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Home My WebLink About80-00720 ..~).\.., ;~~;;;. . tit.~{:"~'~~'~-:: ~. ii~f {j?",''-'J"..-".. '..-, ~~i~,,~,;!:, ..:i1;':'1"':' I~{ """""",'~ , l/-J?""'l;'f'- ~t(":::,-,,, '~~~(::.~~t, ~{"+"">' " Irl1j ~;V>,;". ir.0)i;!~,i ~"r' " :iit;')ir." " ;&,1r-';\"'" , >~\-14\.'~ .,. \-('$'_'':.' ~):'.:I"' :~0.?:: iv. ~,."" Itr 'if~,t..." " lrj~,r,~''':' ,,,-~ ~"'p \ ' tll~8 ~~2r: to:. f1;,~.~,:..';~" " r.t:!~r;,,', ,:,'~'i\... " ,,", :' ~: ,'.,: 0 \_', >< ~ ~ . ~- .. , ~ .. ~ .- ~ ." tI): :J tI) ~ .. m H i , . rx. fj I C- O tI) N ::i: ~ ,'.. I'- ,~ u C) OQ I '''..- ,N - o . o Z B ID - '" LIJ ~ ::1~~ ,,'::if. '\''.\l~ ii ,<,~ .,;,:;,:\,';};i;~~ ';'. ',' G: Ctc No. 21.80 '720 PETITION FOR PROBATE OF WILL AND LETTERS TESTAMENTARY in the Estate of F.VA jI HEMl'H.lLL , deceosed. MARY C. LEWIS To Richard L Andcrson, Register of Wills for the County of Cumberland, in the Commonwealth of Pennsylvanio. -t5' Petitionerls) are the execuL_d&e.s_ named in the Lost Will and Testament of EVA M. HEMPHILL dated Sept. 24. 1970 Decedent was a citizen of the United States ond a resident of Tewnship- Borough, Cumberland County, Commonwealth Carlisle of Pennsylvania. Decedent died on Tuesday the 4th day of November A. D. 19 80 , in the County of Cumberland State of Pennsylvania at the age of 95 yeors. ~ .fle5. her Decedent has not been married and has not hod children born to ~ since the execution of the obove described Will. Decedent was possessed of personal property to the volue of Unestimated and of reol estate to the value of None as near os can be oscertained; said real None estate situated os follows opply Therefore, your petitioner(s) respectfully ef.l~ligs for the probate of the said Last Will and Testament and for Letters Testamentary thereon. Dated Nov. 10, 1980 Nome and address of Petitioner(s) .. ~Q ~Y>~. r-. k4?MtQL; QJ!... Evelyn :; C. Hemphil . -\- 1&(0.., ~ tV." ~ ~n, ' ,2\{.tl"""(?!.l ,-L'L1t. Dorothy . Hemphill 643 North East Street Carlisle, PA 17013 COMMONWEALTH OF PENNSYLVANIA ~ ss COUNTY OF CUMBERLAND Evelyn C. Hemphill and Dorothy M. Hemphill named in above opplication, being duly say(~ that the statements set forth in sworn according to law this petition are true to the best of knowledge and belief, their sworn and subscribed before 9~/) 'k .'.. /1.1~ O'~ (\ C--1- " f' Ii" L: \-S)~'L\...l\...\:..l{f". \'-,dfl :-'~Il. ,,",,' \~ \l.....l.. 'l..~ me, Nov. 1O;t: 19BO u. A a,'L~ ~~I.ld C. A 30n, Register MARY c. LEWIS zJ -'-" i:l-f!- WILLIAM F. MARTSON, P.C. Ivo V. Otto, III, Esquire Attorney: Filed; November 12. 1980 "? t.,f-Q . ;;La ... , '. .a:. ' . . ;.~.. "'- MART50N 8: 5NeLDAICI:R ATTORNCYS AT LAW , . ., .-. .- LAST WILL AND TESTAMENT I, EVA M. HEMPHILL of the Borough of Carlisle, Cumberland County, Pennsylvania, being of sound and disposing mlnd and memory, do hereby make, publish and declare this to be my Last Will and Testament, hereby revoking any and all former Wills or Codicils by me made. 1. I direct that I shall be interred in the Family Plot of the Newville Cemetery, adjoining the William P. Caldwell lot. 2. I give, devise and bequeath, all of my estate, both real and personal property, unto my husband, WILLIAM J. HEMPHILL, absolutely, and I hereby appoint my daughters, EVELYN C. HEMPHILL and DOROTHY M. HEMPHILL, as Executrices of my estate. 3. In the event my said husband shall predecease or fail to survive me, then I give, devise and bequeath all of my estate, both real and personal property, in equal shares, unto my daughters, EVELYN C. HEMPHILL and DOROTHY M. HEMPHILL, absolutely and I appoint my said daughters as Executrices of my estate. In the event one of my said daughters shall predecease me, then the survivor shall take the entire estate and be the Executrix of my estate. 4. I give the sum of One Thousand ($1000.00) Dollars to FARMERS TRUST COMPANY, Carlisle, Pa., to be held IN TRUST and the income paid to the United Presbyterian Church of Newville, Pa., as a bequest in memory of my Mother, Anna H. Caldwell, and sisters MARGARETTA and BLANCHE. This bequest is conditioned on said church not having merged with the Big Spring Presbyterian I I i I , , ! , i I I \ 1 I I ! ! i ; I , I I I i , I , I I I . ".~ " . # .... l -' . ~.. ," .. Church of Newville at the time of my death and if such be the case, then this bequest shall be null and void and the same shall form a part of my residuary estate under the following paragraph. 5. In the event neither of my daughters shall survive me, then I give, devise and bequeath all the rest, residue and remainder of my estate unto FARMERS TRUST COMPANY, Carlisle, Pa., IN TRUST, for the purposes herein set forth. My said Trustee shall hold, invest and reinvest the principal of this trust and shall accumulate the income arising therefrom for a period of two (2) years from the date of my death. Thereafter, all income arising from the trust shall be paid to the Trustees of the Governing Board of the Elizabethtown Crippled Childrens' Hospital, Elizabethtown, Pa., to be applied by said Board for any surgical procedures, braces 0r other appliances for any child or children who shall be deserving of such financial assistance in regaining their ability to walk. The disposition of this income shall be at the discretion of such Trustees or Governing Board. I hereby appoint FARMERS TRUST COMPANY, Carlisle, Pa., as Executor of my estate under this fifth paragraph of my Last Will and Testament. IN WITNESS WHEREOF I have hereunto set my hand and seal this 14t~day of September, 1970. 9 '1 ~ h' t: Vc[ Ill. _l.<Y1vP/ ;.J'L (SEAL) V SIGNED, SEALED, PUBLISHED and DECLARED by the above named Testatrix, Eva M. Hemphill, as and for her Last Will and Testament, in the presence of us, who, at her request, have hereunto subscribed our names as witnesses thereto, in the presence MARTGON & SNl:LBAKl:R ATTORNEYS AT LAW 321 OATH OF SUBSCRIBING WITNESS COMMONWEALTH OF PENNSYLVANIA I ss: COUNTY OF CUMBERLAND \ ,10th November 80 ThIs........................................................,.............., day of ,.....,................................ , ,...................... , A.D.. 19........, MARY C. LEWIS before me ijjg~~ Register for the Probate of Wills and gl'llnting lelters of Administration in and for said County of Cumberland. in the Commonwealth of Pennsylvania. personally came .............. .""..,..., ,..,',.......:.,.>>!~;J,.+.~~m.".f,:.,...k!~!,t:!lR,TI"" ",~J::l,g" ,"" F.-~~!}".,.F.-, :".,'~9.~~...,",.,""',.,..,.".,' ,." ".",.. ...." ,. the subscribing witnesses to the foregoing instrument of writing purporting to be the last Will and Testament of "..""..,..,Yf..Y.A.. . J1... ,.. ,.l:U;;!:W,!iJ1J:;, , ""...""", ",." ..,."" ".,.,.,." ".., Dated ~~.?,~,:,..~ ~,I,..,~.? 7.,9".,..... late of ................G.aX'.l.j,Il.l.~.....~R,+.Qh1,gh..,........................,......................... Cumberland County Pa" deceased who being duly ...........RW.Q,J;n..................... according to law. depose and say. that ......~~,~y....~~::.~............. present, and saw and heard the testa,t:r.,:!.,<>......................, ..........);:,Y.4.....!1,:.....tI,;;~,~:J;J:.,1........................... sign, seal, publish, pronounce and declare the said instrument of writing as and for h..~E.......... Testament and Last Will. and at the time of so doing ..............,(l.h~............................was of sound and disposing mind memory and understanding, to the best of ..........kh~.~L.......................knowledge, observ 't and belief. mmm ,od ,ob=ib<d b<foro j)JL,,'m~~m f~~~' ......................... .................................................................................. AFFIDAVIT OF DEATH COMMONWEALTH OF PENNSYLVANIA I ss: COUNTY OF CUMBERLAND \ ........,..,.., ".......Ev.ely.n."t;;"",U~mp.h,:(.J;J",.,' ~[l,9..,',.~R!,9.!;hy. "..,J:1:.....,~,~.I,I!p.~~ ~.~",.,...,",...".".,., ".being duly ..................l\w,Q,m................... say. that as nearly as can be ascertained the said decedent .......................... .",...,........., "",..'"... ,.,...".",......".,..,..".",..f,'j,4.."k1.."" "~~,~tI,p~J:.,.,' ,.,." ",..,.."., ,. '.',.."""..'"..,..', ,..."" ",died on .........:J:ue,~,d~y....................... the ..........4t!;h..............,day of ........~!?,~~~~~::........................... A,D,. 19.~~.., at or about .......................................... o'clock. ....M, ................~~~;7',~.......,................and subscribed this ...........................}.9.!:!:.........., day of ....,!'!!?,~~~~E, 19,~R....., before ,." ,:f,\ ,:~..~,l,:.~..,. ,~:...k~f;.""V..( l.~.(,~.".,..,..," . ~"-t.-'-\}...\..\.'-~ '--)l\,j':,\f j~-"-f3~.~\"...\S--_. ."..~J..4Jc!..{!...,#f.. ,c:~(:~,:::/.............., Rioboxci~, Reg' er Mary C. Lew s OATH OF PERSONAL REPRESENTATIVE COMMONWgALTII OF PENNSYLVANIA} , COUNTY OF CUMllERLAND 55: Before me. the Register for the Probate of Wills and granting of Letters of Administration in and for the County of Cumbel'land, personally came ...E)le,ly.JJ...C....,Hemllb.iU..,aJJ.d..D,aJ:o,t:hy..,M.....H.e.mphill who, being duly .......,.i,~QX',n........, do .......... depose and say that as..........E)).~a!.\t:J:;i.c.e,s............................. of the last WiII and Testament of .......................EVA.....M.......J;\EM.P,HIl.L..........................................deceased .....I;)),~y........... wiII well and truly administer the goods and chattels. rights and credits of said deceased according to law. And atso wiII diligently comply with the provisions of the law relating to Transfer Inheritances, ...........~~.'?~!!...... and subscribed before me. .............~~,"f.~~.l?~!:..,~~.................. A, D., 1l'P.~......... ..~iU .a.~~...................... MARY C. LEWIS ,,' ,.X,:, :~:A~~;}",...,.,f.,.,..J.+.:;..'\;.'..'aIJ;\,~.:"lL....."... ,...~.~~:-:.~~.~:-:'.~:::n~..j~..!X~\1';;')...'><\-r.~..,.: :..; 0: : 0> "' ~ :~ . 0> 1"""4: : " :0> :Q o:jo u.. 0) .'I: :IF 0 0 .'I: N: N H: ....: ::r::: ...: r- 0: ....I p..: 0 k: N: :<:: 0 t': ....I gjj ell Cll: I: - ~j 0: - 0): - ,~ .: S .: ~ u: Cll: I: ~: \:-I: :>: c; ....: ..;: .6 W: 0: N: Zj 00: :>: '"d W: 0> 0: . : 0 '"d _: Z ... N: c-c; 0 C"l: " i'l Q) :IF: S ... Q) '"d 0 '"d l:lD Q) "' <= ~ - Z r.::l ~ ~ ii: DECREE Be it remembered that on the ..........~,~~~...... day of .............~,?~~,~~~,':',~................. A, D,. 19 ~~...., there was probated and recorded the last WiII and Testament of ......~,~:7..,~.:...~,~,~?~,~,~,~.................................., late of .........~.'i':!:,H!!J.l?,.......................................,........, Cumberland County. Pennsylvania. Deceased, Letters ............. .......?;~.~,!;,'.l,~!:,~,t:~,;-,y.,...... were granted to ..,~~,~ ~X,~,S.:... ~,~~)?,J:!~,~, ~..,~..~,C?,7:~,~J:!X...~,:...~~~p.!}.~,ll Witness my hand and official seal the day and year aforesaid. ""'3 00' . . -' REVa~17 (ea181 COMMONWEAL TH OF PENNSvLVAHIA OEPARTMENT OF REVENUE BUREAU OF FIELO OPERATIONS APPLICATION FOR AND CONSENT TO TRANSFER SECURITIES REGISTERED IN THE NAME OF A RESIDENT DECEDENT *, --~_.__._._~-~. DATE__Ja..nuary 20. APPLICATION (MUST BE FILED IN TRIPLICATE) TO THE PENNSYLVANIA DEPARTMENT OF REVENUE: Application is hereby made lor consent to the transfer 01 the lollowing securities of 0 Pennsylvania Corporation or a National Bonking Association located in Pennsylvonia: (a) 106 (b) Commonwell1th national Bank ____.(c)_c!)nrnon stock (NOTE: In describing securities enter in (0). ab Ole, either Ihe number of shares 01 stock or the face amount of registered bonds, in (b), the name 01 the issuing company and in (c) the closs 01 stock or the stated interest rote and maturity dote 01 registered bonds.) 4/1/80 - 105 shares ISSUED ON 6/30/80- 1 share; and having a TOTAL MARKET V HUE OF S _?.L56. QQ (Dale) as of the date of deoth of the decedent EVA M. HEHPHILL , (Name of Decedent) , onNovember 4. 1980 (Dote of death) who was late of 6[.3 North East Street, Carlisle. Cumbertl1n<,L_____~m!!i'lvania (Street ond Number) (Post Office) (County) (Slate) The securities are registered as follows: lalliam J. Hemphill and ~va H. Hemphill (Name or names in which cerliflcates arc registered) ADMINISTRATOR) EXECUTOR ) Street. Carli~le~aJ-170l3 (Addrc!os) Hil1iam F. Hartson TO-East-High Street COUNTY FILE NUMBER 21-80-720 ADDRESS OF APPLICANT Cl,1rlis.lc, Ph l7~_ BUREAU FILE NUMBER SIGNATURE OF APPLICANT [t/LL11' r;:?rric~ NOTICE: IF YOU FAIL TO PROPERLY FILL IN ANY PORTION OF THIS APPLICATION, IT WILL NOT BE CONSIDERED COMPLETE ANO WILL BE RETURNED TO YOU FOR COMPLETION, Evelyn C. Hemphill and Dorothy M. llemohill 643 N. East (Nome) NAME OF APPLICANT COMMONWEALTH OF PENNSYLVANIA - DEPARTMENT OF REVENUE (~ CONSENT TO TRANSFER SECURITIES \ -- ~O DATE ~ ~ ; I hereby consent to the transfer 01 the above securities noW registered in the nome olth olores'aid ( C( ,fj Decedent and waive the filing of a certificate certilying to the payment 01 the transfer inheritance tax to which the property of said Decedent is mode subject pursuant to the provisions of the Act 01 June 20, 1919, P,L. 521, os amended and the Act 01 June 15, 1961, P.L. 373, os amended, This is also in accordance with the provisions of the Act 01 April 9, 1929, P.L. 343. This Consent to Transler the ~erein described property operales only in reference to the estate of the above-named Decedent. ~~~ i....... ~ ~ p A.. Tj ,{H,,;. ~, I-.~..."-I "IJ::"~...~L\t Signed for the Secretary. of Revenue B;J~(J1il~L.,~'t-V\1..in) /\ZO.b-"'1~ (Sir \"c) , ,) ~t ::1~" 1:1~:;-\Jt- ..J.li .l'l C"w.h\j.~~'f'~' -l j (-f1tla,\ - (County) '-. COMMONWEALTH OF PENNSYLVANIA OEPARTIoIENT OF REVENUE BUREAU OF COUNTY COLLECTIONS APPLICATION FOR CHARITABLE EXEMPTION FROM PENHSvLVANIA TRANSFER INHERITANCE TAX (Act of May 28, 19S6, P,L, 17S7, and Act 01 Juno IS, 1961, P.L. 373, al amendod) Application is hereby filed lor the approval of an exemption from Pennsylvania Transfer Inheritance Tax on the transfer of tha property described balaw: 1. Bureau File # 21-8_0-=-OJ20______- ----- 2. Date of Death _~ember 4 I 1980-- - . - 3. Date 01 Approval .!::d)Ltd2~-~/-fXL 4. Name 01 Decedent E"a 11. Ham hill 5, The Commonwealth's appraised value 01 the property lor which an oxemption is claimed is S -.L. 000 00 (Note: Where the property is other than a specified amount of cash, the exemption cannot bo approved until tho value of the property has been estoblished by appraisal by the Commonwealth, except in those cases where the amount of the gilt or bequest represents a stat~d fractional or percentage portion of the entire ostoto or tho entire residue. In those cases enter such fractional or percentage amount above). 6. Check the manner in which the transfer was effected and submit 0 copy of the document authorizing the transfer, unless such material has been previously filed, WILL t/.; DEED 0; TRUST INDENTURE 0; SURVIVORSHIP 0; OTHER 0; (II other, explain) 7. Correct Business Name and Address of Charitable Organiz.ation receiving property: NAME First United Presbyterian Church ADDRESS 111 Big Spring Avenue. Newville. PA 17241 o See listing on reverse side far additional charitable organizations covered. 8. I certify that the information contained herein is, to the best of my knowledge and belief, true and correct. Signature of Applicant ~~d";( ~e~~iit" Q ( 1'&1\.A..':;...~1il!nj~ Doroth M. Hemph 11 Add,e.. al Applicant 641 North F.~st Strppt, r.~r1is1e, PA 17011 This form must be completed in triplicate and all three copies delivered to the Reglsler of Wilh for the County in which tho decedent resided, or in '.vhlch letters wore Issued for a non"resldent decedent's estate. If the decedent was a non"resldent of Pennsylvania and letter. were not Issued by a Pennsylvania Register of Wills, deliver 011 three copies to the Director, '3ureau of County Colloctlons, Penna. Department of Revenue, 26 S. 4th Street, Harrisburg. Po. Offlciol Title Executrices Date l'>p .../, .1tC, /'7 J' / Do not write below this line. For Official Use Only REFER RED to Bureau Headqua,ters Approved 0 For Secretory of Revenuo Denied' 0 (Initials 01 Register of Wills) (Authori.ed Signature) (County) (Title) (Dote 01 Relerral) (Date of Action) . See reverse side for roasons MUST BE FILEO IN TRIPLICATE COMMONWEALTH OF PENNSYLVANIA COUNlY OF CUMBERLAND I J ss: __________ ...EVELYN_C_.___HEHPHILL-and _ DOROTHY__H., .J1I;:HPHI1_L being duly ---Sworn----.- according 10 law, depose. and say. that thoY _ are the _Exe_c_u.tti_Cl'!_lL______ ___ ______ of the Estate of EVA M , HEMPHILL late of _the Borough of Carlisle __ _______, Cumberland County, Pa., deceased and that the within is an inventory made by Evelyn_C.__Henllhill-&-Iklroth)t-M.-HenphilL, the said 1':><",,"1""; "F>" of Ihe entire estate of said decedent, consisting of all the personal proparly and real estate. excepl real estate outside the Commonwealth of Pennsylvania, and that the figures opposite each item of the Inventory rc resent ii's fair value as of the date of decedent's death. e C". ~ ' jJ --/-- Eve yn C. Hemp ~ ~,;.t.:-~-z.. f/ L.., and subscribed before me, t'\ ' ~t\.-L~x:t~ 111 ;1.Lt,-"""Jo~JJ Q.Q. Dorothy M. ~.cutor . ~ Herlq)hill }11ti. ,,--",I; "CJj C~'- .2 ~, ;::f, 9~'-'L-f 19 ~ I 643 North East Street I'lIlLlAM L, EARP, Nol.ry Public Car!i:l(', Cumb~r1and Co., Pd. My Co:r.m::!;;j;'j Expire:. AIJ]. i~. 1961 r.",.1;"1,, PA 1701~ Addun Date of Death 4th O'Y November Month 1980 Y.on INSTRUCTIONS I. An inventory must be filed within Ihree months after appointment of personal repreoentetive, 2. A supplement inventory must be filed within thirly days of discovery of additional assets. 3, Additional sheets may be attached as to personally or realty 4. See Article IV, Fiduciaries Act of 1949. l.; L ~ '_,0.. ~::-:. ~ u Cl_ ....c.:. ii:~. ::-'W "'-' =r:; 0' r--- ".,(-.. _0"- C)!. N '-<.1. Uj; ~ 9::_J 0' ocr: on: 0:"'''' ::c ,w OG vCU Uw --:>: :::10:: - ""=:> :c ~u ,J:: u >- ~ ,; 0- W 0 " k ~ ~ 0:: S ~ w 0 " 0.. ~ U 0 0 Vl " w 0:: w c I- J: 0.. Q) Z 0- -' U. ..... ~ u. -' <( 0 J Ol 0.. i W 0 <( w ...l ,;. 1\ > z 0:: ..... + Z 0 Q H c <11 ~ .; Ii Vl z 0 0:: U Z w <( ~ 0.. "" C ~ ~ I - ;: 0 " .0 " E + , . ~ , ...J U " '" '" '" :0- m c ~ o := < .... "" .! u: .>< o o ... Inventory of Ihe reol ond personal eslole of PERSONALTY: 1. Checking Account No. 4-1765-3, Farmers Trust Company, registered in name of decedent Date-of-death Balance 2. Checking Account No. 412-300091-3, Commonwealth National Bank; account registered jointly in names of decedent and W. J. Hemphill, who died October 15, 1971. Date-of-death Balance 3. Statement Savings Account No. 41-1086065-9, Commonwealth National Bank; account registered jointly in names of decedent and W. J. Hemphill, who died October 15, 1971. Date-of-death Balance Accrued Interest 4. 106 shares, common stock, Commonwealth National Bank, CUSIP No. 203155-10-6, registered in the names of William J. Hemphill and Eva M. Hemphill as Tenants by the Entireties. William J. Hemphill died October 15, 1971 Date-of-death value $26.00 per share 5. Optional Savings Account No. 002-00-07949, State Capital Saving Association, account registered in name of decedent. Date-of-death Balance Accrued Interest 6. Savings Account No. 1-23197-5, Farmers Trust Company, account registered in name of decedent, with Dorothy M. Hemphill, Power of Attorney REAL ESTATE: NONE EVA M. HEMPHILL deceosed. TOTAL REAL ESTATE NONE NONE 236 65 - 0 t I 2,782 18 1 60 2,756 00 3,033 43 57 54 Date-of-death Balance Accrued Interest 2,101 61 38 09 TOTAL PERSONALTY 11 ,007 10 RECAPITULATION TOTAL VALUE REAL ESTATE TOTAL VALUE PERSONALTY TOTAL APPRAISED VALUE $NONE $11,007.10 $11,007.10 ... EENNSYLVANIA INHERITANCE TAX GENERAL IN FORMfl.T10N 1. PERSONS RESPONSIBLE FOR RETURN Section 701 of the Inheritance and Estate Tax Act of 1961 provides that ihe fOllowing lJersons shall prepare and file a return: a. The personal representative of the estate of the decedent as to property of Ihe dec(;denl :,t1ministered by him and such additional properly which is or may be subject 10 Inhelitilnce Tax 01 which he;she shall h;1'1c or acquire knowledge; b. The transferee of property upon the transfer of which Inheritilnce Tax is or may he imposed by the 1961 Statute including a trustee of property transferred in trust, provided lhal no separate relrHllneed be made by the tlansf~ree of properly included in the relurn of a personal representative. 2. PLACE FOR FILING The return is to be filed in duplicate with the Register of Wills of the counly wherein the decedent resided. 3. TIME FOR FILING The return is due nine monUls after the decedent's death, unless an extension lor filing has been applied for and granted by Ule Secretary of Revenue within the nine-month period. 4. FAILURE TO FILE RETURN Section 79\ of the 1961 Stalute provides that" . . .any person who willfully faits to file a return or other report required of him. . .shall be personally liable. . .to a penalty of 25% of the tax ultimately lound to be due or $1,000 whichever is the lesser to be recovered by the Department of Revenue as debts of like amount are recoverable by law." 5. TAX RATES Inheritance Tax is payable at the rate 01 6% on transfers to lineal descendants, such as father, mother, husband, wife, son, daughter, grandchildren, grandparent, son-in-law and daughter-in-law and at the rate of 15% as to ali others. 6. PAYMENT OF TAX The tax assessed on the transfer of property reported in the return is due 9 months after the decedent's death. Interest at the rate of 6% per annum accrues thereafter until payment is made. All payments received are first applied to any interest which may be due with any remainder applied to the tax. IF TAX IS PAID WITHIN 3 MONTHS AFTER THE DECEDENT'S DEATH, A DISCOUNT OF 5% OF THE TAX PAYMENT IS ALLOWED. All checks should be made payable to the Register of Wills 01 the county wherein the decedent resided and are received subject to the final determination 01 the Department of Revenue. 7. FAILURE TO PAY The taxes imposed, together with any interest thereon, are a lien upon real property, which lien remains in effect until the taxes and interest have been paid in full. The taxes may be sued lor against any real property in the decedent's estate or against any property belonging to a transferee liable for the toX. 8. FILING OF FALSE RETURN Any person who willfully makes a false return or report required of him shall, in accordance with Section 793 of the 1961 Statute, be guilty of a misdemeanor and, on conviction thereof, shal! be sentenced to pay c: fine not exceeding $1,000 or undergo imprisonment not exceeding one year or both. " REV-4S0 EX+ (3.S0) COMMONWEAL TH OF PENNSYLVANIA DEPARTMENT OF REVENUE TRANSFER INHERITANCE TAX RESIDENT DECEDENT SCHEDULE "A" REAL PROPERTY '* (Inslructions on Reverse Side) ESTATE OF EVA H. HEMPHILL ITEM ESTIMA TED DEPARTMENT NO. DESCRIPTION MARKET VALUATION VALUE (OFFICIAL USE ONLY) NONE NONE TOTAL THIS PAGE NONE N M1.U . ~ INSTRUCTIONS FOR COMPLETING SCHEDULE "A" i I I I .1 [ I Schedule "A" should include a delailed descriplion 01 all real property locoled in Pennsylvania and held solely by the decedenl or held jointly with anolher individual (s) as tenants in cammon. List Ihe decedenl's percenlage 01 ownership and the eslimaled market value ollhe decedent's inlerest. (Praperty held as joinl tenants with the right 01 survivorship or lenanls by entireties should be reparled on Schedule "E".) All real estate lacaled in Pennsylvania should be described by 101 and block number, street address, number of acres and general description of land and buildings. Also, include the book and page number in which Ihe deed is recorded and Ihe exacllitle as indicaled on the deed. If Ihe praperty has been sold, attach a copy of Ihe settlemenl sheet. If the properly is subjecllo a mortgage encumbrance, include the name of Ihe morlgagee, dale, rale of inlerest and the oulslanding balance on the date of death and attach a statement from Ihe morlgagor verifying Ihe oulslanding balance. Properly laxes and inleresl on morlgages as of the dale of death, assessmenls and other encumbrances should be listed an Schedule "F". Do nol deducllhem on Schedule "A". , REV"'" EX- (3.eal COMMONWEALTH OF PENNSVLVANIA DEPARTMENT OF REVENUE TRANSFER INHERITANCE TAX RESIOENT DECEDENT SCHEDULE "8" PERSONAL PROPERTY *' (Instructions on Reverse Side) Estate of EVA M. HEMPHILL ITEM ESTIMATED OEPARTMENT NO. DESCRIPTION UNIT MARKET VALUATION VALUE VALUE (OFFICIAL USE ONL Y) 1. Checking AccQ\ID.t No. 4-1765-3, Farrrers Trust Conpany, registered in name of decedent. I Date-of-death Balance 236.65 2. Checking Account No. 412-300091-3, eomromrealth National Bank; account registered jointly in names of decedent and W. J. Herrphill, who died October 15, 1971. Date-of-death Balance - 0 - \ 3. Statenent Savings AcCQ\ID.t No. 41-1086065-9, ~alth National Bank; Account registered jointly in nanvas of decedent and W. J. Herrphill, \ who died October 15, 1971. Date-of-death Balance 2,782.18 Accrued Interest 1.60 4. 106 shares, comron stock; eomromealth National Bank, CUSIP No. 203155-10-6, registered in the names of William J. Herrphill and Eva M. HeIqlhill i as Tenants by the Ebtireties. William J. Herqlhil I died October 15, 1971. Date-of-death Value 26.00 2,756.00 5. Optional Savings AccQ\ID.t No. 002-00-07949, State , Capital Savings Association, accQ\ID.t registered \ in nane of decedent. Date-of-death Balance 3,033.43 Accrued Interest 57.54 6. Savings Account No. 1-23197-5, Farrrers Trust Conpany, account registered in nane of decedent, with Dorothy M. HeIqlhill, Power of Attorney. i Date-of-death Balance 2,101.61 I Accrued Interest 38.09 I I i I i i , TOTAL THIS PAGE 11,007.10 I~H1. !k .{I QUESTIONS CONCERNING PROPERTY TRANSFERS 1. Did decedent, within two years of dealh. make any transfer of any material part of his estate without receiving valuable and adequate consideration? (Answer "Yes" or "No".) NO 2. Did decedent, within two years of death, transfer property from himself! herself to himself/herself and another party or parties (including a spouse) in joint ownership? (Answer "Yes" or "No".) .J::ill.....- 3. If the answer to one or two above is "Yes" and the transfers are claimed to be nontaxable, provide the following information: a. Age of decedent at time of transfer. b. Copy 0 f death certi Ii cate. c. Affidavit by the attending physician indicating the state of decedent's health at time of transfer. d. All other information supporting nontaxability of transfer. 4. Did decedent, in his/her lifetime, make any transfer of property without receiving a valuable or adequate consideration therefor which was to take effect in possession or enjoyment at or after his/her dealh? (Answer "Yes" or "No".) NO a. Was there any possibility that the property transferred might return to transferor or his/her estate or be subject to his/her power of disposition? (Answer "Yes" or "No".) b. What was the transferee's age at time of decedent's death? 5. Did decedent in his/her lifetime make any transfer without receiving a valuable and adequate consideration therefor under which transferor expressly or impliedly reserves for his/her life or any period which does in fact end before his/her death: a. The possession or enjoyment of or the right to income from the property transferred? (Answer "Yes" or "No".) NO b. The right to designate the persons who shall possess or enjoy the property transferred or income therefrom? (Answer "Yes" or "No".) NO 6. If the answer to five b. above is "Yes," state whether the right was reserved in decedent alone or others. 7. Did decedent in his/her lifetime make a transfer, the consideration for which was transferee's promise to pay income to or for the benefit or care of transferor? (Answer "Yes" or "No".) NO 8. Did decedent, at any time, transfer property, the bll1eficial enjoyment of which was subject to change, because of a reserved power to alter, amend, or revoke. or which could revert to decedent under terms of transfer or by operation of law? (Answer "Yes" or "No".) NO 9. If the answer to eight above is "Yes," was the power to alter, amend or revoke the interest of the beneficiary reserved in the decedent alone or the decedent and others? (Answer "Yes" or "No".) NO LAST HILL AND TESTAMENT I, EVA M. HEMPHILL of the Borough of Carlisle, Cumberland County, Pennsylvania, being of sound and disposing mind and memory, do hereby make, publish and declare this to be my Last Hill and Testament, hereby revoking any and all former Wills or Codicils by me made. l. I direct that I shall be interred in the Family Plot of the Newville Cemetery, adjoining the William P. Caldwell lot. 2. I give, devise and bequeath, all of my estate, both real and personal property, unto my husband, WILLIAM J. HEMPHILL, . absolutely, and I hereby appoint my daughters, EVELYN C. HEMPHILL and DOROTHY M. HEMPHILL, as Executrices of my estate. 3. In the event my said husband shall predecease or fail to survive me, then I give, devise and bequeath all of my estate, both real and personpl property, in equal shares, unto my daughters, EVELYN C. HEMPHILL and DOROTHY M. HEMPHILL, absolutely . . Church of Newville at the time of my death and if such be the case, then this bequest shall be null and void and the same shall form a part of my residuary estate under the following paragraph. 5. In the event neither of my daughters shall survive me, then I give, devise and bequeath all the rest, residue and remainder of my estate unto FARHERS TRUST COMPANY, Carlisle, Pa.. IN TRUST, for the purposes herein set forth. Ny said Trustee shall hqld, invest and reinvest the principal of this trust and shall accumulate the income arising therefrom for a period of two (2) years from the date of my death. Thereafter, all income arising from the trust shall be paid to the Trustees of the Governing Board of the Elizabethtown Crippled Childrens' Hospital, Elizabethtown, Pa., to be applied by said Board for any surgical procedures, braces or other appliances for any child or children who shall be deserving of such financial assistance in regaining their ability to walk. The disposition of this income shall be at. the discretion of such Trustees or Governing Board. I hereby appoint FAR}ffiRS TRUST COMPANY, Carlisle, Pa., as Executor of my estate under this fifth paragraph of my Last WILLIAM F. MAIH50N. P. C. LAW OFFICeS Witness: l L L~_Q l.':L<~ L \ . L___tQt-..~l..."- . r) -'t- ?,'L'~r f........* I!. /.k-..r>:...u. Evelyn . Hemphill Executrix and Legatee &O-A ,~....(l.t,,~ 7/1 ':}'krHjs-~lLt. Dorothy M. emphill Executrix and Legatee . a ;::j: :-J,....,,-I{' . . REV~53 EX+ (3-S0) COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE TRANSFER INHERITANCE TAX RESIDENT D5CEDENT SCHEDULE "0" BENEFICIARIES *\ (Instructions on Reverse Side) Estate of F.V A M HF.MPHTLT. BENEFICIARIES AND ADDRESSES RELATIONSHIP SURVIVEO DECEDENT DATE OF BIRTH INTEREST OF BENEFICIARY 1701 Da h er One-half (1}2) of lite Residue 17241 Be uest of $1,000.0 er Agr~grnen.t:J2- R~c eJ:ve~_l!f!h Distribution in L ieu_o f _1l~.q.\t~!tL.1n Tr!.!JLt;.._.~.QP'y"..Q..f_ '~attBched. -....----... The above beneficiaries are living at this time except for the following: ___ ..~::..J.'::'J.:-~~::n...'a!.~t'_~.l''''"L,~..;._~~:,:,:,::.:..._-::t NAME lJATI: (11' IlI:ATlt INSTRUCTIONS FOR SCHEDULE "0" 1, List full names and addresses of all who have an interest in the estate either vested, contingent or other interest. 2. Indicate the beneficiary's relationship to the decedent. Specify if stepchildren or illegitimate children are involved. 3. Indicate "Ves" or "No" if the beneficiary survived the decedent. 4. Indicate the date of birth of the beneficiary if the interest is a life interest, term certain interest or a future interest. 5. Indicate the interest of the beneficiary in the decedent's estate. For example: Specific bequests of a diamond ring, savings bonds or cash of $5,000; bequest of 25% of residue; remainder interest; etc. 6. At the bottom of Schedule "D" state those beneficiaries who are not living at the time the return is being filed and include date of death. . . REV-454 EX+ (3-S0) COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE TRANSFER INHERITANCE TAX RESIDENT DECEOENT SCHEDULE "E" JOINTLY OWNED PROPERTY * (Instructions on Reverse Side) Estate of EVA M. HEMPHILL P ITEM TOTAL \ VALUE OF DEPARTMENT DEseRI PTION MARKET DECEDENT'S VALUATION NO. VALUE INTEREST (O((/e/.I lire OIl(Y) - l. NONE NONE NONE I , ! i \ i i ! , I TOTAL THIS PAGE NONE f\l,c-nu J..'nG , v INSTRUCTIONS FOR COMPLETING SCHEDULE "E" Schedule "E" must include all property, real and personal, owned by the decedent jointly with another party or parties as joint tenants with right of survivorship. Both tangible and intangible property are to be included. List real estate first. 1. Describe all real property as indicated in the instructions for Schedule "A". Describe all personal property as indicated in the instructions for Schedule "B". Include the name, address and relationship to the decedent of the co-owner (s) and the date the joint ownership was established. 2. Indicate the total market value of the jointly owned property. 3. I ndicate the percentage of the decedent's interest. 4. Indicate the market value of the decedent's interest. C '"0 U n ;;- r.1 ;;- ~ z >- 0 0 0 Vl 0 C'l n c: 0 -l Z :;. Z t"" r.1 m ;>; Z :::l >- 9 :: 9 t"" Z Z r.1 -l r.1 -l ~ 9 9 -l ><: Vl r.1 Vl Z 0 Vl 0 -l 9 -=1 -=1 ;>: ~ I ~ 0 : I -=1 :J\ 0 -=1 ~ - '. Ll... Z 0 ~. . I~.' I >- 0.. ., I (." I t"" ,<. '.' j ,., ~(:1 c: -=" l'- . ~-,... Vl c,:.. N ~j t::l l....l ~_. ~ Oc 0 0...... cr. on-: I o:;u:. '" Z 0(::: :c ~~ctl (.,.):"J -', I I t"" a::~- -< ~o:: ~ w::> -< -< ~ -'u ~ u ! m t"1 >- > :::l :::l I I "~V.414 EX+ tHOI INHERITANCE TAX SUMMARY SHEET (BUREAU USE ONLY) 21-80-0720 o Original o Supplemenlal o Remainder File Number Estate Nome Eva M. Hemphill Dole of Death November 4. 1980 Social Seeurily Number 202-20-02880 REPORT OF INHERITANCE TAX APPRAISER I, the undersigned duly appolnled Inheritonce Tox Appraiser In and for Ihe County of Cumberland Pennsylvania, do rnpecllully report Ihat I hove opprolsed Ihe real ond personal property as reported In Ihe laregolng return at the vatue, let forth opposite each item in the last column 10 the right in Schedules "A", liS", "C", and liE" Dated: April 13. 1981 (1/ . . I,'" t' ) it.. I' ) ~ Illl" tJ .0" INHERITANCE TAX APPRAISER ADJUSTMENTS REMAINDER APPRAISEMENT CODE INVENTO RY VALUE AS APPRAISED CODE (HARRISBURG USE ONLY) Real Property (Schedule A) S none 00+ 92+ Personal Property (Schedule B) 11,007 10 10+ Jolnt.Held Property (Schedule E) none 2lH Transfer. (Schedule C) none 30+ TOTAL GROSS ASSETS 11,007 10 Leu O.bts and Deductions 40- 93- (SCHEOUlE F) CLEAR VALUE OF ESTATE o Life Estate RATE FACTOR PRINCIPLE VALUE CODE o Annuity FOR USE OF REGISTER ONLY Tax on $ CODE COMPUTATION OF TAX S $ S $ 6'. .. Tax on S 15% Tax on $ Tax on $ Tax on $ s Exemptions Totol Estote S S S TOTAL TAX INTEREST FROM BALANCE TO L.eu Crodlts DATE OF PAYMENT AMOUNT PAID TAX CREDIT S $ INTEREST FROM BALANCE DUE REV.4S70.BO) COMMONWEALTH OF PENNSYLVANIA OEPARTMENT OF REVENUE TRANSFER INHERITANCE TAX RESIOENT DECEOENT INHERITANCE TAX APPRAISEMENT *' Estate of Eva H. Hemphill File No. 21-80-0720 County Cumberland Date of Death November q. 1980 In ,he e,ent th.' .nv utur. Inter." In thl. em'. I. ,r.n. err.d In po.....lon or .njovm.n. '0 coll...r.1 h.ln 0 t ,. ee. en.. t.r' · e.p r.' on 0 anv ...... for IIle or lor V...., .h. Commonw..lth herabv OKpresslv r.""as tho rlgh' '0 .ppr.'" .nd ...... ".nal" Inh.rl,.nce ......t .h.law!ul coll.terel r.t. on any such future Interest. PROPERTY REPORTED BY THE ESTATE DEPARTMENT'S APPRAISED VALUE none 1. TOTAL REAL PROPERTY - SCHEDULE "A" . . 2. TOTAL PERSONAL PROPERTY - SCHEDULE "6" ,. I 3. TOTAL TRANSFERS - SCHEDULE "C" . . . . 4. TOTAL JOINTLY OWNED PROPERTY - SCHEDULE "E" $11,007.10 none none TOTAL REPORTED PROPERTY $11,007.10 PROPERTY NOT INCLUDED IN RETURN BUT APPRAISED BY THE COMMONWEALTH TOTAL UNREPORTED PROPERTY TOTAL GROSS ASSETS $11,007.10 LIFE ESTATE OR ANNUITY CALCULATION I do hereby certify th~tthe above apprai~emcnt is made in conformity with Pennsylvania law and has been filed this day with the Registel 01 '.Nills. .ii//. ., /7 ;' ./iJf,1 J1,' 'fJ APPRAISEH April 13, 1981 DATE ... Q) Q) " ~ ... ~ ~ ~ en .-< .-< ... :z: ~ ~ ..... !Jl 0 >- .c Ol < l>o I<l p.. ~ m '" '" .c . @ '" ;:l p: ... Q) "" " .-< .-< ...l . 0 !Jl " < :<: :z: ..... Q) - .-< .c U :z: Ol M " 9 M - 0 &i '" Ol .-< .,., ~ "" u u .-< .-< .-< ~ - 0 ~ ci ~ ~ I:.. 0 !ii 0 '" :z: ci - t:.l tIl >- !-o ci :z: ~ t:.l !-o t:.l :z: :z: ::l ci - ci ~ :z: ::<: t:.l ;:;; 0 ;:l u ~ z :z: !-o t.:l :z: - ~ tIl ~ 8 0 < a= ~ 0 "" :l _.-._-~~~ .. REv.4" EX. (J.HO) COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE TRANSFER INHERITANCE TAX RESIOENT OECEDENT SCHEDULE "F" STATEMENT OF DEBTS AND DEDUCTIONS Estate of EVA M. HEMPHILL Date of Death 11/4/80 WHEN CLAIMING THE FAMILY EXEMPTION, COMPLETE THE FOLLOWING: EVELYN C. HEMPHILL Claimant DOROTHY M. HEHPHILL Relationship to Decedent_ Claimant's t\ddress 643 North East Street. Carlisle. PA 17013 File No. 21-80-720 Daughter Daughter ITEM NO. OATE NAME OF PA YE E REMARKS AMOUNT and i es' No i e Short Certificate Funeral Ex enses Commission Sale of Commonwea National Bank Stock 2 000 00 22 00 18.00 44.00 191. 00 18 00 1.00 2 922.00 th al Advt.-Executrices' Notice Funeral Flowers Account Pa able A c u ravin on monument orney I s Fee Reserve for closin and miscellaneous costs 100.00 TOTAL THIS PAGE 5 971.61 I hereby certify that to the best of my knowledge and belief the foregoing is a just and true statement of debts, funeral expenses and expenses of administration submitted to the estate as deductions for Inheritance Tax purposes. [71, . .--...v f. ~., J.,-.....Li... ~.~>L '-' QLl~O ..9'" 7J1t.lMf..-.tQK'1 SIGNATUUE or- AT RNEV/FIDUCl RY DATE OFFICIAL USE ONLY DEBTS AND DEDUCTIONS ARE ALLOWED IN THE SUM OF $ !J tf 'l/'(" ( I AT t PERCENT. L/ .;; 7-Y / DATE GENERAL INHERITANCE TAX INFORMATION Unsatisfied liabilities incurred by the decedent prior to his/her death are deductible against hisfher taxable estate. In addition to debts incurred by the decedent or estate, other items are claimable including the cost of administration, attorney fees, fiduciary fees, funeral and burial expenses including the cost of a burial lot, tombstone or grave marker. All debts being claimed against an estate are subject to the approval of the Register of Wills with whom the Inheritance Tax Return is filed. Evidence to support the decedent's or the estate's liability for the debts being claimed should be attached to this schedule. A family exemption of 52,000 may be claimed by a spouse of a decedent who died domiciled in Pennsylvania, If there is no spouse, or if the spouse has forfeited his/her rights, then any child of the decedent who is a member of the same household can claim the exemption. In the event there is no such spouse or child, the exemption can be claimed by a parent or parents who are members of the same household as the decedent. The family exemption is allowable only against assets which pass by a will or by the Pennsylvania Intestate Laws. c "" " n > t%l > :s > 0 0 " tIl C Z C1 n c: c ...., z s: Z t"" ,., t"l ~ Z ;;;l > 9 Z 9 t"" Z Z t%l ..., t%l ...., 9 9 ...., -< tIl t%l Vi Z 0 tIl 0 ..., 0 '":1 '":1 ::<l ~ ~ 0 - .." 0 .." _:\ Z i'i .. - - > '.' t"" 0_ ,- ,- ,., I. . (-; c: c: ;--. -::~.:J tIl ~. -- t"l c;.: N .~. ... L.);." i;t":1: 0 0" er ~ ___I -':c: Z c:c.o co: ~J~ 0-' ::t: t"" (,)1.." ;,;;0;:) '"' n:}: -< -< -< ~cc - u.'''' t"l t"l ~ EO -JU > > (,) ;xl " INSTRUCTIONS FOR COMPLETING SCHEDULE "F" 1. If the family exemption is being claimed, indicate the claimant's name, address and his/her relationship to the decedent. Enter "family exemption" in the remarks column and the amount claimed in the amount column. 2. Assign consecutive numbers to each item listed. 3. Enter the date on which each debt was incurred and/or paid. 4. Enter the names of each payee. 5. Provide a brief explanation in the remarks column for each debt claimed. 6. Enter the amount of each debt being claimed. 7. The form must be signed by the person who has assumed the responsibility for paying the debts. COMMONWEALTH OF PENNSYLVANIA OEPARTMENT OF REVENUE BUREAU OF EXAMINATION OFFICIAL NOTICE OF INHERITANCE TAX ASSESSMENT . COUNTY FILE NO: 1- ';/ - /.';; (,' OATE J.{ ,(L~//' /tJ:?( /0' / r;:(,,(o~ 7/1 -X~N.(h~J::k./ '/ ' ',:71 d /0 ~, I.'lfl- /] //., /."",--"'--4./.-1',4,-"'<- -/ " '-, I) :."",;; TO: ./1 I/A/...A..-'I. I ,/ >'/'/-1 :!J ..OJ/""" . .... C .' -.- ,".;, r "," . . . . t- --- -' /,./) I C. r:!./;A' _ // ,,~J/..' .. U.~ II./'. (j(/Al.d.,L- .~ ,// '/i I -: /' ESTATE FILE NO. COUNTY ,/' I;' ~" '.-:r--j OATE OF OEATH',-/.';//-/;. >_", .../,/ /I,;c. 'f Appraised Value of Estate: Real Estate $ Personal Property + //, /(/) "/ 1/-' Jointly Held PropertylTransfers + Total Gross Estate $ // ; ,/} ,) /L.' I "i'/ '1/ (". I I / $ /- " -;"I.~ 'i 'I , ,; ...1../. I "-/).() ",_(1 , ,~/ ?,'-:'; - /1 '7 G " Total Approved Deductions ~ Clear Value of Estata i Less: Approved Charitable Exemptions Clear Value of Estate Subject to Tax Amount Taxable @ 6% Rata G 1/ /; <-.,": ,':1'/ G ./.; 1/:/. /;) tax due Amount Taxable @ 15% Rata tax due TOTAL PENNSYLVANIA INHERITANCE TAX DUE $ ;)4') /~ 11 * * * * * A five percent discount totaling $ will be granted if the Inheritance Tax is paid bV Less Credits: DATE OF PAYMENT AMOUNT PAID DISCOUNT INTEREST TAX CREDIT /" -,/ -.AI}-II + $ 1.;/) - $ G ,I Y'i' ;. / S /11), ILl) = + = + = Interest accrues at the rate of six (6) percent per annum on the unpaid balance of Inheritance Tax from to date of payment. Interest due if paid bV is ,~.- 'I c; I BALANCE OF PENNSYLVANIA INHERITANCE TAX DUE $ rc.J !,:l-lJISiid Ci \',.'111::" ... .- INFORMATION To insure proper credit to your account. tho name of the estate and tile number should be clearly print- ed on the check or money order. This assessment is made in accordance with Sect,on 708 01 the rnheritance and Estate Tax Act of 1961 (72 P.S.!i 2485.7081. To the extent that inharitance tax is paid within three 131 months alter the daath of the dacedent. a discounl al five (5) percent is allowed 172 P.S.!i 2485.7161. Inheritance Tax, other than tBX on a future interest, is due at tho date of the decedent's death and becomes delinquent at Iha expiratian 01 nina (91 months after the decedent's dealh (72 P.S. !i 2485.711). Inheritance Tax on a future interest is payabla within three (3) months alter the transfer takes effect in passession and enjoyment and is delinquent therealter (72 P.S. !i 2485.7121. Calculate interest from the delinquent date shown on the face of this form to tho date of actual payment using Iho following interest table: ------------ --- ------ ---------- --- ---- --------- - - - -- - --- -------- -- -- -- - ---- 1 month .005 4 months .020 7 months .035 '0 months .050 2 months .010 5 months .025 8 monthS .040 , 1 months .055 3 months .015 6 months .030 9 months .045 12 months .060 1 days .00017 11 days .001e6 21 days .00352 2 days .00034 12 days .00203 22 days .00369 3 days .00051 13 days .00220 23 days .00386 4 days .00068 14 days .00237 24 days .00403 5 days .00085 '5 days .00250 25 days .00420 6 days .00101 16 days .00267 26 days .OO4a7 7 days .00118 17 days .002e4 27 days .00454 8 days .00135 18 days .00a01 28 days .00471 9 days .00152 19 days .00318 29 days .00488 10 days .00169 20 days .003a5 ao days .00500 ----------- ---------- ------- ----- --- - - --- -- ---- ----- - -- --------- -----. Any party in interest. including the Commonwealth and the personal representative. not satisfied with the assessment may object thereto within sixty (601 days alter recelpt 01 this Notice es provided by Sactian 1001 of the Inheritance and Estate Tax Act 01 1961 172 P.S. !i 2485.' 001). Make check or money order payable to: "Register of Wills. Agent" Mail to the address listed below: \ .._..... __ _~ __ _~ __ __ __ __.. ~_ --a; ",:IIIV'IIIHX. ,:, .... ~~W{ii""~,':":'~';;";'::"': ',' ,. COMMONWEALTH OF PENNSYLVANIA I 4 )loiK~(J29523":" DEPARTMENT OF REVENUE I , :~t~~;!.f'.' ,,' 'OFFICIALRECEIPT · PENNSYLVANIA INHERITANCE AND ESTATE TAX 1 ~ I ~ ~= , i. , . ~ . 1 .. RECEIVED Bve 1 !I';~FROM II ADDRESS 10 :I. Hi h S~Z'..t: i I cu1b1e, P.. 17013 il I I I' j I 2 COUNTY ,------------------------------------------ I ,POSTMARK OA TE 1\1 l' ",'AA" ..... IR 1'lJLL" SEAL 1\ 1\ I I I i I . i I I I I I 1 - TAX AT 6% TAX AT 15% Herophi 11 .. TAXAT_% ESTATE TAX 57.91 TOTAL TAX CREorT '--Es-iATEj'NF(jRMAriO~~~ --4 - l-'-a-o-------------- DATEOFOEATH ., FILE NUMBER 21-80-720 DATE OF PAYMENT May 18, 1'81 LESS DISCOUNT PLUS (FROM % INTEREST TO_I NAMEOFOECEOENT EVA M BBMPBILL m m TOTAL AMOUNT PAID 57.91 CUllberland RECEIVED BY / vc.J REGISTER OF WILLS -- -- ~-~... ~..... INFORMATION To insuro proper credit to your account, the name of tho estate and file number should be clearly print- ed on tho check or money order. This assessment is made in accordance with Section 70B of the Inheritance and Estate Tax Act of 1961 (72 P.S. 9 2485.708). To the oxlonl that inheritanco tax. is paid within three (3) months after the death of the decedent. a discoun' of five 15) percent.s allowed (72 P.S. \ 2485.7161. Inheritance Tall, other than tax on a future interest. is due at the date of the decedent's death and becomes delinquent al Iho expiration of nino (9) months after the decedent's death (72 PS, ~ 2485-711). Inheritance Tax on a future interest is payable within three (3) monlhs alter the transfer takes effect in possession and enjoyment and is delinquent thereafter (72 P.S. ~ 2485.712). Cnrculme interest from the delinquent date shown on the face of this form to thl.! date of actual payment using the following interest table: ------------------------------- --- ---- -------- - - - --- - ----_.- ------- ---- ----- 1 month .005 4 months .020 7 months .035 10 months .050 2 months .010 5 monthS .025 8 months .040 11 months .055 3 months .015 6 months .030 9 months .045 12 months .060 1 days .00017 11 days .00186 21 days .00352 2 days .oooa4 12 days .00203 22 days .OOa69 a days .00051 la days .00220 23 days .00386 4 days .00068 14 days .00237 24 days .00403 5 days .00085 15 days .00250 25 days .00420 6 days .00101 16 days .00267 26 days .OO4a7 7 days .00118 17 days .00284 27 days .00454 8 days .00135 18 days .00aOl 28 days .00471 9 days .00152 19 da~'s .00318 29 days .00488 10 days .00169 20 days .00335 30 days .00500 -- --- ------ ---------- -- - - -- - -- - - - -- - - - --- - - - --- ---- - - - - --------- ------ Any party in interesl. including the Commonwealth and the personal representative, not satisfied with the assessment may object thereto within sixty (60) days alter receipl of this Notice as provided by Section 1001 of ,he rnheri,ance and Esta,e Tax Ac, of 1961172 PS. 9 2485.10011 Make check or monev order payable to: "Register of Wills. Agent" Mail to the address listed balow: __ .~~~..~:'"..,"-...":'.k.=,--t...-"",:,,<O..~~.....,:..:..:....\....n.:..',....v>;....-,..':"';.r."l!OJ:.i....~~~-:.:~_t:t:'1- ,;...,.-...-..:..