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Home My WebLink About81-00065 <h fil n:: 'oll - b .~ 0 ~ <fl E!l ... 0 t1 c~ . <l; ~ f/J gJ r~ :a:; r:Il \ q; :>:: . .. 8 If.) r./) - .,- 0 CO "'It . ~ :0 . or- 06* IU "'. ... . en 0 LLI Z t;,to 2t:81 6~ IN ~~1;:'~':'~1~; (~~~=~..~~~~~~:R~~::~J~gll. r:r..RY c. LEh'n; To ",.".,"""",..,.""..,..,."",....."..,...,..,..."."..,...,",.....,.....,...",..,..."..,.....,..,........."..... Hegistel' 01' lI'iIlS~' I' .he (,OUllt.~. I' ('U~lI ",,,,d. ill the ('onllllOIlI\'(!lIlth 01' l'enns.\'lvllnia. .. <-2, yT<<, A; . ?, The Petltloll 01' '" .. "..{,#.~'" ...:..'.. ..~.t...:;;..).~, ,~..?.l./....:;;..............,..............,...............,.., ........................,.,.....,.,..",..,.........."... I'CS(.'Clt nll.I' shol\'elh~t ...".,.....-.J<..~:~,..............,.......,.......,.............. . .)~...-/" A!.C TO\\'llShip,. . '. , . , , was a resident of --"".d':.t. .., .. ..<.<:'=....."'................1'.... It ,(.umhel'ialld (.ount)', Stolte ot Penns~ 1- vania, and a Citizen f Uniled Slales, an~glll'ted ~;hiS 1;'l'e inlest"te in lhe COUllt)' of6~~",/.~J ........ ......'Zi....................... and Stale of ,......,....:7"""~, :>.'-=~., ..<<.~...~."".........,.......................... on ..~.,(.t'4;. the ..,....'..'../..,5?~.. dll)' or " '1j1~~::<J...... A. D., 19.~ at the age 01 ..?e...~}. ;.~ (I, That the said ..~.u.~Wd.:??~,~deeeased, left surviving the following named widow or husband, heirs and next to kin. loMit: ~ ~ Name Helatiollship Residence r;;~ ..~~~.~4!!!~ .........................................................,...... ............................................ ................................................................ ................................................................ ............................................ ................................................................ ................................................................ ............................................ ................................................................ ................................................................ ............................................ ................................................................ ................................................................ ............................................ ................................................................ ................................................................ ............................................ ................................................................ That those above named it,eludc all of the next of kin, so far as known. ()<.I The said decedent was p088ess~d of personal propel't,\' to the cstimated value of $,..<~...?... ~ and of Real ~;state, less incumbrallce, to the estimated value of $,......::::::::-...z:7...:::::::.. as near as can be ascertained. That the said Real Estate in so far as is known is located in ......~~_..................,.. ........................................................................................................................................................................................ Therefore, your petitioner(s) respectfully appl.I'{ies) fOI' Letters of Administration in the above named estatc. Dated ......, i{2 I (. 1/ ......~D,~l. ~.....,............ ~=;;J~:~ ~~~~)'Q.<~.&J .. 11'::::..15,).. I" ~~ - J.;.: ::7.Ut~.,,2~? A. V., lif?! Sig&ture and Add,"ess of Petiliollcr{s} //-/11- 2- COMMONWEALTH or PENNSYI.VANIA I ~~~~~.~...~I:~..(:~~I;pZ~ta? ,Il,..,..t,d~fr~~~~"<"""""""""""""""'" named in the nbove application being dull' ..,..~~r.::<Y..\,c=-,,=r,JjrcOl.ding to III\\', sa)' that the factK set forth in the abol'e npplicalion al'e t,'ue to t1", bo,t or ".~2..., knowledge and belief. ~;:~~;:~~:::::~~ ",," """":';"" 'U;~~,~~e2~~ ..................,.................."................,..., A. D.. In.......... I .......,..............,..,......,...,............'..........,...................,....... ....~a,,:t...~~:"~~~i'~;~.~..,. Filed: ' ........~~.!!.':l.~.!:y...,?~.f,..).?.3.;]...,.....,...,....,...., Altol'lIe)': ,~~ y ) CY C-t..- OATH OF PERSONAL REPRESENT A TIVE COMMONWEALTH OF PENNSYLVANIA } COUNTY OF CUMBERLAND ss: .......................................................:~.j,...d.7;YJ1..~........ petitioner(K) being duly .......~................~ Jaw do ~~d say that as the :::~:f::::;;':::;,:';~;~I;:;~;;;~;;Z::~:;;~;;;~:;;;;;: deceased, according to law. And also will diligently comply with the provisions of the law relating ~~..~~~~....... and subscribed b ore me. . ... . . .~...:~~.?....... A. D., In?'/. R~ii;t" f;:Z.1tSrL..~.(.a:.,;/........... ....~~m... DECREE Be it remembered that on the ..........~.~.~~'............ day of ....",..~~.:~.~~.~y.."""....,,....... A. D., 19~.~..... L tt f Ad . . t t' . th t t f Theresa Thompson e ers 0 miniS ra Ion In . e es a eo................ ............................................................................................ ............ ........ ......... ""................................. ..... ........... In te of ....... ",.. ,....". ::;~).::.::: ~.';. ...~.?~~!:.:;:~I.~ 12................ .......... C b I C P I. d d t d !iarold ,J, Thompson urn er and ounty, ennsy vanta, ecease, were gran e to ...................................................................... ........................................................................................................................................................................................ Witness my hand and official seal the day and year ~d. ~ ........~."(ldfl...d?...../.<<;~ii~~.~........ /31:,5: COMMONWEALTH OF PENNSYLVANIA l. COUNTY OF CUMBERLAND J 51: Harold J. Thompson boing duly sworn according to law, dopo.e. and .ay. that he is Administrator__ of the E.tate of Theresa Thompson late of j[jJJJ.~_m.s;. 9r:.9Y?Mqbi,;J,g,I:I.9.m~L Mech. , Cumberland County, Pa., deceased and that the within is an inventory made by Harold J. Thompson_ , the .aid Administrator of the entire e.tato of .aid decedent, con.i.ting of all the personal property and real est.te, except re.1 e.t.te ouhide the Commonwealth of Penn.yivania, and that the figure. oppo.ite each item of the Inventory repre.ent it's fair value a. of the dato of decedont'. death. Sworn and .ub.cribed before me, ~,~ fJe~: -...J September 29 c--:..... :.wv.o- 7h mtt~. " ,~,' .... ..,\ i'URtlC' .,.. "".n~'~ ,,,. -. !I.. " pl;l,~~lllfbUilb: ~..::~ COUN1Y'~ .' MY COMI.'''SION [XPIRb "PH. 15, 198, Member, rennsylv<in1il A~jGr.IJtlOll ollJotJf\es 19 81 Williams Grove Mobile Home Park Mechanicsbura. PA 17055 Addral1 Date of Death 14th Day September Month 1980 Y.ar INSTRUCTIONS I. An inventory must be filed within three month. after .ppointment of personal representative, 2. A supplement inventory mu.t be filed within thirty day. of di.covery of additional a..eh. ], Additional .heets may be attached a. to personalty or realty 4, See Article IV, Fiduciarie. Act of 1949. ') ri \'0 -3 >- l': -0 ~ I- W 0 ~ ~ "" I- Ul . w ~ ~ ..... a. E u 0 '" .. 00;, 0 w "" w 0 C I I- J: a. u. ..c I- -' E-t Ul . -.. Z u. -' :5 0 E a. ~ W 0 < "" ~I III ,;. > Z 'M + Z 0 M c c ~I . - '" Z M 0 0 "" 'M CJ Z w < ... a. ~I ~ ." c - . ;: 0 .. I .., ." , .. E + ..! . . -' CJ u: /, . / /- /1/-;;;) INHERITANCE TAX RETURN FOR INSOLVENT ESTATES (Instructions on Reverse Side) REV":iHI EX+ {7.ool COMMONWEAL TH OF PENNSyLVANIA DEPARTMENT OF REVENUE TRANSFER INHERITANCE TAX RESIDENT DECEDENT Estato of Theresa Thompson Last oddre"Williams Grove Mobile Hom! (STREET) Par. COUNTY NO. STATE NO. ( ) Exoc. (xl Adm. Other Harold J. Thompson Harne Social Socurity No. 17055 ,. 0: .. U ::> o u: PA (STREET) Williams Grove Mobile Home Park (CITYI Mechanicsburg, PA Dote of Deoth Socia' Security No. TYPE OF ASSET Personal Property '" Personal :;; Property '" '" .. OFFICIAL USE ONLY DATE 1/28/81 1/29/81 OFFICIAL USE Addr." (STATE) (7.IP) September 14, 1980 086-018-416 DESCRIPTION ESTIMATED MARKET VALUE $1,000.00 U.S. Savings Bond M204318008 issued to Mary Ann Lineberger and Theresa Thompson $ 868.40 $1,000.00 U.S. savings Bond M204318009 issued to Mary Ann Lineberger and Theresa Thompson 868.40 17055 .:;)q- rl/ DEPARTMENT VALUA TICN (OFFICIAL USE ONLY) '" 00 (' C' ::u:::o (, ,." ~ :1 ", ,.,,"" :'" ~., (") t: , ':'..0 " (1)::0 Co .. - I!::J , " '. ,." " N , T .. N .;: " " ;"0 '-C .;,;. TOTAL $1,736.80 / 7Jt. f'() I do hereby certify that the above assets were appraised in accordance with Pennsylvania law. NAME OF PAYEE NATURE OF CLAIM Mary C. Lewis Grant of Letters, 1 short certificate Myers Funeral Home, Inc Funeral expense Family Exemption claime by Harold J. Thompson, husband TOTAL /1-/tJ-? DATE AMOUNT CLAIMED $ 14.00 706.00 2,000.00 'UJnlOH x01 aWOJUllonp!^!pul'O~'\ld WJOj uo palJodaJ eq pnoy' wal! awoJu! olqoxoI '!41 ',a,odJnd x01 ewoJul O!UO^I^'UUad JOI alqojJodoJ '! 0101'0 uo 6Upal'!U!W .po u! pawJojJad se:J!^Ja!f JOI 'JOIOJISIU!WPO JO JOln)Oxa uo 'AtBWOU :O^!lOllJ9s0JdOJ olOlsa ua 01 Plod 500::J :310N II"MOI '<'1 "19\)J3AO:lOJ OJD ,unOlUD o~!IIO s.qop so onul)^oH jO IUllWIJodoQ Oll' Aq pOJ,nO:HU D9 01 'isal (HII S! 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S.tUOp3:)3p 3tH jO onlOA ~;)>tJOW POlOW!~Sa alii PUD SJOUMO lU!O! 6u!^!^JO'S a~I jO ~uap3:)ap ayt Ot d1ysUO!~oJ<u puo (s) "WOU ayt 'd!qs,IauMo jO a6o,ua:)JC~d s,Juapa:)ap aYJ apnl:)ul '~loap jO aw!t alii 10 d!YSJO^!^Jns fO Iq6!J llt!M Sluouat IUlo! 50,10 UOWWO.? U! SJUOU"I 50 sa!pod ,10 ,<~,1od Jaqiouo !.Ill"" '<,Iu!ol paUMO ,10 tuap"';)P attJ ,(q '<13101$ paUMO siasso liD ~s!1 - NOlldl~JS3Q 'P"UMo.'<IJU!O! JOJaj5UD,I~ ',(padoJd 10UOSJ"d 'aiotS;) 103,1 S! ,laSSO ayt 0I"Yi3YM alo:l!pul- 13SSV:l0 3dAl '. SNOllJnM1SNI :S13SSV REoVJ.519 F~ (7.90) I~~ ..~,,;.. COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF FIELO OPERATIONS NOTICE OF FILING OF APPRAISEMENT Mr. Harold J. Thompson Box 136 Williams Grove Mobile Horne Mechanicsburg, PA 17055 RE: Estate of Caunty of File No. Theresa Thompson Cumberland 21-81-0065 Dear Mr. Thompson: You are hereby natified that the insolvent appraisement in the estate af Theresa Thompson has been filed in the affice of the Register of Wills of Cumberland Cauntyan November 23 , 198.L.. Said appraisement roflects the fallowing voluations: Real Estate Personal Property Jointly Owned Transfers Total None $ 1,736.80 None None $ 1,736.80 As to such tax that is paid within three months from date of death, a five (5%) percent discount is allowoble. As to any tax that remains unpoid cfter nine (9) months (filteen manths when death occurred from December 22, 1965 to June 16, 1971, inclusive; and twelve months when death occurred prior to December 22, 1965) from date of death, interest at the rate of six (6%) percent per annum is charged. Any party in interest wha is aggrieved by this notice may object thereto within sixty days alter receipt of said notice as provided by Section .1001 of the Inheritance and Estate Tax Act of 1961,72 P.S. 2485-1001, P,L, 373. Date S'~'d~- Title Chief Appraiser NnvpmhAr ?1, 19R1 NOTE: This is not a bill. I~~' PETITION FOR GRANT OF LETTERS OF ADMINISTRATION Eswte of "'f.~,'l.J'.(, 0... iA01'l<.fJ S(Y1\. also known as No. ~I- ?/. (p<; To: /.:<. -<?..z -/;.1...- (11-17'1 - :;..) Register of Wills for the .1 County of (I. ~,ItJ1..( h,,<1I in the Commonwealth of Pennsylvania Deceased. Social Security No. CJ '6" - 0 I 'l: - ll/ (. The petition of the undersigned respectfully represents that: ror letters or administration on the estate or Your peti ihe~fol, who is/life 18 years or age or older, appll <., (d.b.n.: pendente lite; durante absentia: durante minorilalc) the above decedent. Decendent was domiciled at death in LluYlb.tJ'lo "d County. Pen)1sylvaIJia, with h rr lastfamilyorprincipalresidencea~o(\% I.,Jdilo.m; Gr"".., fY10bk [it,....... IOJ/:. (f'Q.rJ". PA (list street, number and municipality) Decendent. then ( D years of age, died .$'f!6 (,~r ( '+ at t ~ ,hnN)t"\ Cov,"*j ,I 'J,'\:;kJ,,(k"~') -r,"p Decendent at death owned property with estimated values as folllows: (If domiciled in Pa.) All personal property (If not domiciled in Pa.) Personal property in Pennsylvania (If not domiciled in Pa.) Personal property in County Value of real estate in Pennsylvania situated as follows: ,19 ~() $ ( ,CJOO. ()l.) $ $ $ Petitioner_ after a proper search ha.s..... ascertained that decedent left no will and was survived by the following spouse (if any) and heirs: Name Relationship Residence 111\0.. !Y\ (Y\ u- None THEREFORE, petitioner(s) respectfully request(s) the grant of letters of administration in the appropriate form to the undersigned. ~ u u C U '0_ .:;;~ U" "'u c -g.g Ill'':: 3~ U~ ~o ~ c '" in .--..' . :S...A.w" '-n'1 .....l")1);y~..) W AIlNINC: It is lllegul 10 olter Ihis copy QI 10 duplic(llo Ly Jlhoto~lat 01 photograph. Hl0S 112 SOOM R(V 2-78 (100 Cerl. per book) (FEE FOR THIS CERTIFICATE $2,00) COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF HEALTH,VITAL STATISTICS N9 1860241 LOCAL ImGISTRAR'S CEIlTIFICA liON OF IlEATH 11,~I"<rcd No. Full Nome jj) 1/ /, !-Ii of Dccc:\5cd __~....&'Ud.Llil-.J'L.....-u~__________ ~ --- L' ___t.S~f.4..L.._~~~ nrl' f,) Middle (J lal' /) Residence cl:.kl~)a,j.J.d.tf(r..iW_;d'U':<.v...JA.~(J1.. _,?/2cc:.I1(u)<u~3,<1"1-;-.cu..,.,...L- .t!.., nfl! If. Plocc of :Q"'h; S'r,,,1 .p [J C~IIi1or T~';n i7 A C,OI4!U Sla'o Dcath ~~~...1-CU\.~ ___.. --Ct..:J..1..~c:....-: ....:.L_ '-!:J-UJ1,.o~ffL-) PcnnsyIv;mla -; CDllnt~ D _ Cil~, B01Dugh or ~wn~hIP Sex ,1i.0zt.dL-___.._ ..... On". of Oeolh ...J:.ef.;t....J.ILJ_2..~...L. P J' () Race .....J.&d! / (, ~. . Dole of 81rth~lliLLL::7-/-_r1-l-Q.... IlIrlhp!a" .,~t.&k"~dJu..n'~,,"--_... Mn,Ua! Slotu. _22JJ'A-z...,rL- - . " SodsI Sccurit)' No. o...fL - .9..LP - YJ ~._ OCl'uplIllon -.J.,h"u-{ . l' (. .# ;=...L Vclernn's Serial No. MEDICAl. CER1'11'IC'\ TE i)art I. Dculh was caused by: Interval Dctween Onset lIud Death Immedtal. Cause (a) -C..YJ...u.-~...a..-1-'~~J Due To (b) Due Tn (c) _-.___ Part U. OTIIER SI(~NlFICANT CONnlTlO~S: cOl1trlbuting to llc~\th hul 1I0t related to the immediate cause gIven in Purt I (nj l.I" ~ Accident, Suicide or Homicide --- '! Name .Ill! Title of Pm"" -../.i "'", P ,~ n Who Cntilied Cuu!l-e of Dealll (M.D., n.o., Coroner, :\t.E.) __._KI_J::~.__L~:S:.f.-=-.-" . -- J / l Addrm j~L~_rJ.d.._dl{.<..~-/L;>~",_.._-------,-- ~~ ~ Streel (),/ City (.-!': ~ This is to ('uti f)' Ihlll IiiI.' infurlllfitinll here ghcn 1.<; correctly COllil'cl frnm all urlginal I:Htifkate of ,Jellth duty melt ",ilh me :1.'. Local Registnlr. The ul'iJ.:luul ccrtlficlllc ",ill he Coryell (u the Sl:llc \~jja) Statistics Orfirc for permanent filing. .i~"N "~,~ t.r:--<LP_,~,j,f4,-..&I.I~. 0>1'.)1cJ. ~ (-:S. lo<oi Rt'<J;'lrnr of Vilol SWli_lio I / Oi.triet Nr.:. . I~~"" t.A:;._-C~_JJl.._ltz...t..GA'-~1-'''' //. '.'" , ;! ~lfe',!'\ Addn"\' ICily. 5oroughl ow"'~hip I ,~4~ '&. /i '" I ~ _.._....~A.J'!Z._.J!;....&........./~TLLf..cJ A :;-.e\t"/ / Out" fl('((,i..,d br lot~j Ji.C'JilllOf 1HOfn:: ,j~.....L~,.l..l.!':.Q--_......_-- ~ g Oat" of 1~lue 01 11m (Ntif,CClI,orl I ~~~~~~===,'." ~.. =,...-', .. " I How did injury occur ....~.._.._.._._____.._..._H ~ _.m__ __" ._,_,___._.'~_''''_'__ -.-.-------...-.--------.-..----- - _._-_._...__.~-----._--~_....._--------_._._-- " ;( / - t/ - ttr c' , ,.. . <:t " '.... : ~j ) ':;.-' -~ c: !~:;e '1: 7:i , ,l.. . oj: l~~cd co:t..~J < ',/Ll 0- ~~Q:! (.)~ ~Ct: '" .- .~.) W~) !:'O ,0 u " 19J .... w Bond No. 68093309 WESTE R t-{l~,;ll;l'C~D M PANY ()fre oj 1I~>iIfI:~t.),,';r4ttllj}:(eOmpalti&t c H ICAG.O:.':.~f.OP,~: FA ~~~. '~'Ip"Ap"A.S PALO AL;fO"','S'ALA:c'\'J<lWYD. PA. Know all Men by these Presents: THAT WE Tina M. Myers , as Principal, and thc WESTERN SURZTY COMPANY, a corporation duly licensed to do business in the Commonwealth of Pennsylvania, are held and firmly bound unto the Commonwealth of Pennsylvania in the sum of Two Thousand and No/lOOths ($2,000.00) Dollars, to be paid to the said Commonwealth, or their certain Attorney or Assigns. To the which payment well and truly to be made, we bind ourselves jointly and severally, for and in the whole, our Heirs, Executors and Administrators, firmly by these presents. Sealed With Our Seals-Dated the _18thday of June in the year of our Lord one thousand nine hundred and 84 The Condition of This Obligation Is Such, That If The Above Bounden Tina M. Myers , , , I! I' Administrat rix of all and singular the Goods, Chattels and Credits of Theresa Thompson deceased, do make or cause to be made, a true and perfect inventory of all and singular the Goods, Chattels and Credits of the said deceased, which have come or shall come to the hands. possession 01' knowledge of Tina !1.......M~ers the said Administratrix ,______'....,...____._'_'..___'.... _____, or into the hands or possession of any other person or persons, for Theresa Tho1!lPson and the same so made, do exhibit, or cause to be exhibited, into the Register's Office in the County of Cumberland ........_, within thirty days from the date hereof; and the same Goods, Chattels and Credits, and all other the Goods, Chattels and Credits of the said deceased, at the time of Her death, which at any time shall come to the hands or possession of the said Tina M c...l1.Y.ers I or into the hands and possession of any other person or persons, for Theresa Thompson do well and trul?-i administer according to law. And further do make or cause to be made, a just and true account of er said Administration, within six months from the date hereof, or when there- unto required by the Orphans' Court, and all the rest and residue of the said Goods, Chattels and Cred- its which shall be found remaining upon the said Administrator's account, the same being first examined and allowed by the Orphans' Court of the county having jurisdiction, shall deliver and pay unto such person or persons at the said Orphans' Court, by their decree 01' sentence, Pill'suant to law, shall limit and appoint, and shaJI weJI and truly comply with the laws of this Commonwealth relating to collateral In- heritances; and if it shall hereafter appear that any last will a'1d testament was made by the deceased, and the same shall be proved according to law, if the said T~na M. Myers heing thereunto required, do surrender the said Letters of Administration into the Register's Office aforesaid, then this obligation to be void, otherwise to remain in full force. I ( I I I I Sealed and delivered in the presence of ! Principal L / . Cy ~~r.IL (.J th.tJL' -"-'''-.. ...~- I '._~. Principal WE$.TERN SURETY COMPANY A,-\) By~0}..\\\. ~,\ llllShrR .. Ani.Wll Stactl ". '-"'" I. ,~ ' ntt-A-+70 '. .- .. rgJ .. --~_.. ~ . " " " -. .. ~ ~ . . == i-,l m , . . -: . ~.:: . .:_- ::r \:>Ul , (") , ~ ,.. ~ ro ;.. l-i , ~. - ~ t1 "-.m , , 'U b:l m ro 0.. '~~ , , 0 0. UJ 3 , 0> ~ , , OQ ro III , l1> t1 ~. ~'f -'[ri , i-' i-,l ::l M ~. hlli'\ ~ ::r CIJ ~ U1 .... t:<H :. _) 00 f;: o-l '1 lr 'l:l ;to ~ 1:1 (") >-l UJ >-l .... :t~.' -i 0 trJ 0 M 0 ! . -< '1 <t. n 5 0 ::> 0 CIJ >>j >>j ,r ",", CJ I, rt t.tI '< tI 0 1;: ro ::l ,1J ~ n 0.. '> ro ~ 0> Z ~ -< I in' - ro ~ co a. ro I ~ I '"' . 'to.l 0- "" " I, a:: :..::~: l.....1 ':';'& .....1<.1 t r.::} ~.- C2~ ~u u :1 6-,' l.l.ll" c:...- Q:~') 0- uC3 ~"" ~ =; =; ~ I: , \,-, . 1~t;.V.1500 SX + ('HIl) BUREAU OF EXAMINATION PENNSYLVANIA OEPARTMENT OF REVENUE .t. P.O. BOX B327 HARRISBURG, PA 17105 INHERITANCE TAX RETURN RESIDENT DECEDEN)T 1()~'lql-,J File Number 21-81-65 Decedent'. Name (Lest, First, and Middlelnitiall THOMPSON, THERESA DECEASED. . Soc"i Security Number CHECK 086-018-416 1. Originai Return 0 Se t. 14 1980 2. Supplementai Return rxl to Insolvent Retlrnrl Decedent's Address Uilliams Grove Hobile llome Park Hechanicsburg, PA. 17055 Date of Death 3. Remainder Return 0 APPRO. PRIATE 5. Federal Estate Tax 0 Return Required. 6. Decedent died testate 0 7. Decedent mainteined a iiving D 8. Number of safe deposit 0 (Attech copy of Wiill trust (Attach cepy of trust! bexes inventoried All cerrespondence and confidential tax infermation should be directed to: 4. Life Estate 0 BLOCKS CORRE. SPONDENT Name Address ROB A. KRUG Telephone No. (717) 432-4514 City Stete. Zip ~il-;-~ ..,. ~W'r1 . (") r"'l ~ \~"O S ' ;, :;r~1 "iO -=: . '.':~1 - I '.:;:' Recapitulatien 1. Real E.tate (Scheduie A) ( 11 2. Stocks and Bonds (Schedule BI ( 21 3. Closeiy Held Stock/Partnership interest (Schedule C) ( 31 4. Mortgeges and Notes (Schedule 01 ( 4) 5. Cesh & Miscellaneous Personal Property (Schedule EI I 51 1.000.00 RECAPIT. 6. Jointly Owned Property (Schedule FI ( 61 ULATION 7. Transfers (Schedule G) ( 71 8. Total Gross Assets hotai lines 1-71 AND 9. Funeral Expenses Adminimative Costs/Miscellaneous , '" Expenses (Schedule H) ( 9) 1,732.20 TAX 10. Debts/Mortgages/Liens (Schedule II (10) 11. Total Deductions (lotallines 9 & 10) 12. Net Veiue of Estate liine 8 minus line 111 CALCU. 13. Charitable Bequests (Schedule J) LATIDN 14. Net Valuesubjectto tax liine 12 minus line 13) v c -' .,.1 ( 81 1.000.00 (111 (121 (131 (14) 1/732.20 732.20) (732.20) Computation of Tax t5. Amount of line 14 taxableat 6% rete (151 x.06= Onclude values from Schedule K) 16. Amount of line 14 taxebleat 15% rate (161 x.15= Onclude velues from Schedule KI 17. Principel tax due (add tax from line 15 plus tax from line 16) (17) lB. Total Prior payments: (e) Amount Paid (b) Plu. Discount (c) Minus Interest (1BI Ilo tax due insolvent 19. Balenee Due liine 17 minus line lB) (191 Make Check Payeble to: Register of Wilis, Agent ... PLEASE RECHECK MATH'" 0.00 Under penalties of perjury,l declare that I have examined this return, including eeeompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer other than the personal representative is based on all informetion of which praparer has eny knowledge, A.I !J 'I" :t:::'v"". /)1 ';rYJ",,, ('(( S /.3,,_<i.{2""L~ ;lU... , dr...../ti'.... 1/ - r -l 'I SIGNATURE OF PERSONAL RE RESENTATtVE(S) AOORESS I OATE , , ~..--' , I:;. S' j)~jr/2 AOIlRESS frr, ll/{j./y . OATE " ..~v.l~lII.A ,- ,'f'II,/ .' COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SCHEDULE "H" FUNERAL EXPENSES, ADMINISTRATIVE COSTS AND MISCELLANEOUS EXPENSES THERESA THOMPSON FtLE NUMBER 21-81-65 ITEM NUMBER DESCRIPTION 1. 2 A. Funeral Expenses: Myers Funeral Home cremution urn Opening cremation grave 1, 2, B. Administrative Costs: Register of Wills - Grant of Letters, 2 short certificate Personal Representative Commissions Tina M. Myers Attorney Fees Rob A. Krug, Esquire C. Mi.cellaneous Expenses: 1. 2. 3. 4. 5. 6. , 7. 8. Family Exemption due but not received from first filing H.F. Miller Mobile Home Transport - services to move mobile home Mary A. Murray - permit fee to move mobile home Thomas Staub - appraisal fee on mobile home Uilliams Grove Mobile Homes, IIIC. - labor of 2 men to move mobile home ($lO/hr per man - l~hrs) Dillsburg Agency, INC. - Bond for Tina M. Myers, Admin. DBN Notary fees on title of mobile home Reserve TOTAL (Also enter on line 9. Recapitutationl (If more spece I, nelided Inurt addition. I sheets of ..me size) AMOUNT $225.00 60.00 23.00 50.00 50.00 983.20 215.00 2.00 15.00 30.00 50.00 4.00 25.00 $ 1 2.20 'UJnIOll x01 owa,uI lanpI^!pul'QV-Vd WJOI uo popadoJ oq pna4' WOllowa,u! o!qaxal '!41 '.o.odJnd x01 owa,u\ O!UO^I^SllllOd Jal olqapodoJ SI 0101.0 lIa 6upOI.!lI!UI _po "' p"""'" '''''''' '" . ,,,.,,,, 'I.P" " '" "". .. . ".... '''11 ",.""" .,.". .. 0' PI" ..., "ION ."......01 ,(~ O\qu,.^O'O' 010 Iunou,o O~!\ 10 slqop sU onuo^.lI 10 lu.,"pod.O .~I ^q I'.J.^O,.' oq 01 ".1 .'11 'I J.^O~,!~M 000'1$ '0 .np oq 01 punol ^\.IO,"!IIn xOI 0~1 10 ~;S~ 10 ^llou.d 0 01' . . .\qO\1 ^1I0uoSJ.d .'1 1101\' '"\~ 10 p.,!nb.' IJod.' 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'.~/'14 p.ll.poI 'O~ .,nods 041 l!'o '..nod. oU SI 0'04111 'oIUO^I^suu.d U! 1'.11'1,"01' pO!p 04/^ IU.p.'.p 0 10 ..nod. 0 ^q pO,"lol,.q ^ow uO!Id,".X. ^I!,"ol V u,nl.' s!~I 01 p04,01la oq plno~' 1'0,"\01' 6uI.q "qop .41 '01 ^,!\I~OI\.,.IOI'. .41 '0 S,IU.po,.p .~I I,oddn. 01 0,UOpI^3 'pou1lol' 6uI.q Iuno,"o 041 puo p.W!OI' Iqop 4'0010 o.nlOU .4110 UO!IOUOldx~ 1.I'q oop!^O'd '.o^od ~'o. 10 .o,"ou .~I puo Plod ,o/puo p.lIn,u! ,OM Iq.p 4'00 4'!4M uo .101' 041 1'\1 '''~IO," ,,0,6 '0 ouoI'qwol '101 10!.nq 010 ISO' .41 6ulpnl'U! so.u.dx. lo!'nq puo lo,.unl "..1 ^,o!,npll "001 ^.uIOllO 'uO!loIlS!U!Wpo 10 ISO' .41 6U!pnl'U! olqo,"!OI' 0'0 'W.II '.~IO 'IU.po,.p .41 ^q p.lIn,UI sIq.p 01 UO!llppo UI '.101.0 o\qo,ol '.4/'14 ISU!060 olqlpnpop 0'0 ~IOOp 'o~/'!~ 01 ,ol,d IU.P"op o~I ^q p.lIn,uI .olllllqol\ p.!I'!lo.un - SNOiJ.:>n030 'llSJ.930 'poop .Jl{l uo p3~D'!P'U! 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'UO!~OJOp !S,u 0' olOnbopo puo olqonlo^ O^!.,., IOU PIP 04'/04 4'I~M '01 ~IO.p 10 SJo.^ 010'1 UI~IIM ,u.po"p .4' ^q p.UOI,uoII ^I,.do,d ^UO IS\1 'Sluno>>O l.nIlO^IIOIUOI puo spu09 .6u!^OS Tn 'Q'O'd 01 p.I!'"!\ IOU Inq 6U!pnl,UI S.II,od '0 ^pod '.~IOUO 01 410.1' 10 .\qo^od Inq IU.p.'.p .~llo .wou .41 UI 1'.1111 ^p.do,d \ouoSJ.d .lql6uoIUI .pnl,ul '41001' 10 .101' 041 10 '0 1..'.IuI S,IU.p.'op .4110 on\o^ I.~'o," p.IO'"IIS. .41 puo SJ.UMO IU!o! 6UI^I^'n' .4110 ,u.p.,'p 041 01 d!~'UOIIO\.' puo (.) .'"ou 0~1 'd!~".UMO 10 0601UO,.od S,IUOp.'op 0~1 .pn\,ul '41001' 10 OWII.41IO dI4Sl0^1^'ns 10 '461' ~IIM 'luoU.I IUlot so '0 uo,","o' U! sIuouol'o '.Ipod '0 ^pod '.~IOUO 41110' ^llulo! p.UMO'O IU.p.'.p .41 ^q ^1.IoS p.UMO '1."0110 "\1 - NOIJ.dlll:>S30 'p.UMO.^\IUIO! 10 '.IsuoII '^I,.dOld 10uoSJ.d '.IOIS. 10."1 I.SSO .41 '0410~M .Io'lpU\- 13SSV ~O 3dAJ. Q< <( w >- NOll VWllO~Nl -lJ U1 QJ .'1.. "' ~ ~ 0 11l'" 0 .... M :1: If' u M co 0 :.0 rt: '" Q) t"- o III M ~ M M 0 ..-\ i .Co UJ .g .q ~ .... 0. do . <:J ;:l Q< r: :<: p. u 'C1 0 <( 0 u ~ U1 ill ,c III ~ <r.l '" III r- >- '" ::- l" c ;I, 0'1 '" 0 14 rU '" c..) .,. " 0 .. nl ~ :;. M C ~, .-l " UJ 0 " \.t ,:t, ~ '" III "u-i 01 " . '" \.t UJ U Jl tl. .-l I OJ " 'M 1: 0. N M .c ro .: ;:l e <I' co E-' ..-\ n: U ., ~J I M ,r; " :< M M U >- " 0 N ~ QJ ci . I, \ "1 u.. ".. :::: u.. E 0 '" 0 :z; ci g ci '" ill '" >- f- :z; 0 '" 0 f- W f- W :z; ill :z; <( Q< :z; '" W c W '" UI 0 t;; 0 ::> U " :z; ::E 0 0 0 0 <( <( 0 W <( U 0 0- ::; :z; <( ..I ..I 3' ci :z; :z; o i= <( Q< f- '" % ::E o <( SNOIl:lnlllSN1 .' '" M o t""" n: M N r.t ~ Po ~ . ~ !\ ~ u' ~ ~ UJ M M .r; ~ o u ci :z; w :z; o :x: 0- UI ..I ill f- :SJ.3SSV REV, 1547EX (11-84) J COM~ONW[A(tH or "ENNSVlv~Mt. NOTICE OF INHERITANCE TAX ~C~~:~Mg~IE~:M~~~~~~ APPRAISEMENT, ALLOWANCE ClR DISALLOWANCE ACN r.o. 80X "21 , OF DEDUCTIONS. A.'ID ASSESSMENT OF TAX tWIRISBlIRG. PI. \710~ DATE ESTATE DFI THOMPSON THERESA FILE NO, 21 81-0065 DATE OF DEATH 09-14-80 COUNTY CUMBERLAND NOTE: TO INSURE PROPER CREDIT TO YOUR ACCOUNT, SUBMIT THE UPPER PORTION OF THIS NOTICE WITH YOUR TAX PAYMENT TO THE REGISTER OF WILLS OF THE ABOVE COUNTY, MAKE CHECKS PAYABLE TO "REGISTER OF WILLS. AGENT" . 101 R08 A KRUG 148 S BALTIMORE DILLSBURG ST PA 17019 PLEASE RETURN THIS PORTION TO REGISTER OF WI LLS IF PAYMENT DUE Amount Remitted to Register of Wills 9~'I ,A.L9~~, 'IHJ~ ,L!~E, , .. _ ~, .!'lp,!,~I~ ,l:C?~~R.. !'9!l,!:19~ ,~C?R, Y9Y!l,R..ES::9!l~~, ~ , , '.. , _ , , , , , , , . NOTICE OF INHERITANCE REV, 1547EX (11-84) ESTATE OF THOMPSON TAX APPRAISEMENT, ALLOWANCE DR DISALLOWANCE OF DEOUCTIONS AND ASSESSMENT OF TAX THERESA FILE NO.21 81-0065 ACN 101 DATE 02-26-85 TAX RETURN WAS: ( ) ACCEPTED AS FILED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: 1 SUPPLEMENTAL RETURN 1, Real Estate (Schedule A) ( 11 2. Stocks and Bonds (Schedule BI ( 21 3. Closely Held Stock/Partnership Interest (Schedule CI ( 31 4. Mortgages/Notes Receivable (Schedu!e D) ( 4) S. Cash/Bank Deposits/Misc. Personal Property (Schedule E) ( 5) 6. Jointly Owned Property (Schedule FI ( 61 7, Transfers (Schedule GI ( 7) 8. Total Assets (X ) CHANGED - SEE ATTACHED NOTICE .00 .00 ,00 ,00 1,000.00 .00 .00 ( BI 1,000.00 APPROVED OEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Administrative Costs/Miscellaneous Expense. (Schedule H) ( 91 749,00 10. Debts/Mortgage Liabilities/Liens (Schedule I) (101 ,00 11. Total Deductions (11) 12. Net Value of Tax Return (12) 13. Charitable/Governmental Bequests (Schedule J) ( 13) 14. Net Value of Estate Subject to Tax (14) NOTE: If an assessment was issued previously. lines 14. 15 and/or 16 and 17 will reflect figures that include the total of ~ ~eturns assessed to date. ASSESSMENT OF TAX: 15. Amount of line 14 taxable at 6% rate 16. Amount of line 14 taxable at 15% rate 17. Principal Tax Due TAX CREDITS: 749.00 251. 00 .00 .00 (151 (161 .00 .00 X,06= X,15= (17) ,00 .00 .00 PAYMENT DATE RECEIPT # DISCOUNT (+1 INTEREST H AMOUNT PAID TOTAL TAX CREDIT BALANCE OF TAX DUE .00 INTEREST .00 · IF PAID AFTER THIS DATE SEE REVERSE FOR CALCULATION TOT DUE OF ADDITIONAL INTEREST AL. 00 (IF BALANCE DUE IS LESS THAN $1 OR IS REFLECTED AS A "CREDIT" (CRI. NO PAVMENT IS REOUIRED) 0. ..;,.. :.:-> oi.:.- Wid ~LI: n~ ~'. ~::. ,"r LJ', ~ , .~. ..' <., RESERVATION: Estates of decedents dying on or before December 12, 1982 -- If any future interest in the estate is transferred in possession or enjoyment to Class B (collaterall beneficiaries of the decedent after the expiration of any estate for life or for years, the Commonwealth hereby expressly reserves the right to appraise and assess transfer Inheritance Taxes at the lawful Class 8 (collateral) rate on any such future interest. PURPOSE OF NOTICE: OBJECTIONS: To fulfill the requirements of Section 1740 of the t~herilance and Estate Tax Act. Act 255 of 1982 (72 Pa. C.S. Section 1740), Detach the top portion of this Notice and submit with your payment to the Register of Wills. --Address information is listed on page 13 of the booklet, "Instructions for Inheritance Tax Return for a Resident Decedent." --Make check or money order payable to: REGISTER OF WILLS, AGENT. A refund of a tax credit. which was not requested on the Tax Return, may be requested by completing an "Application for Refund of Pennsylvanii Inheritance ind Estate Tax" (Form REV-1313l. Applications are .wailable at the Office of the Register of Wills, any of the 24 Revenue District Offices, or from the Department's Forms Service Unit 24 hour Forms Ordering telephone lines in Harrisburg - 17171233-3443, in Philadelphia - 12151 351-2065. or," Pittsburgh - 14121 565-3601, Any party in interest not satisfied with the appraisement, allowance or disallowance of deductions, or assessment of tax (including discount or interest) as shown on this NotIce may object within sixty (60l days of receipt of this Notice as follows: --by written protest to the Department of Revenue, Board of Appeals, P,O, Box 1874, Harrisburg, PA --by election to have the matter determined at the audit of the account of the personal representative --by appeal to the Orphans' Court. 17105 OR OR PAYMENT: REFUND ICRI: ADMIN- ISTRATIVE CORRECTIONS: Factual errors discovered on this assessment should be addressed in writing to: PA Department of Revenue, Bureau of Examination, P,O. Box 8327. Harrisburg, PA 17105. ATTN: Post Assessment Review Unit. See page 3 of the booklet "Instructions for Inheritance Tax Return for a Resident Decedent" for an explanation of administratively correctable errors. DISCOUNT: If any tax due is paid within three (3) calendar months after the decedent's death, a five percent (5%) discount of the tax paid is allowed, INTEREST: Interest is calculated on a dally basis at the following rates: pclinquent Date 5/27/4310 and including 12/31/B1 1/1/82 to and including 12/31/82 111/B3 10 and including 12/31/B3 111/84 to and including 12/31/84 111/B5 10 and including 12/31/B5 Interest Rate 6% 20% 16% 11% 13% Daily Intarest Factor .000164 ,000548 .000438 .000301 .000356 --Taxes that became delinquent on or belore December 31. 1981 will r:1aintaln a constant interest rate until the delinquent balance is paid in full, --Taxes that became delinquent on or after January 1, 1982 are subject to a variable interest rate that changes each calendar year. --Interest is calculated as follows: INTEREST . BALANCE OF TAX UNPAID X NUMBER OF OAYS OELINQUENT X DAILY INTEREST FACTOR --Any Notice issued after the tax becomes delinquent will reflect an interest'.calculation to fifteen (15) days beyond the date of the assessment. If payment is made after the interest computation date shown on the Notice, additional interest must be calculated, REV.1470 EX (6.841 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF EXAMINATION * P. O. BOX B327 HARRISBURG. PA 17105 .', INHERITANCE TAX EXPLANATION OF CHANGES , DECEDENT'S NAME '\, ( E,CHEDULE \,i ITEM NO. EXPLANATION OF CHANGES kr .\, ., .\ \' .. (/ \ , TAX EXAMINER: FILE NO. : : ACN \,., I \ 1(' " . PAGE 05 V1 c<<: .= I .""- .." :",( .r'~~ P1C) ~::-: ;~ ::J ."'1