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79-00629
j i (I" . INST~UCTIONS To In.~re proper cre~lt to your occount,thenamo 01 tho estato on~ file number should be blearly'prlnt.~ on'trecheck orh1oney order,' .' . " This determlnollon and olsonmqnt ISfl1odoln accordonco with Section 421 and Soctlon 7,32 ',01 the ,Inheritance a,nd a.tqlo.TaxAct 011961,721".5.2485-421,732. , The05ll1te tax, Imposed by Section 4Z1,Is dUll at tho dato III tho docedent', doa,thbut ,sholl no,! bocllme delinquent until ,tho expiration III alghtO\) n (18) months aftor Mcodont's doath 'provldo~ that any lI,stolo tax occasioned by o,llnol change In tho Federal return or 01 Iho'\oxdue thoroon sholl not become delinquent untllthe expiration III one (1) o1Onth ufter tho persoidloble to pay the tax recoivn Ilnol notlco of thelncroase. Calculate Interost from the dllllnquont dote shown on tht lact '01 this form to the dato of payment using tho follo\,!lng Intorost tablel ----~~~----------------~--~-----~-~----------~-------------------~-~--"~--------- 1 month .005 4 months .020 7 months .035 10 months .050 2 months .010 5 months .025 8 months .040 11 month. ,055 3 months ,015 6 months ,030 ' 9 months ,045 ,12 months .060 1 day .00017 11 day s ,00186 21 days' .U0352 2days .00034 12 days .00203' 22 days .00369 3 days .00051 ,13 days ,00220 23 days ,00386 4 day. .00068 14 days . .00237 '24 days ' ,00403 5 days .00085 15 day,s .00250 25 days .00420 6 days .00101 16 days .00267 26 days .004,37 7 days .00118 17 doy s .00284 27 days .00454 8, days .00135 18,~a YI .00301 28 days ,00471 9 days . ,~O 152 ,19 days .00318 'J!} days .00488 10 days .00169 20 day~ ,00335 30 duys ;00500 '" -- .. - ,. .." ".... "-' t___________~---_________________________~-------------_________~~---------------"- , Ant pony ,In Interest, Including tho Commonwoalth and tho porsonal repruentotivo, not sot,lsllod Vllth,the O$$ossmentmay object thereto witHin sixty (60) days aftor recelpt'of this ' 'IIO.tl,coas Provided by Section 1001,01 the Inhorltnnce and Estate,.Tax Act 0(.1961(72 P.S, 02485-1001) , . " " Make checkor,fI1oney order payable tal "Roglstor 01 Wills, A~ent"" ' Moll to tlio uddress listed b~lowl \ jj",L 6.kl :':Ir;" j'! n ; ,'~)I l7' :; Ii ... , United states Estate Tax R,eturn , Eatat. 01 eltlzen or resld"lt 01 the United State. (SlIe aoparaI1lInttn1allona,) FII. within 0 llIontht .Iltl d.lo of dutil, IRS u\t D~I, 0.1. tmlvt.d ,""''''' 70S ! Ih'~";' h*,,' t914) Ufltf41f1nfll If !h,lrt'\IU, Ifll.,II.I'II..",I\;' ",...1.. --- lllHl.~.nt'M IIr.l n.ma,and mlddla Inltl.1 Oacldln". 1..1 nom I Dote or denth HUSSBf,L C.. KlDD, Septomber 27, 1.~"6 -...,.- ,- " ' --....-----..........-- --.--.,........_--..-------,-~_... --.-.....---. , ,..----.-.. Domicil' et tlm. 01 dIRth ,. ,VOM dOlTllcll. "tlbll.h,d Deced.nl'l ,acini ucurltr nllmber Came Hill, l"onnaylvuni" ,.--.,.~~66 _ 209-20~0246 " Exlcutall, ,dmlnlltraloll'(llIcludln. ,nolll.t)! Rl(ac~lolaand ndmlnlttr'lol"), or parton, In oo",lnlon or f1loperty , ,N.ml DUIIBn,tlon ,Mdr... (Numb.r .nd It,ut, olty, et'I.. 'n~ ZIP co~.) .. "'... " , , None Appoint:~d - NO PH BATE ESTATE .---- --- - , ,- Aftornlrs r,p~"lntln' \!!!.. .aht., If 'ni... , , ' N4Im' --,-~-_... _...... r Atldt...(Numht, ,"d -"'H'. clt1i 8t.,., Arwt tiP CQd.~ ---..+:..:.0- , , T.l,phc,n. hUlnMt '. William Foaren, Esquire 31 North Bocond stroot Harr iElburg,pcnnsy1vanfa l'/lOJ '717/23B-1731 DeclaratiOn under :16 C.F,R, 60, 1.502(,0)(3)(11)" rolulO ~lIpared by 'on attorney ,. ' '1 , Ponns~lva a I dill." tMII.", (thtAli-~OCIx:.nOffl.,(KU"M.M-tt ,......11\111. 'h..."t'j 1M l~'t 1.'" CUfrtfltl. qu.llfltcl to pflcUe-tllt ltl. SUh' ol.................tI.'....,.r T...t....... '(ili...il~.,~..i~''''~,~~t~,,;f... '<:..................,' ,.............:.::::.:..........'..:..........:.....,............ .., ...~ i~i.,~t.'J,.l. Ne'1l1 end loc.tion 01 coUrt whera will WU p,obalad Or ..tal. admlnlstalad Ca.. number " ,. -'" --- -, ,,- ',.-..,.- " deO~denl died teslala ch.ok hare 0 and atl.oh . r.ortllled copy of thl will, . Compulal1on 01 Tnx - tl., a pllor ..tala tu re\\lIn bun fll.d. havo any pllor .olat. tax parmonls blon ma~e' or, hava oert.ln mOlket.bl. \)nlllq St.tn Trl.'ut)! bcIndl h..n redlamed 81 explalOftd In Instll/ctton 51 , . . . . . . , . , .0 Ve. D\l No ""VI." .ttach e~ 'an.l/on, ' ( I - ,1229141 ~ Total BtOn el,.t. from F1ec.pltu 8tlon, pi'lSI 3) , .. t' I t I . I. . '.' ,................I..........!...... - a Total .1I0,w.bll deduction. (from Rec.pltulatlon. pas' 3) . ,.........~.%~.o.;~tk;~g.. ' ! 3f.Jcemptlon, . , '. , . . '! . .., . . It Total ~aduotlona'plUt exemption. . . , , . . .. .. ,. .... 123 rOll. 4<; ,ll Taxable asia.. (ltem,t mlnUlltlm 4.)., . ,'_' . . " ~_' '. . ,., , . , - 0 - G Om.. osta'_ tlX. (Ule 'rabl'A In' separata 1"ltructlons.), I I --:--. . . . , '., . ::::::::~:::...~..:::::9:::~..:: '7, Cledlt for Stale, death ta,x", (u.. Tabl. B ,In .eparata lltatructlonl and furnish clodlt ovld.ncl.) , . 8 Oro.. "ta\." tnx I... clldlt far St.to death lax.. (It,,," 6 minua Itam 1),TI\I. lolh. nitt .mollnt p.yablo unless crodll for F'!,cJ!ral Sill ta'91, f<!':!1!!~ d.a.!!!.~~,!...,:!!.!.~~ on prlol trontf.r~~almtd IMPart III. ..........,......::'...0...:... II 'Cr.dlt fo, Fe~.I.11I1f1 tax.a, (Attach oompul.tlon,) . , . . , . . :1::,'..,........."..:,....,... 8 ~~. ~;~:: ::~ :~~el:~ ~~~~".::~:~.~~~~d~h:~~~~~l~~' ~:D:m .10~C~ I. .r.:ulr~l.~ C.....'...... ............;; ~ 12 'rutal bI credit. unde,r Part III (tol.1 of Itama !I, to. ond 11) , .., . . 13 N.Ulli:1l!..~lIbl" (1lem l!.J!lI.nuI Itom 12) '. . ' ,'. .....;.."" , ,'. , .:.-cr~ 1'10." olt,lol\ l~ ""c....ly ou,Uf!!!m"ntal daout11!!,"t,s: ~oo 1".lIuetlon r" _ , ,,- tl"~" r.i'ltllltl ClI,pttjUIYf I dHhlt ',hllhI11t1UIn1InCllldlh, 'H(lm~.nrll\' ".hm.n", hat lIun .,.mlll'" b~ fflt, .lIdl.. tQ 1M bnlol till kn...ltd.t.ftlI b.UelI flU'. tO"UI, 'Il~ COIlipl,I., I pflplltcl I1y . ~'11011 'lhtt' IhU\ th. un:lI 0', ,dmlnUh.ltIt, 01 P'''I1" In po"t"lon ,I ~IOp.r1,. hh declmUon II I>md on ,lIlnvlin.llon 01 -,hl(h ht "U '11, kl'll1'lfltdu, , (. . 'iij,;~.;?,1;(;':Ji0i~l~i;;'~'~\: ..r;..~;/lJ~;i,':.{;,tp'~"ilii"""""""""""'" .......',...l,......,.. .......................,..... .............. ..... h,'" ........ ..~....... ......h.. ,". ............. ............ .".',....... .........'... ..-......, .....n.....~H.................. ....... ..................... = .~ .... :f!-l.U: J...?..?.. ; 011' ..."".....;',...,..........,.:",...,..."...,.........",,,.........,,...,,.....................................'....7tl:......,9J ........... " ,..(,.(" .,.. ........j.... j ,/2' ,', '7 I ,../ '2 / Pi.>' f"vt L/-I, " I' ? .,',:..-::),::.:;....:::.::(~r.,:::.:::::.::..:::-::.~ ..:.".) ," ...,,/1..., "...:~,;..:.,..:1..,.:.. :""./." ,~:".~.~~?:~ 1 O,::..~. .. .",.,,?f".... Slrl'llhlt. " pJlpm' 0111. t/llll 'lIt14lllr, .U.,'. ~ddt." h"d ZIP (;Qlhl ,. 'tn., , "'t. Of he. IIC! ".. ,0.1' ---, '.--. "" --, - , 23'-149321(, /." ?(i ;_/ " I ',/~/l,j / r9" .