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HomeMy WebLinkAbout81-00759 ,OATH OF PltRSONAL REPRESENTA'rIVE COMMONWIMurn Ol~ V!DNNBY1N ANI A COUNTY of'buMur~nI4ANj) } HHI 1I1l1li!\;HlllllillHIII"lIl1 It II' 1<', 1I','1l<.ItI' ""iY.X!?I~I~r., ,~,~.~...9.~~Jf1J" "HI'" ",,,., ",'" " '" '" "'"'''' I" ,,-, It "...:; ""t! '"'' pot,tttonOlt-( tl) tiOhlJtduly ".,I'''';i,~_"~h'.9J~rL,,,,,,,t1.tlli,,..,,.lti'''';I'' I\cool'dlng to Inw ,do ~>>'"1''''' tlOIlCJlolO uud Rt\~' thnt 'ua th~ udmtnt~trt\ ~~J.~..il"1! .ot tho oRinio 'ot' .,I""....\1~~).\I;\"-t"\T.,,'-.~\~Qd.,,.,...""..,,",...,',:..,q"!lII"(j"""I<OIl..",,,j'''''''''i1i. 1\~9.~nRl\rJ 110001\ROll, 1I00111'dhllf to IIIII'. to Trnnsfor InnOI'ltllnoOH, 1I1U till,; i" 11'11"" i \ ',','" i.. I "I'" II ..."".,..,.." II ;iH..." ", \I"" II" I; ","; II'" II "" "'"'''' HI"""'" I.", Ii'" ,',.."""" ,- "',," I'''''''' ,.. II'" 11111111 ,'" III -' "'" ....,Po""............. wtll woll IIl1d 1I'IlI~' IIdI11II1IHtOI' Ihu gurJlIH 1\1111 Ohllttol~, 1'lghtHllnd ol'odltH of HRId ".- ' . And III~o will dllhl'ont.1~' o()rn\ll~' with tho \l1'ovIHloIlH of ,Ihll Inw I'ohltlnll' , . Sworn I I. II I '.III'II!",.II'''H'UII""",.,.""",,,,.IH.,H'"Il. lUll 6\tIJSCl' lO( betol'O mo, :2.';"~,\l,"ml?fl;r." ,1.~"" ,.."" ..:I)l~",a....:, Regls~~ f . lo"I),L ') C r~. .f''--'~ ." I." .~l /,::...._" '7~ ~ """'.'" V'..'. "'".'l,..h,m-.., ,....f~,'.n,"." n'....~'rf, '. I, lvonno A nlQ(h;aIl8 . . ' .. ";..""",.""",..".".."""""".,....",..,,,.,."...j,II""I,,,,....,.,,,,,,.,,1 DECRE~ Be It remomlJorod thllt oll,lho "".",....1,:('.1),I:!......,... lhl~' of ,........"P,\'1P.fUllP,~;r.........,....... J\, o,.llfl,L.., LQttO~8 'of .AdminlstttuUon in the oHtntc of '",.""tiP"M;~n.hlM~,Jr";J.".,.n,(:;~.Q.,'',,.,,''',.,'''''''''''"";''''''';11';11'''''''''\ ;Htl"i;"'l"'\'".'.;''''' II""",,,,""'I'~' """ lI"It ;.,...,"'" ",,,'Il,' Into of .... '"'''' Q, ~t ,~\~.~J,fil.". it..", 11",,,,,,,,,.,,,_'.,,,1+',"""'\1 .l+lnUI/ Omuborll\nd Counh', Pelll1sylvllnllli dOCCIIRor1; worD Il'I'Imtcd HI ......X,Y,I?P.}.l,f;1";I.\;l,\\l.\\,,,(l;r.fi!ZP.:...........,,,,,.., "11'"""" ''';''';''"''.'110'-''.''''''''11/'''''' ",,,'i""" I ...,'.11 ,-,',,,,,.., ..", ,'",,,, '.....11 II"" "" It.""", ,,~"'"i''' ""'~ 1+ Ii ",,,,",,,,,,,,,," .,i ,...jli"" 111"'1"" Wltnosl! my hlll1l11llld omclnl HOIII tho dl\Y IInd ~'Oll\' IIfDl'~" / " ,..,.".""."";.!Jlf',,,..c?.l'" " (t' , 0, j,1 .:r ., , 'c -'C~;-, , ',- ... ;1;".( <':'1' l4-11.1 c. 1I':r,..J '; ,:\1:' I:!=: ';:.JLJ U.;Vl '1'-' ~W ~=:i:; 50 3.1i3 _J t.J II !~~~.Ot) ~ ~ ~ ~ fltr ,1- ';V.f.r REV, 18478X (Q7-"1 \ ' ., I, NOTlOI O~ INHIRITANOI TAX ' .~. ,. APPAAIIIMINT, A~~OWANOI OR OJSA~~OWANOE AO~ Of OIOUOTIONI, AND AI,IIIMENT O~ TAX 1,01 J COMMOh'l\'I.All'l or l'Uj~5"1....aIW, Otf'~!llMlIl1 ('II 'nvt~I'( IHIII[M' 01 AJ;(:oulitr. U tt~(MiNl 1'0 P())( H9o,J tt~ImIUIIM_ tit. 1110f, ,mATt OfRlnll:O MICHTlll:!., J fl~e NO, ~1 al-0761l gAI1...QL/llAIt\..U,:li~~l _____.___m~~ ___.ugUNTY OVliBERLIINP NOTlITo JNIURI PROPI" cRlolT To YOUR ACCOUNT .UIMJTTHI UPPIR PORTION OP THII NOnOI WITH YOUR TAX PAVMeNT TO THI RIlllITIR OP WI~~1 0' THIAIOVI OOUNTV, MAKe OHICK, PAYAI\.I TO "RIGIITIR Of wm., AllINT" , rPLI.:ASE RETURN THIS--- PORTION TO REGISTER OF WIL/.S IF PAYMeNT' out; Amounl l1,mlll,dlo l1'OI,I't of Will, . HtlllllRT X GILROY 4 N HIINOVER ST CIIRt..ISLE ESO I'll 17013 cu'!' Al.ONa THIS LINI .... RITAIN LOWIR PORTION FOR YOUR RICORDS ... .....;.__...." p... '7''' ,...... .... ,..-.. -...... "'." ._..r.... -'.;'" ---.. .,"';' ~... -....... - - -... - .-... --.. - -.-"~' - - -"....... -..... - _.....- NOTlCI Of' INHIRlTANoe TAX APPRAIIIMINT ,A~~OWANCI OR OJlA~~OWANCI OP OIOUCTlONI ANO AnlOIMINT OP...TM RIV, 114nX (07-14) ., "TATI llP, Rll:lllD M10HIIlllL J fILl NO, 21 81-0759 AON 101 OATI 10.':1.6-84 T A>\ I1ETURN WAS, (X I ACCEP1aD AS PILeD RIIIIIVATIQIi' cqNOIRNJ~lL~L JNTlRur - d.lJU,WW. APPl\AlIIll VA~UI OP RITURN IAI.,1l ONI ORIIUNIIL RlllTURN 1, R..I a,I,I' (SQh,dule Al 2, SIOQk, ,nd !lond' (Soh,dul, Il) 3, CloUly field SIOQkIP,rlne"hIP Inl"e,1 (Sohedul, C) 4, ,Morlo'O"/Nol,, R,Qely,bl, (SQh'dule DI 8,' C"hlB,nk p,po,II./MI,o. P",onal PropetlY (SQhedul, a) ll, JOlnllY Own'd ProperlY (SQhedul, PI 7, Tr'n,f.r' ISQh.dule G) B. Toi,1 Auel, ) CHANGED ( 1). .00 H ( 2) .00 ( 31__-L2.L (4)_ ,. .00 (6) 73,602.A- I 5)...---'-- ' . OD " I 7) .00 101 73,602.1l1 . APPROVlll DIOUOTIONI AND exlMPTlONI I 9, pUner.1 axpen,,~IAdmlnlttr'\Ive Co'I,IMi,aell,neQu' eXp.en,.. (8Qhedule H) . ( 9) 12,454.60 10, Debl,/MattOloe LI,bllll,..'Llen' (SQh,dule il (1 01_ -!.~ 11, TOI,I D.duQ\lon, (I II 12. N'I V,luO al ,n. Relurn (\21 13. Chttl\,bleIOavernm.nl.1 a,qu.,I, (SQhedul' JI 113) 14. N.l V,lue 01 eal'l. Subjecl 10 r.. '., 1141 NIlnl H..n ..... ..~ntw.. 1e.II.d pr.V1ou.,y,.,tn.,. 141 11 ,ndlor 18 .nc;t 17 \<It\1 r,".ot flgur" thet 1 no I lid. the t\lb' of.ill r"urn. .......dta det., AIIIIIMINT Of TAX I III, Amounl al line 14 "~'ble el 6", rele Ill. Amounl 01 IIn, 14 "..bl. .1 Ul", rele 17, Prlnclp,1 T,. 'Du, TAX CRIOITII PAYMeNT DATe 06..16-83 0~"~6"~4 12,4!i4.50 61114B.41 .00 _~,,14S.41 "0)_6:1.,148.41 (16) '.00 X,06- X. la- 1171 i ,(1~8,1l0 .00 3,668.90 l1eCSIPT # DISCOUNT (+) INTIlI1EST H 498.02- 451.33M AMOUNT PAID 070796 087372 1,500.00 2,093.1l0 INTmREST IS CHIIRGED FRoM 08-17-84 TO 10-31-84 liT THm RIITIllS A~~LICABL& liS OUTLINlllD ON~Hm amvmRSE SIOm OF THIS FORM.- . IF PAID AFTaR THIS DATS See ReveRse FOR CALCULATION OF ADDITIONAL INTel16ST TOTAL TAX Cl1aDIT IA~ANoe or TAX DUe 1 02435 INTlRIIT 23. 3 TOTAL llUll 1 047.78 (If a.l,nQ, Due I' Ie.. Ih.n . \.00 no p,ym.nl I' requlredl \,- Hldl\ll"l J, 11;;,,11 . Raard Unuktk"n In127~ -l" ~HIClln:tlfl f.l1D' t',HL1.':r.: huC'()rr110,.ly, , It. lit,h'i'f'f,~h4{f Ord'itfl!L t.htll'. thh ptot:nM't 1* U\HJtia,~n<j)\t"\f'" .\.'llrt. 1'1..-11. t.1IL< ,.I\..~ I. ,\'''''"'''',' fJf ) r\'/'\, 0') (II u"",u,,t tnl' ",(U.ly J.l"yn\~nt. 1.. 8u..t~ni_n,"d t,HU1^;.UH~ ",hit! -ti.nYI,Mi-nt. \f;.t.;'f Ui'J\; mf"iit! ~lt;:.h,}n t-h<C1 "t.,ilt.\ltfH"Y tllnn ruu:'lod l'itl r,UL'\V~1, duoh \lL4\o(J\lnt.~ ~f,jCUOdf th!;/11t.!,!.:t~t,!Mlnt~ nt' r-ut~(t1HJiv t. (\lt~otur1 tf) '''d\..to i;'Ul\,q~_r'jlttf.1 "\f1II\.~i;'i:iIP"''M'',,:,t~ \1..0'-\ r\'IO:l.~jjiiili~\\t Uh(}W.l'Ht t;lw MU(tI'\lhl of Jnt./!'i'rnllt, 01\ t.h\! Ar.et+\';H l,'fHWl.VliH\ hy tJ\ft,t11il-_ab~ t-ti hn~ ,~,!!o'!r~t Ihu;(~ l \1"(\ )\""nl<l ~.. ~,nt,.y""t ~ ,iCl.Ol) 1,1\10,1I0 ~m]~(\O 2.IlIlO.r)n ~H 1'.10 1dl() .In, (>21.'11 '\\ ,(")')0; 011 11 1/). f)fl ,J,~IlUlltV 1',1. "W;~ J....'\II1..V ~b i fllMl rohr'\'1IJ1'V \\, , ~liJ ~ "I'tH 1J, 111112 lI~y 10, l'lILI ,'lhr',~h 1'1, 1':J114 "llY 1.\,' H\I'1 "I<Y 1 0;, 1 '1M tl"l [hlt~ ilr " " " " ., . " " " " " " f"lV"ullt " " " .. Ii " ..~\')n '1'HV~ i,\OI\HO \W' ~r'l'qt"lta ,'Onk (). rO'J t, ahal pUll :roll... ,1, l1utch!)r. 1,1\" 11,,<1\""1' ,HY\\(JH P 1 f;tvit i ;\')lflrd,biU' T,tUtuthy ",.1 ~ i1..r:n/itY, t\fili"but l',.ill! n .;t" NoOo1y. l~~ ...."nbtlt. f'ol\/I.l,l !I. > l1",tth, I,\q\l1l,l"" ,h-,t'ftny G~ ~v,'t'lt1tbthu~bfjl. lilJ_PH()'J{~[l1 NOT", .\N\' I\P~,:l\l., fllm1 'rllll') .)l:f~Iln()t1 ."\0';1'1' n,; ,'It,itl) \it'l'n 'fHl': "~I'lll\tllJ I)OIHt'f,H1'rllrN "'lXI'~ (('11) l'lIlY', iJr' H'><:\:1\"1' ,Ill' 1'II.W tlIWICll,or1. 1\ SJ'fM'UI1l'.N'f ')I' IIctutnrl' IIILl, ))F:. I1IIH,!t,!) .,,:, 'fClll II\( 'flnl llURI:...\} Of' l<X/ltUNM'l,mj. ~r. 45,1\401\\1 j REV, 1113EX (.11'84), . CO"""..""" Of "~~.,,y.~,,' INHIRIT'''Oe TAu A"IUMINT o'''''"'N' ", My"" ,I "" ^ ONT.O' . NO 101 ion"" "' IW'"'~'f10~ .~....,., C. "h , f;~."~~i:,"~~':. 11'01 RICORP AP~UITMINT PATI IITAft OP Alll!!lP MICJ:(IIEL J fm NO, 2~ 8~~0?6 PATI Of OIATIi l1-U-~l-,. . QO~NTY CUM~~R~IIND , NOTe I TO JNIURI PRPPIR PlIIon TO YOUR ACOOUNT ,IUIMIT THI UPpeR POI\TION or THU rOllMWITH YoUR TAl( PAVMINT TO THI RIOIITIR OP WILLI OP THe Alove COUNTY, MAKe CHeCKI PAVAI.I TO' "RIOIITIR o~ WILL', AOINT' " ., HUBI!lRT X QILROY !!lSC 411 HIINoVI!lR aT OARLISLli) PA l?Ola PL~ASE R~URN THIS PORTION TO REGISTER OF WILLS, IF PAYMENTDVE 9Yt .Aj.9~g..tl1J' .L!til. . _ .,~. . _ .F!.I.:r~lN. ~~'l>"R. .P.O.R)'lO.N. ~gR. .Y.o.l.I~.~@o.QR_D_S. . _ H H . .""!'. .- . . . , RIV, 1"'IX (11'14) ..INHIRITANcl TAX RlcollO AO~U'TMINT.. ' IITATI Of RllilllP MICHIIEL J ~M NO, 2~B1-0?BIl ACN 101 DATe OB~lO~SB I AOJUSTMBNT BASBD ON: PROTIllST SOARP Pli)CISION VA~UI or IITATII I. R..I Bill" lSoh.d~l. A) ( II .00 2, 810~kl Ind Bondi ISohld~l. 10 ( 21 .00 a, OIO'''Y H.ld SIOokIP,rlnmhIP.lnler"t (Sohld~II,CI,' I 3) .00 A. Mortgl~..INole. Reoelvabll (Srhldull D) ( 41 ,00 6, Oa,h/S,nk O,po,II,/MI,o, P.r,ona' ProperlY (Sohld~le e) I 61 n.602.91 5, JolnllY Own.d Prop.rlY ISOheduIIF) ( 5) .00 ; 7, "Tren,f,,, (Soh.d~I" 0) ( 71 .00 8. Tol.1 A"III ( SI n,602.511 PIPUOTIONI .ANP eXIMPTIDNI" 9, "un.r,1 bp,n..I/Admlnlllrlllv' Co",/Mllo,llln'O~1 ~~pen'" (Soh.d~I, H) 10, P.bll/Mortg.gl Lllblllllt,ILltn, (Soh.d~11 I , I. Tol,1 Dld~ollon' 12, N'\,VIIU' ot Tlx R.wrn , 3, Ohlrll,bl./Oovernm.ntll B,~~"il ISohedul. J) , 4, Nfl VII~, of hi,l. SUbJ'OI 10 ,T.~ ( 91 ~2 . 454. BO I I 0)......- ,00 (1'1 (\ 2) 113) (\ 4) 12 ,454,1)0 6:1. , l;S'. 4~ .00 6:1.,148.41 TAl( 16. Amount of IIn.' 4 I.x.bl. 1\ 8% raIl '8. Amount of Iln. I 4 "~Ibl. al 16%, ra" 1 7, .Pr,"olpI' Ta~. Du. TAl( ClIlOITlI PAYMeNT DATe 0&-16-e~ 08~le""S4 09-1e~a4 (18) elt14B.4l x,oe- (181 ..00 X,1I5- 117) ata6S,eO .00 3,6158.90 ReOBIPT # 0?0?e6 osnn IIBIITEP DISCOUNT (+) . INTBRBST H 4ee.02- 4111.3a~ .00 AMO\lNT PAID 1,600.00 2tolla,eO S54.6a INTIllRIllS~ IS, OIlARQlliD FROM os-l ?"B4 '1'0 OB"25-95 TOTAL TAX cRBDIT 11'1' THE RATES APPLICABLIll AS OUTLINED ON THE 'A~ANCI OP TAX DUI 161l.?2 REV!!lRBIll SIOli) OF THIS l"ORMl.. INTeRUT 1 .?6 . I"PAID APreR DATe INOiCATED SEe RBVeRse FOR CALCULATION TOTAL DUI lS5 4S OF AODITIONA~ INTeREST . (IF BALANCE Due IS LESS THAN $1 OR IS ReFLECTeD AS A "CREDIT" (CRI. NO PAYMENT IS REQUIReD) REV.UOO F.X t 10.811 . BURB,W OP Bl<AMINATION PBNNBVLVANIA OBPARTMBNT OP RBV6NUe p,O, !l0l< 6327 HARRI6BURO,PA 17101 01c141nl'l Neme (LIII, Flrll, Ind Mlddl.Inll1ell' -----B~, ' J OIOBAefill 80cII18"DUrllv~umblr lNHIlRITANCB TAX RIlTURN RS8IDIlNT DI!CI!DIlNT File Number 21-81-759 1 ,Original "ol\lm [i] Dele of Oelth 11/14/81 2, 8upplementll Return D Oecedent'l Addr... R.Il. 4, L10l< 48 Cur1ia1o FA 1701~ CHICK 3, Remalndar Relurn 0 APPIIO. PIIIATE 4, Life BIllIe 0 ~, Federel BII.ele TexO Return lIequlred, BLOCKS a, OeCldent dl14 teltOtl 7., OecBdl"1 mllntllned Bllvlng 0 a,Numblr of ..fl dCPolII O. .. (Alllch co of Willi trU11 (Atlechcc of trulII .. boxellnVBnlorl14 . .. All corrllPondencl Ind conl14entlll tlX Informltlon Ihould be.dlrlcled tOI COli III. SPONDBNT .Nlml Uuburt,X. Gilroy, Telephone No, 7P-243-4574.. ~,~qu:lro _ Addr... 4 Nor th IiIInovor Stroot cur1iale FA 17013 011 Slale ZI "",pllolatlon " II9IIIII8Ie (ache4ule AI (1) ~O... 2, 8100klend aondl (Qchtdule B) ( 2) -0- 3, Clolelv Held alaok/Plrtnershlp Inlerell (achedule 0) ( 31 ...0..' I, 4, MortgeOlllnd Nolel (aChldule 01 ( 41 ..0_ 6, Oelh & MII08I1~neoul Personelproperty (achedule EI ( 61 71."'0' tQ, II.OAPiT. a, ~olntlv Owned Properly (BChed\lle F) ( B) ...0" ULATIDN '7, Trenlfers ($cl\edule 01 ( 7) -0- AND a, TI\\II DrOll AII"I. hClel lInea 1,71 e, Funer,l Sxpenlel (ldmlnlllretlve OOltl/Mllcelleneoul HxpenlDl (Schedule HI ( ( e) 12,454.50 TAX 10, Oebll/Mort9Igel/Llenl (Schedule II (101 ...0- 11, Toll\ Oedubllonl hOlel11nel9 & 10) 12, Net Velue of BIII16111ne B mlnulllne 111 OALCU, \3, Charlleble gequelll.(Bchedule JI LATIDN 14, Net Vllue ,ublecl 10 tax Wne 12 mlnulllne 131 ('r Or.; !;<~ i~! :}'j'" L'~~' i<~~ :-r,~F Ie ""'/I'j -' ,:.'"1, ~1~ 1lJ!> );;0 ~jC' .1''1 .3:,'" ,dol ~ ( 8) '1~~602', 91j "-J jh- ;,.1 (11) 12,454,50 (1~ 61.148.41 (t3) , -0-.' 1141 61,148.41 i \ COI11Potltlon 01 T~x I 16, Amount of linn 14tlxebleel 6% ta.. i (lMI~d' v~luel ftom Schedule K) 16; Amou~1 of IIn, 14 tlxeble al \6% tile ,\ (lnclu~~ v~lue' Irom SChedule K) I 17, Prlnolpalllx dUe(~dd laK from line 16 plul lax.ftum line 16) I la, Tot~1 Prlot plymen\tl (e) Amounl Paid \ (b) Plul Ollcount (cl Mln\lllnterell le, Bllence DUe (IInl 17 O1lnullI", 16) I MI~e Ohlck P,yable 101 "101,18r of WillI, Agnnl I *"" PUA8' II~CH~CK MATH" " " I , Vnder Plnlltle. 01 perJury,.1 d~cllte thlll hiVe exemlned thll ralutn, Including eccomplnVlng Ichedulll .nd !lltemenll, ,n4 10 the bill of mV ~noWl.doe II' Ind b,lIel, It II true, correcl, Ind complete, Oecleratlon of preplter other Ihan the penonll lepr"enlltlve II blled Qnlll Informetlon of whlchprep.r.r hel I' ::: k ~~~ga~p peRSONAL R~PRUNTATI~ ~... ADDRess. '. ~(Cf;LT~ i 1161 61,148,41 X,oa" 3,668.90 (IB) x,10" (171 3 ,li.68 . 90 $1,500,00 75.00 (IB) $1575.00 21093.90 (19) -~ OK 18,.uarl1ale, va. l/b!J R THAN l1SPR8SSNTATI E ADDRess