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DaRTS AND DeDUOTION8
Dill
NI"" 0' PlY"
Nollnl uf Plbl
Amounl
.....----------.~~."..........-
2,t58.00
Myefs..~ll Fune't'at~
frUfj(IfIlIIlMlIDIlIU' paid
- -~._...............-............,...-..
Ftllf,lI~ o)\omptlM twill nul ho nHm"lJul unlu" dllclldont died
ro'ldln~ with a l10rtlntf IIHlIilU (Jt t;hllllrall.)
--..,............................ ...-....
AllmlolltfltllOfl !1JCllUnlut
------..----...--....
counlul Foat
..........--- -
-----"~
A. ~ .1U.tl'.mlll1 AsSOO. IT)c.
!!:by O1:jUlite WQ't'l<a
~1"b1,lt'g Dairies
Pt. witliamt<anensOll
PP6L
F,eg1Bterof Wills
Jon F. LaFa\let'
FlduCII'V Cumlnlulon
(01110. Pobtl olld Clll1n,l
Professionat SerVioes
M:ml.l'lllilrit
OI.1t:st:anc:\ing , bill
Professional Servioes
mlectric Servic~
Fit;tngFees
Ltg4Fees
22.00
425.00
t.40
200,00
, 16.78
6.00
200 . 00
Total
~,029 .18 13.
0110',1\ l,trUI. ootteot.l1~caIi\PI~II,
I J"'.,& - if
0111
I do hor.1iy mtlly Ihll I have app'II'ld Iha ~lIlt1 oonlalnad Iiltlln In c'
. ~'" _ f~/~31
. In Ihl lvenUhlt InV Mutlln"'alllnlh!,allllll'I,"o,llIted 11\ pO""lIlono. II1I~~~';~'~~ no It..11 111111,of \ho d.O~d.t\I.h~~~1 ..p"~tlon UflllV
6 111111 10,IIlI ot 'ot yalr.,thallommonwooith ha..by a.p.al,IV, tI,o'.lilhO tlQhl lu opp.ol,o .nd 011.11 lIinlf.. 10hlll,Iono, 1"0,11 the lowful 0011010111
, .... ~'". .. '"'""'..,.,, "
beblund deduollolla ate .nowed In tho .um of $
~~ IJ ,,'1.If/' 01_' ',&
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P~N~FIOIARIe& AND ADDIIE88P8 '
18"'" full Dim.. and .dd'..... of III who h.v. .n In'....'
ellh" v..,.d, Donllnglnl Dr Olh.. 1,01""11
PENEFIOIARIES
IISLATlON81l1P 8UIWlV8D
TO DEOEDSNT DE08D8NT
STAT8 Y88
011 NO
ME OF LIFS
, TaNANTB 011
ANNUITANT8
AT DIATH OF
DBO DENT
Adult
INTORE8T OF
BENEFICIARY
IN E8TAT8
- ~
St:anl~ O. Nelson
TI9 Brian OI:1Ve, !l:nola, PA 17025
Son Yes
,-- ~-_._..- .
.JoUlt:.-
Entire
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-~
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Oil m ~ c !!i 1=
m ~ m ~l, ~~
~I' 'II' ~, ~
/'" II, 0
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Ii I,:'
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to: ,'L Ii
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(." 1'-' .t~ "f'
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INPORMATION
~LAoIl POR PI LlN,G - Tho return la'lo be fIIod In duplloete wllh the R~gIRl~r 01 Wills 01 the county Wl'~roln tho decedentrllalqed,
TIMll ,~OR FI\.INO - Theflllurn Is dlle nlnemontha ofter,th.~ deoede~t's deall1, unleaa an oxta,nslon for f11lnll hea been epplhid illr end grenled
by the Saoretery 01 Ravenuo wllhln' the nlilo'monlh parl~d,
FAILURE TO~lLll'Rll""URN ,- 8ool10n,1'91 01 tha 1961 StatulaprovldBa that.". , ,eny person Who willfully IIlII. to fIIut"urn 01'
other raport re\lulrod 01 him". ahellho porsonellY lIablo, ,', toapanelty 01 26% 01 the tex ultlmatalvlowtd 10 be due or $1,000
WhlohoVo, ,Ie Ihelessllr to ha recoupred by IlIe Department 01 Reuenuo ea de,hts of IIku amount arll ,ecovorahlo by law,"
It!lPORMATION
To Ineure proper oro~1I to your 80UOIIIII, Iho 118mo 01 \11. .alolo and fIIo nllmh.r ahollld he cluorly print.
ed on the oheok or monoy order, ' ,
Thll eaauement la mado In 'acoorllallco wllh 50ClloII 708 01 tho IlIherllanoo ond Estole Tax ACI 01
1861 (72 p,S, g 24e6.7001,
To the, eXlenl thet Inherllenoe lax II paid wllhln Ihre~ (31 monlha elter Ihe doolh 01 Iho doce~ont, a
qlaoo~nl of fIYo(6) percenl la allowad 172 P,6, 6 2466."61,
Inl1lrl,tanoe Tax, other Ihan tox 6n 0 1~IUro il1taroal, la d~a ollho dale ollho deoodon\'a donlh ond booO!1'oa
dallnq~enl at th~explrallon 01 nlna (01 monlh, ulter Ihe do.edenl'e doolh (72 P,6, ij 2466.711), Inherllanoo
Texon a I",ure Inloreat II peyabla within Ihroe (31 monlha after tholranalo, takoa .lleol In poeeelllon and,
anloymenlend la dallnquent tharoaftor (7~ p,e, 6 2486.712), Colo~lela I"ler,,' Irom IhO dallnquent dato ahown
on,lhe ,faoa of thla form to tha dala of MIUal paymanl ualllg Ihe lollowlno Inla,r,eal toble:
.."!'__..._..........-_..._~_......._- -...-.............--;0 _...- ..-_... ......_--~.._-..... -.. ...--... ......... -...---....-...........-....... ---'--
1 mOnth ,006 4 monlhl ,020 7 Inonlha ,036 10 montha ,060
2 montha ,010 6 monthe ,025 6 monlha ,040 11 monthl ,066
3 months ,016 8 montha ,030 9 monlha ,045 12 montha ,080
1 dey' ,00017 I I doye" ,00186 21 daye ,003S2 '
2~eya ,00034 12 doya ,00203 22 daya ,00389
3 deye ,00061 13 dllya ,00220 23 d,aya ,00388
4 ~eV, ,OOO~6 14 deye ,00237 24 daya ,00403
Sday. .0008S 16 doya ,00250 26 doy' ,00420
Ilqeya ,00101 , a daya ,00267 26 dava ,00431
,1 deya ,00116 17 daya ,00284 27 deYe ' ,00464
:,ad,,'1 ,00138 Ie daye ,00301 26 deys ,00471
e deya ,00162 18 doye ,00318 29 daya ,004S6
10 daye ,00168 20 deye ,00336 30 daya .00600
-... ...-...----...----..----.... ---... --_...- --- ......- .,..---......-... -..... .........-- -... -... -...............-... -....-....
~ny pOlly In InlOreat, Inolulllng Iho COmmonwoaUh ond tho, peraonal repr.aonl.llye, nol aatlefled \,/lIh
Ihe eneeemanl meY' obJeot\herolo Wllhln alxlV (80) ~nye ollar r..oll>I of thla Nollce eb Pfovldod hy S..lIon
100' of Iholll.horitan.e end'Ealoto Tax AOI 011.961 (12 p,s, ~ 2480'1001),
MaKe ohook or mo!)ey order peyable to:
"Register of Wille, Agent"
Mall to the eddre8sIIstod beloW:
INfORMATION.
To I",ure proper oredlt 10 your eO'lo~nl, Iho namo of lho oilole and 1110 numllar ehould Ilo olaarly prlnl'
ed on lhe oheok or monay ardor.
Thla e..aumenl la mede In ocoordonoe wllh SootlOI\ 709 of Iho Inha,lIanoe and Salllle TOl< AOI 'of
1961172 P,S, i2496.7081.
To Ihe axtonl thaI Inho,ltance lex la paid wllhln Ihree 13} monlha nfter Iho ,death of Ihe deoedenl, a
dlaoount of five (6) percenlla eltowod 172 P.8, i 2496.7181.
Inherltanoe TaX, othllr thon tal< on a IUlure Interael, Ie duo ellhe data of lho dooedont'a deelh end beoomaa
delinquent at lite axplratlon of nine (81 monlha after Iho daoodonl'a .doeth (72 P.8. i 2406.711), InherltMoo
Tal< on a' futuro Into rOIl la paYabla within thraa (3) montha oftar tho tronalor ,okoa eff.ot In pOllan Ion end
enjoymenlllnd II dellnquanph~reofior (72 P.8, ij 2486.712). Caloulato Int.reSI from the dolinquent dote ahown
on the leoe 01 tltla lorm 10 Ihe' dele of aowal pevment ua"'9 Ihe following Intereallolllo:
.......-......-.."'.....--................-.. ......-.................. ..,.......- ...--- .........------ - ...,.....'-1""" ............------...........-..... __....._
1 monlh ,006 4 montha .020 ' 7monlhe .036 10 montha .oeo
2 montha .010 6 monlhe .0~6 8 mbnlha ,040 11 month. ,066
3 montha .016 e monlha ,030 9 monlha ,046 12 month. ,oeo
1 day. .00017 ,., daye ,OO18e 21 daya ,00382
2 davs ,00034 12 doya ,00203 22 dava ,00389
3daya ,00061 13 dova .00220 23 dova ,00388
4 doya ,00088 14 daya ,00237 24 doVS :004Q3
8 deya ,00006 16 doya .00260 26 daya ,00420
edaya ,00101 10 doya ,00207 28 daya ,00437
7, daYa ,oon8 17 daya .00284 27 doyS ,00484
8 dllYI ,00136 18 daye ,00301 28deya .00471
8 deya ,00182 19 daya ,00318 29 dava ,00488
10 diya ,00189 20 deya ,00335 30 daya ,00600
""'.~......_...:.:.._-_._-.......-...__..._..... --- "';...__.:.- -....- ......- - .......--... ....- --_...,----- -- --...;-........---.. .................
Any porl'l In ',nl.,oal, Inoludlng Iho 'Cbmmbnwoolth end Ihe pereonal repteaentatlvo, nor&atlalled With
thaU88l8monl may olll.ol thotOlo within al1<ly (90) 'dava aflar, rooelpl of thla, Not'o,a ua provided by 8eotlon
1001 of the In,horltenotl alld ~olelo To~.Aot of 1961 (12 P.S, p48S-10011.
Make oheok or money order payeble \0:
"Reglsler 01 Wllls,Agent" ' ,
Mell 10lhe eddr(l8811sIed below:
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