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1'1-:'1'1'1'10:0.: FOil 1'1I0llATE OF \\'11.1. A:o.:D LI-:'I''I'I-:IIS OF AIlMINIS'I'IIATIO:o.:
,. ClI\1 TI-:STA\il.XI'O A:o.::o.:EXO
LETTEIIS OF All\II:o.:IS'I'IIo1T(O:o.: DI-: 1I0:o.:IS :0.:01'
LE1"I'EIIS OF A1l\II:o.:ISTII,I'I'IO:o.: DE 1I0:o.:IS NON ClI\1
TI-:ST.I\1I'XI'O ,I:o.::o.:EXO
in II", E.,/"',, 1/1 ....O.Q,.\l.~\J......f:......\)~.~,;..~,~......." d,'cI,,,,,.d.
I'etilinnerh;-), ........~.S,~,'S~~.".".:~..'.~.J.........\~~~...,~:.\.\::-.~',,'..""""''''''''''''''''''''''''''''''
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l. P('titi()lH'rA~r ;lIt> IWI.'lIly-olU' yt.ars 01 i\~t. or olell'l' and applit.s for It'lll'I'S of admillistratioll
...."......,...~.:L.A"".."....."."""".."....."..,,...".h"........ in the alm\'(' ('aplioll(.d ('stall'.
2. !)l'Cl.del.ltdied 00 ..........".......(P...(.?T.{...fP.......,..................... at ......",,,....,,,M. in Ihe Connty of
r 1_ \ n I' '--p. ' ,-.-,
"-!.i.JM..~J.~.\:...9.:<~.(Y...."... State of .....S,.,::-..'Y?:'::\. ,.~~..I.~\ ,,/ the "~e 01 ........~.................. years. hal'in~
made ..b.\~.."" Last Will and Tl'stamcnt datl'd tlU' ""..".....". da\' of ........."..."......"...................., A.I): Hl..."""
Wherein ...16g,.:... "ppointed ........D.",..~-\?\,.y.~........~~.ef..:".M.......:r..:E~~~....\.}.\\M.)\.... Exec'~,'.~...."
\Vhich Ex~c~\"!:.:........ has since ....."[.~~.~.~.,.....:.,..,..,.......,,,.,,,..........................................."........................
on
On ................ day of ,......."".............................".. IfL......, Ll~ttcrS of Administmtioll were granted to ""'..,,.........
... COU:o.:TY
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...................................".....",..........."..........,......................"......................................".."......................................".................
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3. Letters of Administration c.La. an' Ill'eded bccamc ..<<;.:..........,...r.-.~.f....~';7.'....,\.~.~S~.k..:.),................. '
~. ~ ~~
..........~~~..~~.q,.~..:~~...................................;......,,,. and petilioher~ applies in ........\.~~....... capacity 1\5
",b.r.l\i;l...,~.~~f.\...~'::l..j).~:~\,.s.."~.:),,...~ """'f-,.. "
4. Decedent diNI domiciled in' ......;~..I.~~~:f..~~.~.....~.. with his last famil)' or principal
residence at ..9:.~~...d...~~\...\~~~"(.~::~.~.~,b~Y.;L\...r.f\,...,"'..CM,~~.~J:,,~~..~ ^~ .
was was :..':':7........V\
5. (Where deCl'dellt died testate) Decedent was not married and a child was not horn to or
adopted by d{~('cdcnt after l')wculion of the will (and wht'n' applicant is alleged spouse) nor was decedent
divorced from applicant after {'XL'cution of will and at death.
6. The said decl~dl'lIt was possl'sscd of Goods, Chattels, nights and Credits to the esli~atcd
value of $......f.,Jl..O,Q...:.. amI of Heal Estate, to: the estimated value of $,............Q......."".... as n~ar as
can he ascertained. That the said Ht'aI Estl1lt.. in so far as known is located in ,.."........................."..",,;,,;..,...
......................."".".................................................,.."..".,,,.......,.,,,........,,....,,.,.,....,,..............."",,,,,.....",,,,.............................
7. (Where decedent died intestalt' as to any portion of this l'statl'). Pl.titiolll'r after a proper
search has ascertained that deced!'1l1 was sllrvived hy till' following-named pt'rsons entitl{,d to distribution
under the Intestate Al't of 1947:
Name
HelatiOllship
Hesidl'llCl'
[........,."....,...,..................,.........,..... ........................................,.................,.,.,............................................,.................."..,...
2, .........,.".................,,,,.........,.:...::,...:.:..:;..,.....,......."......,........,.,.".....;......,...~..."...,...,......,".,......,.""..........",,,..,...........,,....
3.."'"............:r.:".;~.',:...,....,.:.......'.:.,,.':.;....,,.,,,..............,...........,.......,........,.........,...,............"...,..........,...,."...."....",......",..."
4...........,...,.......,.......... ...................,...........,...................................,.,....,.,.....................,.........................,..............,....,........
5.."''''....'''............,...,.. ..,.,....................,............,.,.,.......,........"..........................................................."".".................,..........
6......".."..".."'..,..,.... ..........,.........,...........,....,....,...,..............................,.,.,...,.",................................................",............."..
""...,..............."....,........,............,....,.,.,...,...........,.,................."...,.........,.,.,.,...,....,...........".,.........",.....,.",....................."...",.
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Thl'r(.fon', petilillllt'r~ rl'spel'tfully applil's for (prohatl'of till' will pn'S('nh.d hen.\'.:ith and
for) letters of administratioll ...........~;~:,f~...........".."..............""...""..,............."...".~.....".....".."..."..1'..................,,,.....
Jul 24 1980.. l'If""......!: "".' !I;..~'";,,,.. . .
Dated: "'...."....,,"i........ ..t......... SI~Ill'd: 1..(..f..).'f.:...::-}/;.f'"r......H!.....i:'lh."''''''..:r.Io.I.,,.....?idll.~~.
. II..... ,'.ot/ i.h~l_t..;-"./;."t-'" r;K.' l~~Li..i.....i..J'"I)'1- /"';01.3
.\( IllSS. ,,)........./..,,..........If......''f''\''.....,,....,......................
15-154 ,
c:ml~IIl~II'EoII.T" OF 1'1':t-:t-:S\,!,\'oIt-:IAl SS
....,............,............".............."..,.,."................"....,...,,,...... .". "..."....,.,."..,..........,...,.....,........,........"COUNTY: ( "
,...,',c::l:1,~:r.~,~.,.~,~,<?~~.,I..I\.:,:,.!...,~?Il,I\..,~,~".,,~Il,~,~,!:,r.,B,<:l~.!",'~~~,~...... II", I'l'I it IOIIf'r ( ,)
ill lht' alll)\\' apl'licalitlll, Ill'illg dilly ......~.W.QXrL... a<.'('orclillc III I.l\\' ~ay(.~) that tl.ll' ~tall'ml'llls sl'l fnrlh
ill this Iwtithm ill'l' fnlt' 10 till' hl'.sl 01 ....t.h.e.ir..., kllowl(.d~(. and 1H'lid.
"..... .~.~~.~~..",.." ............, a lid SllIIS(Ti!JI ,t! hl'f'on~;I..., (.j/;"(,;,I.k/;:!...(;{f.,(.~:-:.~t.'.. ,:l..f~;:{,~~:.("..~J~.~.......
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,.........7.'.....1.~jf.;~';.;.....'..."..,,,!..!,,",,..,'..f.(..(.{,Z~t:..~.:!..':.l;~::~.. L ~ ;o,"l-'t.-v'
July 24, ,80
:::(}jFt':'(}:':"~~'I:",":
JanUiE'y 30, 1981
,..........,......................",........,............"...."".........
FiJ..<l:
Atlorncy's Name and Address ;'
"",...,.":R.-.c?,e~,1:,t:,,..~.~....9..~..~JO!~.!L...........................
................."........."....................................................................
OATH OF PERSONAL REPRESENTATIVE
COMMONWEALTH OF PI<:NNSYLV ANlA
COUNTY OF CUMBERLAND
} ss:
''''''"."......."..,,'',.,.,~~,~.~~,~'''~,~,..~,~f.,..~.~~.~.f....q:?~!l,"~"~,.,~~.~~~.~~.~~!.,,'~~,~...,,,....., petitioner(s)
being duJy """."'"''''"...~,w:g;J;:!)."".......",,..,,''''' according to law do "''''',,''. depose and say that as the
administra ..".""....." of the estate of ,....."!?,~,y.,;,~".~.~.,.,~!?w.~;I;,!!...."...".,.,,''',.,,....,.."..."..",,,......,,..,,.,,,.,,,,....
........................................................................................................................................................................................
deceased ...."...."......."... will well and truly administel' the goods and chattels, rights and credits of said
deceased, aeeording to law, And also will diligently comply with the provisions of the law relating
to Transfer Inheritances,
..,..,,,........~~~.~~........,..,........,,....... and subscribed
before me,
July 24 80
..~""" ..",.........".......""......""........, A, D" 19,...."..,
/} ~ -U/
R~gisi' pt....C.....7!1&1::..".....'......."..."'..
.x........4:{;,f.c;.;.kf..~(.I...,l...{f:.:.~(...~j!;2:~~;-:t'..kh~::..,..,...".........
..,..,..1.:;::,....3f.;f.;:>;;,....2!:?,;,,(~'i-:f.~.!;:1:':,',,:~~!..,"gf:~;!.:k/<.
DECREE
Be it remembered that on the .........~~......."... da;' of .........~~~.Y.....,.."..........., A, D" 19..~,L
Letters of Administration in the estate of ......................"'...........?C:~,I!~.~~~,~~!!.....,.........""...."..
....,.......................................................,.............."..... late of ,........,.......,..~,~;I;,~,~!!,~~.................,............"..,........"
Cumberlund County, Pcnnsylvania, deceased, were grantcd to ............"................"......"........"..""..........""
.,........,',......................",.................,................................,..."".....".................."....................,.............,...,.......",.........",
Witness my hand and official s(;al the day and year afore~s . , ~
............,.."'.. ... /1...~(.7f",a..... """ .....R~.~......,:
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LAST WILL AND TESTAMENT OF
DAVID E. BOWERS
I, David E. Bowers, a rosident of the Church of God Home, Carlisle,
Cumberland County, Pennsylvania, do hereby make, publish and declare this to
be my last will and testament, hereby revoking all wills and codicils heretofore
made by me.
FIRST
I give, devise and bequeath all property owned by me at my death of
whatever nature and wherever situate to the Church of God Home, Inc.,
CarliSle, Pennsylvania.
SECDND
I hereby nominate, constitute and appoint Dauphin Deposit Bank and
Trust Company Executor of this my last will and testament.
,
IN WITNESS WHEREOF I have hereunto set my hand and seal to this, my
last will and testament, consisting of one page this fi.!
day of 'f&u,a.O"
1979.
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,Cl:.'i/VA__~ 1-",
<ti,ll.WC.Vl (SEAL)
Signed, sealed, published and declared by the above named Testator,
David E. Bowers, as and for his last will and testament, in the presence of
us, who, at his request, in his sight and presence, and in the sight and
presence of each other, have hereunto subscribed our names as witnesses.
~- ,- !l/df';;'<'-' '"O~~/I. tU4.4...L1Il!/:/l1h I.
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OATH OF SUIISCRlIIING WITNESS
CO MONWEALTH OF PENNSYLVANIA I, ss:
COU Y OF CUMBERLAND
/
..' . /
This day of A,D,,19 ,
before me, Reg) er for the Probate of W;iIIs and granting lellers of.Adlllinislration in and for said County of Cum6erland, in
the Commonweal of Pennsylvania, personally came /
/
/
/
the subscribing witnesses t the foregoing instrumenl of writir.g purporting to be the lasl Will and Tj'lrnent of
\ Dated /
/
Cumberland Counly Pa" deiased who being duly
I
/ '
present, and saw and heard the testa
sign, seal,"IiSh, pronoiInee and declare the said
I
, /
ent and Last Will, and at the tifile of so doing
\ . /
- of w,.r~, """"' mi.' momo~~' "",,~i",. "'7f
knowledge, observation and belief. , \
and subscribed befor<\
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. l~..
late of \
__according to law, depose a~' ay, that
instrumenrof writing as and for h
..
Reg~ter
/
~DA VIT OF DEATH
COMMONWEALTH OF PENNSYLVA7N!~ ss:
COUNTY OF CUMBERLAND / \
/
7tIiat as nearly as can be aseertaineclthe said decedent
/ the day of
/
/
at or about
\
\
\
\
,
\
\
being duly
died on
A,D,,!9_,
o'clock, _M.
and subscribed this
day of
, before
Register
OATH m' PERSONAL REI'RESENTATIVE
~MONWEALTH OF PENNSYLVANIA ss:
COUNIT'OI:.. CUMBERLAND " ' '
Before me~ster for the Probate of Wills and granting of Letters of Administralio; i: and for the County of
~, /-
........... ,..~~.~
"~......
Cumberland, personally came
who, being duly
, do
'~
~.
deposeanct say thaI as
",,- ,_/
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/
of the lasl Will and Testament of
deceased
A.D., 19_
and subscribed before me,
"'~
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,
Register
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DECREE
Be it remembered that on the
30th
day of
January
,A,D"I!13~, there was probated and
recorded the last Will and Testamcnl of
David E. Bowers
Carlisle
late of
Deceased, Letters of Administration, ~<'rt\ranted to
Witness my hand and official seal the day and year aforesaid,
, Cumberland County, Pennsylvania,
Church of God Horn" Inc.
~?l!d1.?/ (!'.1~_f_~
RegISter ,
REV.449 ~Xi (3.801
COMMONWEAL TH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
TRANSFER INHERITANCE TAX
RESIDENT DECEDENT
AFFIDAVIT OF
FIDUCIARY
(lnslruction. on Reverse Sid.)
Estole of David~_~owcrs_____..____
Dote of Death
6/2R/8D
Lost Addres~huJ:ch_oLGo.d_lIome.,_IOc~_____
801 Harrisburg Fike
J::atiis.1eJlL.LLOl3
Soci 01 Securi ty No,179-1O-05DO
Bureau File No.
I(:J'rYI
(STAHl
(ZIPI
County File No. 21-81-72
1. Decedent died:
( ) Intestote (withoul 0 will)
( x) Testate (leaving 0 lost will--copy attached)
2, Is the filing of 0 Federal Estate Tax Return required for this estote? Yes_ No x
3, Executor/Executrix (x) Administratorlilclmimsmotlixx C.T.A.
Nome -Goo"Gl1-Gf-God-HGIl19-r-I"'"
801 Harrisburg Pike
Address
Carlisle, PA 17013
(CITY)
(STATE)
(ZIP)
4, All correspondence should be moiled to ( Attorney
x
) Fiduci ory.
5. If on attorney is representing the estate, indicote:
Nome Fishman and Hess Attn. R. O'Brien
Address 128 S. Hanover st.
Carlisle, PA 17013
(CITYI
(STA.T!::)
(ZIP)
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List 011 safe deposit boxes reqistered in the decedent's individuol nome, or jointly with, or os on agent or deputy
of another, or in decedent's individual nome with right of access by onother os agent or depaty. Include the nome
and oddress of the bonk or other institution where the sofe deposit box is located, the nome (s) in which the box
is registered ond the relotionship of the joint holders to the decedent.
NAME ANa ADDRESS OF BANK OR OTHER INSTITUTION
IN WHICH OECEDENT MAINTAINED A SAFE DEPOSIT BOX
NAME OR NAMES IN WHICH
SAFE DEPOSIT BOX IS REGISTERED
None
RELATIONSHIP OF JOINT
HOLDERS TO DECEDENT
Under penalties of perjury, I declare that I hove exomined this return, including accompanying schedules and
statements, ond to the best of my knowledge ond belief it is true, correel and complete.
" D (\
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151'~ ~':' ;))1., (JlIn",.vrH., ((,I",.,.
, t/ SIGNATURE OF FIDUCIARY ,
~'-j/f/.fl
,
DATE
QUESTIONS CONCERNING PROPERTY TRANSFERS
1. Did decedent, within two years of death, make any transfer or any material part of his estate without receiving
valuable and adequate consideration? (Answer "Yes" or "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",) _
3. If the answer to one or two above is "Yes" and the transfers are claimed to be nontaxable, provide the fallowing
information:
a. Age of decedent at time of transfer,
b, Copy of death certificate.
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 death? (Answer "Yes" or "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" ,) _
b. The right to designate the persons who shall possess or enjoy the property transferred or income therefrom?
(Answer "Yes" or "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",)
8, Did decedent, at any time, transfer property, the bBleficial 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".)
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",)
....
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REV.41S4 EX+ (3.S0}
l;OMMO'NWEAL TH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
TRANSFER INHERITANCE TAX
RESIDENT DECEDENT
SCHEDULE "E"
JOINTLY OWNED PROPERTY
'*
(Instructions on Reverse Side)
Estate of n.:lV; rl F.. Bowp.rs
P
TOTAL E VALUE OF DEPARTMENT
ITEM \
NO, DESCRIPTION MARKET DECEDENT'S VALUATION
VALUE INTEREST (Official Use Only)
T
None
.
TOTAL TH!S PAGE ^'()I\IE
~Ir.
COMMOt,WEAL TII OF I'ENNSYLVM,IA
DEPAfHMENT OF f<[ VENUE
TRANSFER INHERITANCE TAX
Rr.SIDENT DECEDENT
l~ORIG;NAL--
INHERITANCE TAX
APPRAISEMENT
$:
\.:Fk ~
r~}l(l~~~
;~i'. '...\~'..il" ,~J !,'>t
O>""~~'(")'-~"'''''' ,
11EV.4~7 EXt 17~OI
Estate af
David E._ J?Cl:-,ers__._____ . __....__
o SUPPLEMENTAL
File Na, _?:l,..8J,..P072_ _________
County _
Cumberland
Date of Death
June 28, 1980
In the CVftnt thai OilY future Interest In this esloh.! Is trons'errod In pOS!lo5sioJl or cllioyment to collateral heirs of the decedent after the
<<"cpltatlon of ony ostatl! for IHe or for yutH':>, lilt! COllllllollwuo\lh herehy expressly resolver. the right to llpproise and assess hansf6r
Inherltanco taxes at tht! lawful collo'flfol role on any such futuro,lntorost.
--.--....
- -
PROPERTY NOT INCLUDED IN RETURN BUT APPRAISED BY THE COMMONWEALTH
ASSET SUMMARY
DEPARTMENT'S
APPRAISED VALUE
Unreported $ $ None
Unreported $ $ 10,071.45
Unreported $ $ None
Unreported $ $ None
TOTAL GROSS ASSETS $ 10,071.45
1. Total Real Property - SCH. "A". , . , ,. $ -li.Q.ne
2. Total Personal Property _ SCH. "B". . , . $ 10.071.45
3. Total Jointly Owned Property _ SCH. "E" $ None
4. Total Tronslers _ SCH. "C". , .'. , , ., $ None
o LIFE ESTATE
DANN~ITY
DREM~~DE~________
_._-----,.__.-._-_.,---_._---_.~._.
TOTAL VALUE
$
- --_._~---_.,._._._--._----_._._----- ---.--....-------.----- - . '. ---
I do hereby certify that the obave appraisement is mode in conformity with Pennsylvania law and hos been filed this
day with the Register 01 Wills. ' \. (' , ,
,ji I)d ~ (1 j {[i ~! l tij Ill{ ( ( 11/27/81
APpr~AI5ER
OATE
.
0
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0 ~
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REV.1SOOEX+ ('2.~1 ~. ..
COMMONW{A~~NSYlI/ANIA
DEPARTMENT OF REVENUl
IURlAU OF EXAMINATION
P.O.80X8327
HAARISBURG, FA 17'05
INHERITANCE TAX RETURN
RESIDENT DECEDENT
File Number ~\ - 'ill- 00\ l.-
Decedent's Addl'ess
CHECK
1. Originel Return 0
o .~~-<60
2, Supplementel Retu," 0
3. Remeinder Retu," 0
BLOCKS
5. Federal EstateTex 0
Retu," Required.
6, Decedent died testate 0 7. Decedent maintained a living 0 B, Totai Number of safe 0
(Attach copy of willl trust (Attach copy of trust! deposit boxes inventoried
All correspondence and confidential tax information shouid be directed to:
4, Life Estate 0
APPRO,
PRIATE
CORRE'
SPONOENT Neme
nil...
Telephonc No.
City
State
Zip
Recapitolation
t Real Estate (Schedule A) ( 1)
2. Stocks and Bonds (Schedule B) ( 21
3, Ciosely Held Stock/Partnership Interest (Schedule C) ( 3)
4, Mortgages and Notes (Schedule 01 ( 41
5, Cash & Miscellaneous Personal Property (Scheaule E) ( 5)
RECAPIT. 6, Jointly Owned Property (Schedule Fl ( 6)
ULATION 7, Tra.sters (Schedule G) ( 71
B, Total Gross Assets (total lines 1.7)
AND 9, Funeral Expenses Administrative Costs/Misce!!aneous
Expenses (Schedole HI ( 91
TAX 10, Debts/Mortgages/Liens (Schedule II (10)
It Total Deductions (total lines 9 & 101
12. Net Value 01 Estete lIIne B minos line 11)
CALCU, 13. Cheriteble Bequests (Schedole Jl
LATlON 14. Net Velue subject to tax Uine 12 minus line 13)
( BI
(11) In)\3~'')5'
(121
(13)
(141
Compotation nf Tex
15, Amount of line 14 taxable at 6% rate (15)
(include values from Schedule Kl
16, Amount of line 14 taxable at 15% rata (18)
(includa valuas from Schedule Kl
17. Principal tax dua (add tax from line 15 plus tax from line 16)
lB. Total Prior payments:
(el Amount Paid
(b) Plus Di!Count
Icl Minus Interest (IB)
19, Balence Due Uina 17 minus line lBl
Make Check Peyable to: Register of Wills, Agent
. .. PI.EASE RECHECK MATH'"
x.06=
x.15=_
(17)
(19)
Under penalties of perjury, I declere that I have examined this return, including accompenying schedules and statements, and to tha best of my knowledge
end balief, it is true, cor eet, and compla", Declaration 01 preparer othar then the personal representetive is based on ell information of which preperer has
~~ ~~
ADDRESS I ' DATE
SIGNATURE Of PREPARER OTHER THAN REPRESENTATIVE
III ")(t \J.HOI
COMMONWEAL TH OF PENN8~LVANI^
DEPAnTMENT OF nEVENUE
TnAN8PEIlINUEIlITANCE TAX
nEBIDENT OECEDENT
SCHEDULE "F"
STATEMENT OF DEBTS
AND DEDUCTIONS
*'
~..~. . ...- .
__.._.__.._.~~:-==.=:;;..;..,~-:;:===..;;::..:..=":;.;..'~.-c~
Estate of _.__..~~!._~_I~:_~IO~:2'~~. _____._____ Dale of DCilth_ 6/28/80 File No,21-81-72
WHEN CLAIMING THE FAMILY EXEMPTION, COMPLETE THE FOLLOWING:
Clalmont
___ Relationship 10 Decedent ._.
Clalrnunt's Address
I~g~ - I
DArB NAME OF PAYEE REMARKS AMOUNT
1 2/10/01 I1nrr 'rhumlllll Ins. Admin Bond 95.00
..
2 " Ku nno th GUH tWll i te , M.D. Medical expenses 267.00
3 " f'Iuhmnn ilnd lIess Costs advanced for Letters 26.00
-
4 " l~vonJ.ng Sen t.i ne 1 Advertise Letters 23.5D
~ " ,,,_I.n~' ",,,, r..,w ;.0 T.~~~~~o , 8.00
" " '--'1010 "no";",,l MedIcal exnenses 8.70
~ " " Ol-M~ eo 313.91
0 " n__H,,'n ... :1-,' u_ " .. 'ElS.- ?01 nn
-
~ " "nU -, u_~, _, a~ Of'
.n " n '00_ I.. .- n_ ". ."- . nf' , ,~ "" '''" 00
" '"0 'on_ "nn'M n__""', u, : .,. "f' b_~ "'MOO 10"' ao
1 " . "~Jon 1", "'~ ,,~Oo f'~~ 1.0',57
. , o ,,~ 'n~ _c n..~ T, ' -~ ;:d"nrc:: f(:lp. I.~, . ~
.. In- , ",,,,, "".. ,n o~ ~ ,~ ,~ " ~~
First and Final Account
-
.
,
TOTAL THIS PAGE I $10,132.75
I hereby certify that to the best of my knowledge and belief the foregoing is a just aod true statement of debts, funeral
expenses and expenses of administration submitted to the cstate as deductions for Inheritance Tax purposes,
5IGNATUIH:: Of ATTORNEY/FIDUCIARV
DATE
OFFICIAL USE ONLY
DEBTS AND DEDUCTIONS ARE ALLOWED IN THE SUM OF S
AT
PERCENT,
HEGISTEH OF WILLS
DATE
, ..
~.
GENERAL INHERITANCE TAX INFORMATION
....
\
\
!
,
Unsatisfied liabilities incurred by the decedent prior to his/her death are deductible against his/her 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 $2,000 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 > tTl ~ ~
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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,
)
I
I
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I
,
REV, 1547EX (1-82)
BUREAU OF EXAMINATION NDTlCE OF INHERITANCE TAX ~ASSESSMENT
PENNSYLVANIA DEPARTMENT OF REVENUE APPRAISEMENT, ALLOWANCE DR DISALLOWANCE CONTROL NO. 101
P.O. BOX 832 7
HARRISBURG, PA 1710S OF DEOUCTlDNS, AND ASSESSMENT OF TAX
~TE ~Q-20-8,
ESTATE OF 80WERS DAVID E FILE NO, 21 81-0072
DATE OF DEAl!:LQ.~80 ___.____ CDUNTL..CJJ.MIlJ:;m,AIiD
NOTE: TO INSURE PROPER CREDIT TO YOUR ACCOUNT SUBMIT THE UPPER PDRTION OF THIS NDTICE WITH YOUR TAX
PAYMENT TO THE REGISTER OF WILLS DF THE ABOVE COUNTY. MAKE CHECKS PAYABLE TD "REGISTER DF WILLS,
AGENT." IF TAX PAYMENTS ARE MADE WITHIN 3 MONTHS OF THE DECEDENT'S DATE OF DEATH, A DISCDUNT
OF 5% OF THE TAX PAID MAY BE DEDUCTED.
ROBERT L OBRIEN
128 S HANOVER ST
CARLISLE PA 17013
PLEASE RETURN THIS
PORTION TO REGISTER OF
WILLS IF PAYMENT DUE
<!l,!'!: _A.L9f\1~ _ ,!:HJ~ _l!~E_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ , _ _ .
NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF BOWERS
DAVID
E FILE ND. 21 81-0072
DATE 10-20-82
TAX RETURN WAS: (X I ACCEPTED AS F!LED
APPRAISED VALUE OF ESTATE:
1. Real Estate (Schedule AI
2. Stocks and Bonds (Schedule Bl
3. Closely Held Stock/PartnershIp Interest (Schedule C)
4. Mortgages and Notes (Schedule 0)
5. Cash & Miscellaneous Personal Property (Schedule E)
6. Jointly Owned Property (Schedule Fl
7. Transfers (Schedule G)
8. Total Gross Assets
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Administrative Costs/Miscellaneous
Expenses ISchedule H)
10. Debts/Mortgages/Liens (Schedule I)
1 1. Total Deductions
12. Net Value of Estate
13. Charitable Bequests (Schedule JI
14. Net Value Subject to Tax
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:
PAYMENT
DATE
RECEIPT
#
DISCOUNT (+)
INTEREST (-)
THIS ASSESSMENT IS BASED ON: 1 SUPPLEMENTAL RETURN
NO INTEREST IS DUE IF PAID BY 03-28-81
IF PAID AFTER DATE INDICATED SEE REVERSE FOR INSTRUCTIONS.
ACN 101
) CHANGED
( I)
{ 21
( 31
{ 41
( 5)
{ 61
( 7)
.DO
.OD
.DO
.OD
.DO
.OD
.DD
{ 81
.DO
{ 91
(101
10,132.75
.00
(Ill
{121
(13)
(141
10,132.75
ID,132.75-
.OD
.00
(15)
(161
.DD
.DD
X06=
X.1S=
(17)
.00
.OD
.00
AMDUNT PAID
TOTAL TAX CREDIT
BALANCE OF TAX DUE
1,519.91CR
RETAIN THIS PORTION FOR YOUR RECORDS
(If Balance Due is less than $1.00 no payment is required)
RE (' ~ ~l. I
! ~ ., r
'iV
~. , 1
I,;
INFORM A TION
This document is the Notice reqUired to be given under Section 709 01 Ihe Inhentance and Estate Tax Act
of , 961 172 P.S. section 24851.
If the lax is paid within three 131 months after the decedent's death. a discount of 5% 01 the tax paid IS anowed,
Inheritance Tax becomes dellnquenl nLne 19I months after the decedent's death. Interesl IS charged al the
rate of six (6) percent per annum on the amount of unpaid tax. (SEE EXAMPLE BELOW)
EXAMPLE: II a balance of tax due of $2,000.00 is Ln a delinquent status from ~. and payment is made
on 5-23-80. the interest is calculated as indicated below:
STEP 1
Determine the rate of
interest from the table below.
STEP 2
Multiply the balance of
tax due by the rate of
Interest.
STEP 3
Add the interest
to the balance of
tax due.
Interesl from 3-03-80 to 5-23-80
Results in: -
2 Months =
20 Days =
Rate of interest =
.010
+ .D0335
.D1335
Balance of tax due
Rate of interest
INTEREST
$2,000.00
x .0'335
$ 26.70
Balance of tax due
Plus Interest to
Date of Payment t+l
TOTAL tax and
interest to Date
of Payment
$2,000.00
$ 26.70
$2.026.70
- - - - - - - .. - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
, month .005 4 months .02D 7 months .035 , 0 months .050
2 months .01D 5 months .025 8 months .040 " months .065
3 months .015 6 months .030 9 months ,045 , 2 months .060
1 day .DOO '7 " days .00,B6 21 days .00352
2 days .00034 ' 2 days .00203 22 days .00369
3 days .0005' '3 days ,00220 23 days ,00386
4 days ,00068 14 days .00237 24 days ,00403
5 days .000B5 15 days .00250 25 days .00420
6 days .00101 16 days .00267 26 days .00437
7 days .D0118 ' 7 days .00284 27 days .00464
8 days .00135 ' 8 days .00301 28 days .00471
9 days .00152 ' 9 days ,00318 29 days .004BB
10 days ,00169 20 days .00335 30 days .D0500
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Any party in mterest, including the Commonwealth and the personal representative, not satisfied wilh the
appraisement and assessment may ob ject within sixty 1601 days after receipt of this Nolice as provided by
Section 1001 01 Ihe Inherllance and Estate Tax Act of 196' (72 P.S. sec. 24B5 - 1001).
MAKE CHECK OR MONEY ORDER PAYABLE TO: "REGISTER DF WILLS, AGENT"
DETACH THE TOP PORTION DF THIS FORM AND SUBMIT WITH YOUR PAYMENT TD THE REGISTER OF WILLS FOR
THE COUNTY SHOWN ON THE REVERSE. SEE 1HE INHERITANCE TAX INSTRUCTION BDOK FOR ADDRESS.