain e reversionary Interest; or .......................... ..................... ....0 0 d. receive the promise for life of either peyments, benefits or care? ........ .........0 0 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 reoelvlng adequate conSideration? ..................... .............. ... ............0 0 3. Old decedent own an "In trust for" or payable upon death bank account or security at his or her death?. ............... ................. ............0 0 4. Old decedent own an Individual retirement account, annuity, or other non-probata property? .....0 0 IF THE ANSWER TO ANV OF THE ABOVE QUESTIONS IS VES, VOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE ~ETURN 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 'rom 6% to 3% for dates 0' death on or efter July 1, 1994 and before January 1, 1995 72 P.S. ~9116 (B) (1.1) (II) provldad for the reduction of the rate Imposed on the net value of transfers to or for the use of the surviving spouse from 3% to 0% for dates of death on or after January 1, 1995. The slatute does not exemDt a transfer to a surviving spouse from tax, end the sletutory requirements for disclosure of assets and filing a tax return are still eppllcable even if the surviving spouse is the only beneficiary. FOR DATES OF DEATH ON OR AFTER JANUARV 1. 1995. Please answer the follOWing question by placing en ''>(' In the approprlete space. Old the decedent crelt. I trust or slmllsr Irrlngement whIch Is soley lor the survIving spouse's benellt lor his ()f her entire lifetime? Vel 0 No 0 If you answered yes to the above question, the tax on tho trust or similar arrengement is postponed until the death of the second spouse, at which lime It will be fully texable at the raters) applicable to the remainder beneficiary(les) Enter the value of the trust on Schedule J, Part II, In order to remove It from the calculation of the tax due in this estate. You may wish to file Schedule 0 In order to makelhe election availeble under Seclion 9113. If the election Is made, the trust or similar arrangement Is taxed in the estate of the first decedent spouse, the portion of the trust or similar arrangement which benefits Ihe surviving spouse is taxed et the zero tax rete, end the remelnder Is taxed at the rate(s) applicable to the remainder beneflclary(les). If you choose to make the election, you must attach Schadule 0 to a tlmely.flled tax return, elong with Schedule(s) K andlor M in order to show the apportionment of the trust or similar arrangement between the surviving spouse and the remainder beneflclary(les) mast mill anll mestament of ELLA M. McCLAIN I, ELLA M. McCLAIN, of 532 West Penn street, Borough of Carlisle, Cumberland county, Pennsylvania, being of sound and disposing mind, memory and understanding, do hereby make, publish and declare this as and for my Last. Will and Testament, hereby revoking any and all other wills and codicils heretofore made by me. FIRS'l'. I direct that all n,',' just debts emil funeral expenses be paid from my estate as soon after my death as practically and conveniently may be done. SECOND. I direct that my remains be interred within my family's burial plot located in Mt. Zion cemetery, churchtown, Pennsylvania beside my beloved first. husband, Ray Shurghart. THIRD. I authorize my personal representative to expend funds from my estate, in such amounts as my personal representative shall consider necessary and desirable for the purchase, erection and inscription of a suitable marker for my grave. FOURTH. I give, devise and bequeath my jewelry unto my granddaughters, Cheryl Ann Hankey and Caryl Sue Dickman, and my daughters-in-law, Barbara McClain, Almeta MCClain, Betty McClain and Mary Shughart, in equal shares per stirpes. FIFTH. I give, devise and bequeath my cherry bedroom suite to my son, Blair McClain. SIXTH. I give, devise and bequeath any and all tangible personal property owned by me at the time of my death unto my son, George Shughart, and my step-sons, Blair McClain, Earl McClain, and Gail MCClain, to equal shares per stirpes. SEVENTH. I give, devise and bequeath any and all real estate owned by me at the time of my death, unto my son, George Shughart, and my step-sons, Blair McClain, Earl McClain, and Gail MCClain, in equal shares per stirpes. E:tGHTHT. I give, devise and bequeath all the rest, residue and remainder of my estate unto my son, George Shughart, and my step-sons, Blair MCClain, Earl McClain, and Gail McClain, in equal shares per stirpes. 06-15-98 MCCI.,illl 12-19-97 21 97-1027 CUMBERLAND 101 t Ao~t ~~ltted MAKl CHECK PAVABLE AND REMIT PAVMENT TOI REGISTER OF WILLS CUMBERLAND CD COU~T HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE .. RETAIN LOWER PORTION FOR VOUR RECORDS ~ if!y;~i4rEjf"AFji-iil9::q;riliiYicE..tiF-YN'iiEiiifAiici-YAx-'A-pjiRAisEMiil'r;-m.-tiiiANCniri'-----..--m----n DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ElLA M FILE NO. 21 97-1027 ACN 101 If .n ........nt w.. i"u.d previously, line. 14, 15 .nd,or 16, 17 .nd IS will re11ect figur.. th.t include the tot.l of ALL r.turn. .......d to d.te. ASSESSMENT OF TAXI 15. Aoount of line 14 et Spou..1 ret. 1151 16. Aaount of line 14 te.ob1. .t linee1/C1e.. A ret. 1161 17, Aaount of line 14 te.ob1e et Co11etere1/C1e.. I rete (171 Ie. Principe1 Te. Duo TAX CREDITS I PAVNENT DATE 03-27=9S It;- ,J.2./-L3 IIURUU OF INDIVIDUAL TAMES Ifll(RIUHCE lAIC DIVUUOH DEPI. ZIOUl HARRISBURG, PA 11118*U601 COMMONWEALTH OF PENNSVLVANIA DEPARTMENT OF REVENUE NOTICE OF INHERITANCE TAM APPRAISENENT, AllOWANCE OR DISAllOWANCE OF DEDUCTIONS AND ASSESSNENT Of TAM WILLIAM A DUNCAN 1 IRVINE ROW CARLISLE DAYE ESTATE OF DATE OF DEATH FILE NUMBER COUNTV ACN PA 17013 ESTATE OF MCCLAIN TAM RETURN WAS, (X) ACCEPTED AS fILED I CHANGED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ONI ORIGINAL RETURN 1. Real E.tete ISchedu1e A) 2. Stock. end lond. ISchedu1. B) 5. Clo.ely Held Stock/Pertner.hlp Intere.t (Schedule CI 4. Kortgagel/Not.. Receivable <<Sohedule D) 5. Caeh/lenk Dapo.lt./Ni.c. Per.one1 Property ISchedu1e E) 6. Jointly Owned Propsrty (Schedule f I 7. Tr...ofe... (Schedule G' a. Total A...t. 11) (2) (5) (4) 15) (6) 171 ,00 .00 .00 .00 71.856.74 . 00 .00 (81 APPROVED DEDUCTIONS AND EXEMPTIONS I -. Funeral EKpen.../A~. Coata/"l.c. Expan... (Son-dule Hl 10. Debt./Hortgege liobilitie./lien. ISchedu1e II 11. Tote1 Deduction. 12. Net Ve1ue of T.. Return 15. Ch.rltebl./Qov.r~ntDl Baqu..t.j Non~.l.ctDd 9113 Trust. 14. Net Ve1ue of E.tete Subjoct to Te. 19) 110) 11,311.76 .00_ U11 (2) U51 (4) (Schedule J) NOTE I .00 60,5(,4,98 .00 M .00. M .06= M .15= ue) RECEIPT NUttIER AA269893 DISCOUNT 1+1 INTEREST/PEN PAID (-I .00 ANOUNT PAID 3,632.70 TOTAL TAX CREDIT BALANCE OF TAX DUE . INTEREST_AND PEN. I. TOTAL DUE L . If PAID AfTER DATE IHDICATED, SEE REVERSE fOR CALCULATION OF ADDITIONAL INTEREST. I C_ *' 'n.t.~1 II ." '....,1 ElI.A M DATE 06-15-98 NOTE 1 To in.ur. proper credit to your account, aubtlH the upper port Ion of thl. foro with your tax pa)lMnt. 71,856.71. 11 .~11 71. 60,544.98 ,00 60,544.98 .00 3,632.70 .00 3,632.70 3,632.70 .00 .00 ,00 IF TOTAL DUE IS lESS THAN II, NO PAYHENT IS RE~IRED, IF TOTAL DUE IS REFLECTED AS A "CREDIT" ICR). YOU HAY IE DUE A REFUND. SEE REVERSE SIDE Of THIS fOIH FOR INSTRUCTIONS.) .- o !!! -) ~~ ~ ~ N 0... t:" "J tJ:: r- ~ >; r; ~ ) .1../ ~ ~~l: U Est.t.. of dlMI.....b dy I~ on or befote O'e....r 12, 1HZ R_ If MY future Int.....t In the ..tete Is .,.....f.rred In fJO.....lon or .,..jOYMnt to CI... B (coU,ta,.aU __fiele"l.. of tht decedent aftar tI'M IlCplratJon of MY ..tat. fur 11'0 or for y..r., the C~.lth hereby l.pr..lly r...rv.. the rill" to ~r.I.. .od ...... ttlnlfer Inherlt~ 'alC.. at the IMfful Cl... II (coH.h,.a.) rat. on My luch future Inter..t. o (., ,_iI @I)) 0: a: RESEllVATlIlH I _OF MOnet I t~ fulfill the r~lr-..nt. of Sactlon 2140 of the I~rlt~. ~ Ett... Tax Act, Act 21 of 1995. (72 P.S. SMUon 9140), PA'tHfNTI INtach the top portion 0' this NoUC)1 and tubll!t with your paY88f\t to tM Rlghta,. of NUb prlntttd on thlt reva.... l1de. ~~...... cMct< or lMKMy order paYable tOI REGISTER OF MILLS J AGENT REFUND (CAlf II '-"1M1d of . taM credit, Nhlch ...s not requa.tad on the lex Rftturn, ..y be rlq\Mltad by cOllPlating an "Appl1caUon for R.fund of Penn.ylvanl. Inharjtanoe and Estata T.~" (REY-1313). Appllcatlon. ar. wyail.ble at the OffiCI of the Raghtar of NUb, ~y of thtt 21 Ravenue Dhtrict Offica., or by calling the .peci.l Z4"hoUr .olwerJng .arvic. nu.bar. for for.. orderIng I In Penn.ylvania 1-800~36Z.Z050, out.ide PennsYlvania .'~ within locII Harrl~rg ar.. (717) 787~8094, TOb. (711) 772-2252 (Hearing I~alrad Only). OBJeCTIONS I Any party In Inhra.t not .athfiad with the apprah...nt, allowance or dh.UONanc. of deduction., cr a"e'lMnt of ta~ (Including discount or Intar..tl as .hown on thl~ NotIce .u.t Object Nlthln .i~ty (60) day, of receipt of thb Notice bYI AOItIN lSTRATlYE CORRECTlOHSI ~~wrlttan prot..t to the PA Depart.ant of Ravenue, ftoard of Appeal" Dept. 2ftlOZl, H.rrl'burg, PA --.Iection to MV. the .att.r ct.t.r.ined at MJdlt of the account of the perlC\tlllll repr..antaUv., ~-""al to the Orphan.' ~ourt. 1712a~1021, OR OR Fact~l arror. dl.eov.r~ on this a..a....nt should be .ddr....d in .rltlng tOI PA O.P.r-tltant of Ravenue, IurtHMl of Individual TIM.', ATTN: Po.t A.......ot RevlaN unIt, Dept. Z80601, Harrl'~Jrg, PA 17128.0601 Phon4 (711) "'-6505. Sa. page 5 of the booklat ftlnstructlons for Inheritanoa TaM Return for a R..idant Deeedent" (REY.1501) fo,' An .KP1anatlon of ltdIIlnlstreUv.lY corrac.:tebl. arrors. DISCOlIfTI If 8nY taM ~ i. paid within thr.. (3) oaland.r .onths eft.r the dec.dent', ct.ath, a five parcant (SX) di~count of the taM paid I. allONld. PENAL TV I The 15% taM -.na.ty non.partJclpatlon penalty Is cu.pqtod on the totol of the tax and Intere.t a.,.,sad, end not paid before January 18, 1996, the flr.t day aft.r the end of the t.x .-nasty periOd. This non-Particlp.tion P<<l81ty Is lIPPIIalabl. In the .... .anner end in thtt the .... th.. period ., '10U llfOultJ IaPpeal the teM and inter.st that has bHn ......ad e. Inetieated on this notlc.. INTEREST I Intar..t I. charRed beginning Nlth fir.t d.y of delinquency, or nine (,) ~th. and one (1) day froe the d.t. of death, to the data of payaent. Taxe, which bac.-u delinquent before January I, 1932 be.r Intere.t at the rat. of elM (6%) percent par annu. c.lculated at . dally rat. of .88016~. All t.Mes which bee... delinquent on and after January 1, 1'8Z NIll beer Inter..t at a rat. which Nlll vary fru. calendar ya.r to caler~ar y..r ~Ith thet rate annou;~ad by the PA o.partlt8nt nf R.veOUQ. The applicable Inter..t rat., for 1982 through 1998 ar.1 ll!t Intar..t Rat. D.lly Inter..t factor :!.!!! Int.rest Rate DaJ1y Int.ra.~ I'U 20:': .000548 1937 9% .000247 lff85 16:': .008436 1988-1991 11% .000501 1984 11:': .000301 1992 9% .000:1:47 1985 1:\% .000556 1993.PJ94 n .000192 1916 10% .000l74 1995-1998 9" .000247 --Inter..t 11 calculatad a. follow" INTEREST . BALANCE or TAX UNPAID X HUMBER or DAYS DELINqUENT X DAILY INTEREST fACTOR . -Any MoUe. luuad aftar tha tax baCOM' delinquent wUI r.fl.ct .n Int.ra.t calculation to flftHn OS) dIIy' beyond the date of thl ........nt. If ~.y..nt is .&de .fter the intar.st coaputation data shown on thl Notice, addltJ~1 Intere.t .ust b. c.loul.t~. STATUS REPORT UNDER RULE 6.12 Name of Decedent:-1ltGL (l1.lJ1a (fIW---A ) Date of Deathl it? - /9 ::'. [1 '7' , I Wi 11 No. ..J.!t!J..~2----- Admi n. No. Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the following with respect to completion of the administration of the above-captioned estate: 1. State wnether administration of the estate is complete: Yes L/ No____ 2. If the answer is No, stat.e when the personal representative reasonably believes that: the administration will be complete: 3. I f the answer t.o No. 1 is Yes, state the following I a. Did the personal representative file a final account with the Court? Yes_._ No. /'. b. The separate Orphans' Court No. (if any) for the personal representative's account is: c. Did t.he personal representative st~ an account informally to the parties in interest? Yesu No______ d. Copies of receipts, releases, joinders and approvals of formal or informal accounts may be filed with the Cerk of the Orphans' Court and may be attached to this report. Date I -l-\-\c.:(" 3::;5l 11 J I ~ ~,(.Y' (' (l/l/'-- ~ure~ .1.0 L 1\ \(j{\", nT') IAIV c.( N Name (Please t}:pl!' or print) I "J:(.2v.lfl.e / J<?D U), C ~elJs.)e fb.-- Address . I 0/'11 Rt/9 - 77 >? 0 Te 1. No, Capacit.YI Personal Representative \t. . Counsel for personal --r--representative (MAH I rmfl AM3)