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IIECIS'I'EII III' WILLS OF
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I'ETI'I'IO~ FOil 1'11011,1'1'1'; III' 1\'11.1. A~IJ LE'I''I'I::IIS OF A1J\II~IS'I'IIATIO~
el'\! 'l'ES'I'A\IE~'I'O ,I~~EXO
LI':T'I'I':IIS III' .1I1\1I~ISTlI.\'I'IO~ Ill: 1l1l~IS ~()~
LET'I'EIlS OF .1I)1I1~ISTII,ITIO~ m: 1l0~IS ~O~ el'll
TEST\\IE~'I'O .I~~EXO
ill JI", E,lal<- "I ~\.',:~~~.\.\',:...:,S...0...\~,(s,.)\Y.',(,o.\.\d,.("'a'",.1.
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............\.t.l....."............"....."......,......................... ......... in tIlt, ahm'(' ('ilptiOJll'll (....I:lIe,.
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.s:.t;.~~\~:~s:~\~~;~;;:-..(,~.... Stall' of ....\~~,~::.\.:;.5.\\\..\:r,~;>.;:';.~L.h at thl' ;IPt of ..........S:~L....".. )'t'ilrs, IUl\'ing
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mild(. "Y.'-~-::-:. Last Will and Tt'slamt'1l1 datt.d tilt' ..l..:~..:::;.. day of ...........);>.,J..':.::":1::.......".......". A,I): lH.'.t".J,
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W)1l'rl'in ...s.t:..:":,:,..,, appoinlt.d .....J. .O.~,.,Q.b:'o.\:::-......." L:"tJ.i..~;..,.\~\.....,,:,4o,.':;;;:-:..~:.L.~J.~:'.:.~:.:. ,... EXt'(' \1'.~I:~::::.....
\\'hich Ext.c u\1.::-.:. ..".. h<ls sifl('<' ... C. ~'. .~'..\.~.':-:>.~.:: .::,:..~..\ ............ ............ ....."... .......... ".............. ...."....".....", ..."..",
on
On ............. " , day 01 ............................"......... ..." H)........, Lt.t!ers of Administratioll WNt. gmnh.d to ."......."....,.
dhn.
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3. l..{'lIl'rs () A( ministration ('.t.a. art.. 11I'l'( l'( )('('.lllS{' ....c.. ...........\:.\.~..~..'..:...,::.!..:..........>.-:'..;.~'..~.:;.."...:. '..'
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..........:;-.....;::-:'::',~"..;.:.~.~;.....~;.~...~;.:;.;.........,....,....,........,............. all< pl'l1l1oll('r s "t-t-"('s In .............t.~..... ('iipil('ltV a~
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4, De('t.dent cli('d c!omidll.d in ..~~~..S..f.(~;'..~~;;~;:/......J~;,,,(:.. with his lil.sl [:unil)' or principal
C .\ ..\ ,(slal(' """lIl1lr)i) , ,) i\
'd. "1 ' .,\1'......'>,.. {l\' \\0\'1.,...... I' Cr.' ....\...' \..... \"
resl (1)("<'.1 ...........,~.'l........... ".... ...".........'.,........l-,. .............. .~,....h-.........................,.......".."............................................
was was
5. (Wllt're d('('edt'nl died f{'statt') J)t.(,(.d('nl W;lS lint marrit'd and a child was uot horn to or
adopt('d by dt.('(.d('nt aftt'r t'Xl'('ution of thl' will (awl ",IWH' appli('ant is alll'g('d spouse) nor was dt.('('dcnt
di\'orc(.d from appli('.lIlt ~lflf'r I'w('ulioll flf ",ill <11)(1 OIl df';llh
6, Th(. Silid d('('(.dc'nt was possessed of Coo(h, Chattels, Hi~ht!l aud Crt'dits 10 thl' estimated
valu(. of $....I1.0.~.'.Q....... ;lIld of Ht'al Estall'. to tll<' l"stimatf,d vahl(> of $.......i.\-.~,-.")~":::~....... as 11('ar as
ca.n he ~ls('('rtaill<.d. 11mt lilt' said Ih'al Eslah' in so far as known is It)(,;lh'd in ..~................."..........................
.........,.........................,...........................................................,.."...,.,...............,..,................,...............................................,..
i. (WIU'rt. dt'f,t.d('nl di('d inh'.st;lh' ;t!i to allY portion of this (..stltt.). P('litimwr ..fh'r i1 prop('r
!it'an'h has ;tM't'rlainc'd thaI d('('('dc'nf was sllr\'h't'd hy IIIl' followillg-n:ll1lt'd Iwrsons t'ntit1c.d to di!ltrihution
undc'r the lnte'stah' A('I nf ]947:
Na.mt'
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for) Idh'rs oj ;l(lll1illi~fr;lti()1l ..."".._.1..::..
Daled: $.t;!pl;emper,18, 1981
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ill this pt'titioll :m' I l'lll , 10 l!ll' lll'!il 01 ,,' ..."",:'.,~.',L
ill tilt' ahm'(' .lpplll.atillll, 11l'1lI~ cllll~' ....;>,~,. ..\:".:,"::.... . OII't'orclillj!, 10 I.m ",tY(') lh,lt thl' !llah'IIlI'nh \t'l forth
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OATH OF PERSONAL REPRESENT A TIVE
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
} ss:
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being duly ,."''',.,..si.:,;,~:-:,.:Y,::::,,.,..,,',.,,.,.,,,.,... according to law do ..,....,.,., deJlM~ and say that as the
administra".\\,;~,.,C ,,!,,, of the es tate of ",.,.~, ,", :",~,;:~,.\,,,,;;,!,~..,,i\,,.,,, ,\,~~, ~'" ~)", \,:-. ~:,,,\A,,,,,,,,,,,,,.,,.,,, ,.,.,.", '"'' ",..
......................................,...................,.................................................,.."...........................,.....................,.....................
deceased ,.,.",:j\",,:-::~.. will well and truly administer the goods and chattels, rights lInd credits of said
deceased. according to law, A",J also will diligen(\;' compl;' with the provi.iolls of the Inw relating
to Transfer Inheritances,
............$-;\,.~..,~::.x~.................,., and suhscribed
before me.
,"':~m!?,~r."'1:~.,,,.,.',.,."..";;J,. 19B1""
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DECREE
Be it remembered that on the .".,.,:),~~!:i..........,.." dllY of "',.,$.~,p,t.!i!,\l),Q!i!,r...,.,."''''''',.,. A, D., 19,.81,,.
Letters of Administration Tn. tn.eae:'tllte of ,..",.......,JIJ~t.f.r,~,<;l,..A,.,.,M,(:,P,Q'W,~"',."",...",.,,..,,,.,.,,.,.,.",.,,,,,
.,.",.,,,.,,,,,,,,,,,,,,.,.,,,......,,,,,.,"',.'" ",..""",.", ,,.,,,,,,.,,., late of "'"..,H+.~.gJ!i!,~!i!.~",r,9.\'!T.\~,l:Illl....""..".."""",,..,'"
Cumberland Count.y. l'enllsyh'lIllill, deceased, were granted to ....<!.~~,e.t.9..~..,)!;~,~~"'~..,o!.~,~,I},..\'?,~....~.ailey
...........................................,....................................,...,..............,......,.............,'........"...................................................
Witness my hlllld lInd ollidal seal the c1uy and ~'''ar af(lreSaid~,/ .' ~.,
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546
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I sound and disposing mind, memory and understanding, do hereby make, publish
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\. and declare this as my last will and testament hereby revoking all prior wills
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Ii and codicils made by me, specifically revoking my last will and testament
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1\ executed February 13, 1979.
L~ST WILL ~ND TESTAMEN'r OF
WINIFRED ~, McDON~LD
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l'IRST
I direct the payment of my debts and expenses of my last illness and
funeral from my estate as soon after my death as conveniently may be done. If
there be no cemetery lot available for my interment, owned by me at the time
'i of my death, I authorize my personal representative to purchase such cemetery
lot with a contract for perpetual care, using therefor funds from my estate,
'~' in such amount as he shall consider necessary and desirable, and I authorize
"~ my personal representative to cause title to or ownership of such lot so
C~ ,I :::::::. ,. .. "'0'" '" 00.0 ,>O'"~ .. m, "'O~""' oo,mo.o,"<'"' .ooU
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~\;: Further, in this connection, I authorize my personal representative to
.~~ \:expend funds from my estate, in such amount as my personal representative shall
.~consider necessary and desirable, for the purchase, erection and inscription
..~
,~ '\
~ of a suitable marker for my grave.
><
SECOND
I order and direct that I be buried in a lot which I own, situate at
spring Hill Cemetery.
THIRD
wherever situate in equal shares to Edward Kunkle and Jean Bailey of cumberland
I give, devise and bequeath my entire estate of whatever nature and
County, pennsylvania, and Janet Kern of York County. In the event that any
such bcnefiddlY l'l'edec:edseb me lhen "did beneficiary's share shall be divided
",:,cng thp surviving beneficiary or beneficiaries named in this paragraph.
LAWor-,.c:t..
F\SIOlAN , BESS
CAIlUIILL
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OATH OF PERSONAL REPRESENTATIVE
COMMONWEALTH OF PENNSYL VANIA ss:
COUNTY OF CUMBERLAND
ore me, the Register for the Probate of Wills and granting of Lellers of Administration in and for the Count
. who, being duly
depose and say that as
of the last Will and Testament of
deceased
and credits of said deceased according to law. And
and subscribed before me.
.0.,19_
Register
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DECREE
embered that on the
day of
,A,D.,19 _. there was~'-
~Iateof
----
,Cumberland County, Pennsylvania,
Dece:lied. Letters e granted to
Witness my hand ~nd officia .~ Ie da)' and year aforesaid,
------
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Register
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AE.V'1500 E)( +(9.81)
BUREAU OF EXAMINATION
PENNSVLVANIA DEPARTMENT OF REVENUE
P.O, BOX B327
HARRISBURG, PA 17105
INHERITANCE TAX RETURN
RESIDENT DECEDENT
1/ ;")/'1 I
DECEASED
Decedent's Neme (len, First, end Middlelnitiell
McDonald \Hnifred, 1\,
Soclel Security Number Oete of Death
201-18-7986 8/22/81
Oeceden,'s Address
208 Bi,rch Lane, Country Hanor RD 8,
File Number
2. I - C; I - $ 7.3
1. Orl~n.1 Return G
Carli ale, Middlesex '!'wI'" Cumberland COlmty
4, Life Estete 0 5, Federal Estate Tax 0
Return Required,
6. Decedent died (estate GJ 7, Decedent maintained a living 0 8, Number of safe d.po,;! n
(Attach copy of Willi trust (Attach copy of trusll boxes inventoried llJ
All corraspondence and confidential I.. information should be directed to: Rob" rt L. 0' Brien, Esq.
CHECK
2, Supplemental Return 0
APPRO,
PRIATE
BLOCKS
CORRE,
SPDNDENT Name I
ROJert
3, Remainder Return 0
L, O'Brien, Esq,
_ Add[m 128 S, Hanover St.
Telephone No,
717-249-6873 City arlislc
Recapitulation
1. Real Estate (Schedule A) (1) 0
2. Stocks and Bonds (Schedule B) ( 21 0
3, Clo.ely Held Stock/Partnership Interest (Schedulec~ ( 3) 0
4, Mortgages and Note. (Schedule 0) ( 4) 0
5, Cash & Miscellaneou. Personal Property (Schedule EI ( 51 18.696.45
RECAPIT. 6, Jointly Owned Property (Schedule FI ( 6) 0
ULATION 7, Transfe" (Schedule GI ( 71 0
B, Total Gross Assets 1I0tal iine. 1-7)
AND 9. Funeral Expen.e. Administrative Cost./Miscellaneou.
Expen.e.(Schedule H) (9)_ 4.158,76
TAX 10, Debts/Mongages/liens (Schedule II (10) 16,261. 84
11. Total Deductions hotalline. 9 & 10)
12. Net Value of Enate Wne B minus line 111
CALCU. 13. Charitable Bequens (Schedule JI
LATIDN 14. Nel Value subject 10 tax Wne 12 minus line 131
Computatlen of Tox
15, Amount of line 14 taxable at 6% rate (151
(include values from Schedule K)
16. Amount olline14 taxable at 15% rate 1161
lincluda volues from Schedule K)
17, Principal I" due (add tax from line 15 plus tax from line 161
lB. Total Prior payments:
(II Amount Paid
(b) Plus Oiscounl
(e) Minus Interest 11 B)
19. Belance Due Wne 17 minus iinelB)
Make Check Payable to: Re;ister of Wills, Agent
... PLEASE RECHECK MATH" .
State PA
Zip17013
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( B) 18,696.45
(11) 20.420,60
(12) (1.723.95)
(13) 0
(141 0
x,06' 0
x,15' 0
1171 0
(19)
o
Under penalties 01 perjury,l declare thlt I have axamined Ihi. return, including accompanying schedules and statements, and to the ben of .,V knowledge
and belief. It is true, co,",ct. and camplele, Oeclaretion of preparer olher Ihan the ~"'on.1 reprosentati" is based on .11 information of which preperar has
a.vknowle A .k:",.? /i~VI()('; AJ,{C/t' I/~d I?; /7'(<"1 C;-,.2<t..{~
OF PERSONAL REPRESENTATIV~ISI / ,. ADDRESS /'. ('" OATE" of
SIGNATURE O~~ARERO;~: ;tE-'~;i"'-~::;' ~;;~~~""/~:~;>91: :L'::
ENl\ riG I '3 DA
COMMONWEALTH OF PENNSVLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
SCHEDULE "A:'
REAL ESTATE
MV.tU1JC+!'.1l1
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FILE NUMBER
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ITEM VALUE AT DATE
NUMBER DESCRIPTION ASSESSED VALUE OF DEATH
1,
None
,
TOTAL (Aloo ente' on line I, Recapitulation' $
(All propertv lolntlv-owned with Right of Survlvor,hlp mu.t b. dllclused on Schedule "F")
Winifred A. McDonald
(H more ~c;" il nHd~ in..," .-Idl\l:r:I;! ,~_tll ot urn. Ilr.1
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COMMONWEALTH OF PENNSVL VANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
SCHEDULE "C.,..
CLOSELY HELD CORPORATE STOCK
INFORMATION REPORT
Winifred A. McDonald
FILE NUMBER 00;- -73
'"? I - " I -S
t:._
1, Name of Corporation
None
State of Inc,
Address
Date of Inc,
Total # of Shareholders
~ \
,
2. Federal 1.0, Number
(As per Form 11201
Business Reporting Year
to
3, Type of Business
Product
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Stock
Type
Total Shares
Outstanding
Par Value
Shares Owned
b Decedent
% of Total Owned
b Decedent
Common
Preferred
Provide all rights and restrictions pertaining to each class of stock.
6, Estimated Value of Estate
Type of Stock
# of Shares
Unit Value
Total
6, Was decedent employed by the Corporation?
D Ves D No
If yes, Position
Annual Salary $ Time devoted to business
7, Amount of company indebtedness to decedent at date of death: $
8. Was there life insurance payable. upon the death of decedent. to the corporation?
DVes
DNo
If yes, Cash Surrender Value: $
Net Proceeds Payable: $
9. Did the decedent sell or transfer stock of this company within the last two years?
Dves
ONo
If yes:
# of Shares
Transferee or Purchaser
Amount
O,t.
.
.
.
10. Did the corooration have en interest in other corporations or pannerships?
o Ves
o No
If yes, report the necessary information on a 5cparale sheet.
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JlV~ISIOE)(+ ('.11)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Winifred A. McDonald
SCHEDULE "G"
TRANSFERS
FILE NUMBER ~I ,c-7 '1.
'2 I -'" -.) ...;)
1. Old decedent make any lifetime transfer of property without receiving a valuable ond odequate consideration which was
to take effect in posseSSion and onjoyment at or of tor death, or In which the decedent retained either:
YES NO
a. tho possession or enjoyment of or the right to income from the property transferred? or,
b, tho light to designate the persons who shall possess or enioy the property transferred or income; or
c. a reversionary interest?
x
X
X
----.--------------- - - - ---- ------
2, Old decedent In his liletlme make a transfer, the consideration for which was transferee's promise to pay incoma to.
or for the benefit or care of. decedent?
X
------------ - ----------- ------ ---
3. Old decedent. at any time. transfer property, the beneficial enjoyment of which was subject to change because of a X
reserved power to alter, amend, or revoke. or which could revert to decedent under terms of transfer or by operation of
law?
------------------- ------ -----
X
4. Old decedent within two years 01 death transfer a material part of his or her estate without receiving a valuable and
adequate consideration?
- --- -- - - - -- ------- - ----- - ---
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES. DESCRIBE THE PROPERTY BELOW.
DECEDENT'S DOLLAR VALUE
ITEM ASSESSED TOTAL VALUE % OF DECEDENT'S
NUMBER . DESCRIPTION OF PROPERTY VALUE OF ASSET INTEREST INTEREST
A. Real Estat.e:
1.
B. Personal Property:
1.
TOTAL (AI," enter on line 7, Recapitulation) $
Uf fllYl. ~;, t"oWo::w ~r,Mrt ~d:tlon.al st.MtI of "me C::.'
IIV',ISIJ IX+ (t..l)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
ITEM
NUMBER
1.
2
3
ITEM
NUMBER
1.
SCHEDULE "J"
BENEFICIARIES
FILE NUMBER
Winifred A. McDonald
21 -(fI-S73
NAME AND ADDRESS OF BENEFICIARY
RELATIONSHIP
AMOUNT
A. Ts.obls Bsque5lS:
Edward Kunkle
none
1/3 of estate
Jean Bailey
none
1/3 of estate
Janet Kern
sister
1/3 of estate
NAME AND ADDRESS OF BENEFICIARY
AMOUNT
B, Ol.rltabls Bsquests:
none
TOTAL CHARITABLE BEQUESTS (AI,o tnter on line 13, Recapitulllilml $
Uf motllPlea~' nMd~ lntett .ddltlonel ....Ht1 of Mini ,In)
^~j' I ,!v,1r
U~ ,,001ISUO) 'U!tpJO SIU'S".! JS)'11 Aq op I pUV
LAS1' WILl, AND '1'1~S'I'M1Et1'I' OF
\;INIFIlElJ A, M<'I~'N^I,11
t, Wiuifred A. Mwol.klll....dd tlf l'HlUlu'l 1.1I111t'tllllllV, I', 1l1l:.ylv.llli.., lu.illq 01
,lIId ,j..,'I..n' IlIis .,,; lilY j,"il w,ll "".\ \0-.1 .lI'" "I 11",.,1,,. ,," "I "''1 "II I'''''' wi I h
:.il\lllld .llId di:ipOliillIJ mind, ant'llllllV .!lI.\ 111..1,'1:,1,11111,1111. ,j,l 1"'lt.tIY 1lL.1t:. , Iql\111~ill
,and codid h mad" by me, "p,,'ci ficJlly "'v,,k i"" lilY I.,,;' WI II ,",.\ ,,,,,U'IIl,,"l
I;
I'
I executed Fcbrudry 13, 1979.
1"1 H:.;'I'
1 direct th~ payment of my rldJtb ,llId l.~Xllt,'m:l.'~,; td my liJ~il. il]Ill':i~) dlld
fuu.'ral from my "ht.alc <lU ,;0011 ..1'1.'1 lilY .1.'01111 ,", .'.."V..,'".''' Iy lIl"y b" d..lle. If
Ul<..... b.' 'I<' C',',nct....y 101 ..v.1i I..bl.. ,.., lilY ilt"'OI".."I, ..wl>..d I.y "'" 01\ 1 b.' I illl"
of my ,10.,,1.11. j autborize my I'ClU"It" I ""l'n'''''lIloltiV'' I.. 1"11>'1""", :;111'1, ..,.'lI",'"..y
lot with d contr.lct for pcr\,t~l\ldl e,JI't' , u:iill'l t1WfI'ltll Itllld~; IltlllllllY t~!;t.atT,
~'\
ill Hlldl .,mollnt ati he tihall ..'onsider 1I""":;,,~ry ,>I,d d.".; I ,,101.'. ,,"01 I ,,"thori ZI!
.....
,my pursllna1 rcpn.~sentative to CdUal~ ti t ll~ to or 11WIII'1 :.ldj' ut
~ill('h hll :;0
~
,--~
purchased tu be vested in such person at; illY pI'nollll,d
It'I,It'~idlt.t1t ivL' ~illlill
designate.
""'-~\I
...... ~,. Further. in this connection. I authori?" my 1,,'rm."oI1 Y('I,r"h"ntal'lw' to
.....J ,'xp"nJ funds from my <!state, ill such amoullt .." illY 1'"",,,,,,01 '''i,r''''I!lIldlive 6100111
~conaid"r nec<!6sary and desirable. foe the l'urcha';c', "1"1'1 lUll "lid im,,;riplion
~.
..~ ~.
~
>< '.
of a suitable marker for my grave.
SECOND
I order and direct that I be buried in a lol wloid, I "wn. "itu..te at
Sl'rinq lIill Cemetery.
TIlIRlJ
wh<!rever sl tUlIte in equal shllres to Edward Kunkle anJ ,)"an Ba i ley of Cumberlllnd
r give. devise and bequellth my entire eslale of whal"v"r natur.. lInd
county. I'ennsylvani... and JlInet )("rn .of York CoulIty.
In llo" ,-,vent that any
bu,;h b<.!l1efid"ry l'redecellse. UI\l \.h"n said b<.!nclici", y'" "h"." "hall bl! divid,-,d
!i
,
:Iauunlj toll.. ~urvivinlj blollOlhciuy or b<.!neficiadcs "...."J jl> llliti pal"yr"l'h.
L.AW O"'CL5
nsBIW'Il Ht:S5
c:AJ1L18L.L
HHNaYLYAHIA nOli
II
p
.1
....
. 'Or,
. .
'.
,
..
..'
.,
..... ., "..,...
J ..'...~ -, . ~a;.. '. ~~ "r,."
"' ,~'~~"'"j'f, ~~"'~'" .',
.. . r,' !,,"ilf!t.,r .....,.. "-
,." /'.. ";.
'.'....' ........
REV, 1547EX 110'B2 I
BUREAU OF E^AMINATION NOTICE OF INHERITANCE TAX i
PENNSYLVANIA DEPARTMENT OF REVENUE APPRAISEMENT, ALLOWANCE OR OISALLOWANCE IACN
P,O. BOX B327
HAIiRISBURG, PA 1 '71 05 OF OEOUCTIONS, AND ASSESSMENT OF TAX I
_~ ~~~ ..... ,~~~~_~..~~~,~..._.,.. ...,-,__. ...-..,.."...~..........._..i!1.e.LE..=-],);;:..Q,k::.!l,i?_.___...,_
ESTATE OF IICDONALD W!NIFRED " FILE NO, 21 81-0573
!1AT.LoLJ?.E,ATH 08,::22::81.._._______._. . .......,.._..., COUNTY.. CUll BERLAND
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
ROBERT L OBRIEN ESQ
128 S HANOVER ST
CARLISLE PA J1013
PLEASE RETURN THIS
PORTION TO REGISTER OF
WILLS IF PAYMENT DUE
CUT ALONG THIS LINE
_ _. _ __ _ _. _. h __ __
NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR OISALLOWANCE OF OEOUCTIONS AND ASSESSMENT OF TAX
REV, 1547EX 110'B2 J
ESTATE OF IICDOHALD
\HIIIFRE[l h FILE NO,21 81-0573
ACN 10J
OATE 11-01-82
,____TA.':.~~:!:~~~~'~?,~l ~:..1 ACC.EP2E.DJ'?.f:IL.EP _., __L-">-i.ANGEO _......____..__~_____._
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURli
1. Real Estate (Schedule Al
2. Stocks .md Bonds (SchedUle 8)
3. Closely Held StocUPartnershlp Interest (SChedule Cl
4 Mortgages and Notes {Schedule Ol
5. Cash & Miscellaneous Personal Properti (ScheauJe El
6. JOintly Owned Property (Schedule Fl
7, Transfers (Schedule G)
8. Total Assets
1 11 ._.._._,00..
I 21_,_,__.._".Q9__
1 31 ......__._,---'--QfL..
1 41 . ._....__........,.."QQ...
1 51 .__.l.l).!.illi~-,-j.?__.
I EI..._........_...:.QQ......
I 71..,....____.._.:.9i!_..
1 81 ______...~.8.,_696~P...
APPROVED OEOUCTIONS ANO EXEMPTIONS;
9. Funeral Expenses/Administrative Costs/Miscellaneous
Expenses {Schedule Hl
10. Debls/Mortgages/Llens(Schedule Il
11. Total DeductIons
, 2. Net Value of Tax Return
, 3. Charitable/Governmental BeQuests (Schedul! Jl
14, Net Value of E!>late Subject 1018)',
I "I ___j..t1.?jl-'.IL_
11 0I___..~.~J]..61-,-.8.i.....
1111 _____:2.0,420.6.Q..
1121 ______1.L723.:.95.::
I I 31_____ ..___,.QQ..
1141 moo.. ._,__,~OO_
ASSESSMENT OF 'I AX:
1 S. Amount of line '4 taxable al 6~(- tal(o
16. Amount of line 14 taxable at i5~o file
17. Principal Tax Due
TAX CREDITS:
1151_.__..._-,-0.11...' 06'" ___,__--'-9.9.,
il6I,.....,..__"'.Q()___, 15'___. .___....&9_
I' 71....___...____,.0.0._
r--.----..------....--.-. -"..-----,
I PAYMENT RECEIP1
l___.?~~~ .._____._____ t1
r
OISCOUNT I" I
INTEREST 1'1
AMOUNT PAID
I
L-_____._~ ~
"."-.,
i01AL iA\ CRED!1
.'"'-"--,.-.--.-----
BALANCE OF TAX DUE
...--.---.'-' -".
INTEREST
TOTAL DUE
.00 .
.00 '
-"'.". _.~ -_.~
.00..
.00
. IF PAID AFTER THIS DAT!; S!;E hfVE~SE ,0, CAlCUlA11CI!Ii
OF ADDITIOI;Al JI;TEREST
RETAIN THIS PORTION FOR YOUR RECORDS
(If Bil,"ce Du! IS It"ss th,1'l ~, ,00 1'lO pl~'m@nl I!; f@Qi.medl