HomeMy WebLinkAbout04-0053 COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
RECEIVED FROM
.... MYERS EDMUND G
,,- 301 MARKET STREET
P O BOX 109
LEMOYNE, PA 17043
........ fold
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
ACN
ASSESSMENT
CONTROL
NUMBER
NO. CD 003734
AMOUNT
101 $12,000 00
ESTATE INFORMATION SSN 183-I 2-2781
~ILE NUMBER 2104-0053
bECEDENT NAME MUCHER MARTHA E
[~ATE OF PAYMENT 03/29/2004
POSTMARK DATE 00/00/0000
COUNTY CUMBERLAND
.DATE OF DEATH 12/26/2003
,.6EMARKS
SEAL
G H MITCHELL
CHECK# 1002
TOTAL AMOUNT PAID
INITIALS: VZ
RECEIVED BY.
REGISTER OF WILLS
$12,000 O0
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
STATUS REPORT UNDER RULE 6.12
Name of Decedent:
Date of Death:
Will No.
MARTHA E. MUCHER
December 26, 2003
2004-00053
Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rule, I report the
following with respect to completion of the administration of the above-captioned estate:
1. State whether administration of the Estate is complete:
Yes No X
2. If the answer is No, state when the personal representative reasonably
believes that the administration will be complete: 6 MONTHS
3. If the answer to No. 1 is Yes, state the following:
a. Did the personal representative file a final account with the Court?
Yes No
b. The separate Orphans' Court No. (if any) for the personal
representative's Account is:
Co
parties of interest?
Did the personal representative state an account informally to the
Yes No
d. Copies of receipts, releases, joinders and approvals of formal or
informal accounts may be filed with the Clerk of the Orphans' Court and may be attached
to this report.
Date: December 10, 2004
EDMUND G. MYERS~
JOHNSON, DUFFIE, STEWART & WEIDNER
301 Market Street
P.O. Box 109
Lemoyne, PA 17043
(717) 761-4540
Capacity: ~Personal Representative
(x) Counsel for Personal
Representative
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
NO.
REV-1162 EX(11-96)
CD 003734
MYERS EDMUND G
301 MARKET STREET
P O BOX 109
LEMOYNE, PA 17043
DUPLICATE
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
........ fold
101 $12,000.00
ESTATE INFORMATION: SSN: 183-12-2781
FILE NUMBER: 2104-0053
DECEDENT NAME: MUCHER MARTHA E
DATE OF PAYMENT: 03/29/2004
POSTMARK DATE: 03/26/2004
COUNTY: CUMBERLAND
DATE OF DEATH: 12/26/2003
R;EMARKS:
SEAL
G H MITCHELL
CHECK//1002
TOTAL AMOUNT PAID:
$12,000.00
INITIALS: VZ
RECEIVED BY:
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
TAXPAYER
dERRY R. DUFFLE
RICHARD W. STEWART
C. ROY WEIDNER, dR.
EDMUND G. MYERS
DAVID W. DELUCE
RALPH H. WRIGHT, dR.
MARK C. DUFFLE
MICHAEL d. CASSIDY
MELISSA PEEL GREEgY
ROBERTM. WALKER
WADE D. MANLEY
LAW OFFICES
JOHNSON, DUFFLE, STEWART & WEIDNER
A Professional Corporation
301 MARKET STREET
P.O. BOX 109
LEMOYNE, PENNSYL~,~NI~ i i'7043-01,09,
wzzs~rr: www.~.c°m
HORACE ,4. JOHNSON
COUNSEL TO THE FIRM
TELEPHONE 717~14~[~ 29 P 3:21
FACSIMILE 717-761-3015
E-MAIL: mail~jdsw.eom
WRITER'S EXT. NO. 114
E-MAIL dlw@jdsw.com
March 26, 2004
Register of Wills Office
Cumberland County Courthouse
One Courthouse Square
Carlisle, PA 17013
Re:
Estate of Martha E. Mucher
SSN: 183-12-2781
Our File No. 9396-1
Your File No. 2004-00053
Dear Register of Wills Office:
Enclosed please find Estate Check No. 1002 in the amount of $12,000.00. This
payment represents the three-month,prepayment in order to qualify for the discount. The
decedent died on December 26, 200~..
Please time stamp the enclosed copy of this correspondence, and return to me in the
enclosed self-addressed stamped envelope. Thanks for your assistance in this matter. Should
you have any questions, or require any additional information, please feel free to contact me.
Very truly yours,
J~Q,,I-INSON, DUFFLE, STEWART & WEIDNER
/
Dana L. Wieseman
Legal Assistant
c: Gilbert H. Mitchell, Executor
#226221
COMMONWEALTH OF PENNSYLVANIA
DE,';'ARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
NO.
REV-1162 EX(11-96)
CD 003734
DUPLICATE
MYERS EDMUND G
301 MARKET STREET
P O BOX 109
LEMOYNE, PA 17043
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
........ fold
101 $12,000.00
ESTATE INFORMATION: SSN: 183-12-2781
FILE NUMBER: 2104-0053
DECEDENT NAME: MUCHER MARTHA E
DATE OF PAYMENT: 03/29/2004
POSTMARK DATE: 03/26/2004
COUNTY: CUM BERLAN D
DATE OF DEATH: 12/26/2003
TOTAL AMOUNT PAID:
2,000.00
REMARKS:
.... ~-SEAL
?
G H MITCHELL
CHECK//1002
INITIALS: VZ
RECEIVED BY:
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
REGISTER OF WILLS
LAW OFFICES
JOHNSON, DUFFLE, STEWART g WEIDNER
301 MARKET STREET
P. O. BOX 100
LEMOYNE, PENNSYLVANIA 11043-0109
'04 M~R 29 ?.0:22
REGISTEF~=O~. WILLS OFFICE
CUMBERI_~pL~:OUNTY COURTHOUSE
ONE COURTHOUSE SQUARE
CARLISLE, PA 17013
.t 70,t 3+~.~0 i 02 h,,llh,,llh,,,,,ih,lh,,lh,,Ihlh,,,,,llhh,hh,,,Ih
Register of Wills of Cumberland County, Pennsylvania
PETITION FOR GRANT OF LETTERS
Estate of
MARTHA E. MUCHER
Deceased
,o..
Social Security No. 183-12-2781
GILBERT H. MITCHELL
Pet tioner, who is 'i8 years of age or older, applies for:
(COMPLETE "A" OR "B" BELOW:)
A. Probate and Grant of Letters and aver that Petitioner is the executrix named in the Last Will of
~ the Decedent, dated October 21, 1993
Deceden__.Lnamed Co-Executors of her Will: Gilbert H. Mitchell and Denise MacLane. Denise MacLane renounced ri_g~ht
her to serve as Co-Executor. Gilbert H. Mitchell will serve as sole Executor
State relevant circumstances, e.g. renunciation, death of Executor, etc.
Except as follows, Decedent did not marry, was not divorced, and did not have a child born or adopted after execution of
the documents offered for probate; was not to victim of a killing and was never adjudicated incompetent:
B. Grant of Letters of Administration
(d.b.n.c.t.a.: pendente lite; durante absentia; durante minoritate)
Petitioner(s) after a proper search has/have ascertained that Decedent left no Will and was survived by the following
spouse (if any) and heirs:
Name Relationship Residence
COMPLETE IN ALL CASES: Attach additional sheets if necessary.
Decedent was domiciled at death in Cumberland County, Pennsylvania, with her last family or principal residence at
~A_partment//3310 325 Wesle Drive Mechanicsbur Lower Allen Townshi Cumberland Count ,
(List street, number and municipality)
Decedent, then 89 years of age, died December 26, 2003 at H01v Spirit Hospital, Camp Hill, PA
(Location)
Decedent at death owned property with estimated ~)alues as follows:
(If domiciled in PA) Ail personal property ..................................................................... $ 45,000.00
(If not domiciled in PA) Personal property in Pennsylvania ..................................... $'
(If not domiciled in PA) Personal property in County ..................... $'
Value of real estate in Pennsylvania ...................................................................................................................... $
Total ................................. . ......... $ 45.000.00
Real Estate situated as follows:
Wherefore, Petitioners respectfully request the probate of the last Will presented with this Petition and the grant of letters in the
appropriate form to the undersigned:
Signature
~rinted name and residence
C~ampGILBERT H. MITCHELL
412 Allendale Way
Hill, PA 17011
Oath of Personal Representative
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
The Petitioner above-named swears and affirms that the statements in the foregoing Petition are true
and correct to the best of the knowledge and belief of Petitioner and that, as personal representative of the
Decedent, Petitioner will well and truly administer the estate according to law.
Sworn to and affirmed and subscribed
GILBERT H. MITCHEI..L
Before me this //,,,~ ¢'/-/ day of
~/~'.,¢,./.~, _./× ,2004.
NO.
Estate of MARTHA E. MUCHER
Social Security No: 183-12-2781 Date of Death:
AND NO _ ~ ,2004, in consideration of the Petition on the reverse side
hereon, sa,~aactory proo~having been presented before me,
IT IS DECREED that Letters Testamentary are hereby granted to GILBERT H. MITCHELL
in the above estate and that the instrument dated October 21st 1993
described in the Petition be admitted to probate and filed of record as the last Will of the Decedent.
, Deceased
December 26, 2003
FEES
Letters ...........................
Short Certificate(s)
Renunciation ..............
Affidavit ( ) ..................
Extra Pages ( ) .......
Codicil ............................
JCP Fee .......................
Inventory ......................
Other ..............................
TOTAL .........
$
$
$
Attorney: EDMUND G. MYERS
I.D. No: 20558
Address: Johnson, Duffle, Stewart & Weidner,
301 Market Street, P.O. Box 109, Lemoyne, PA 17043
Telephone: 717-761-4540
Estate of
Deceased
Register of Wills of Cumberland County, Pennsylvania
RENUNCIATION
MARTHA E. MUCHER , NO.
The undersigned, DENISE MACLANE, Great Niece, Named Co-Executrix of the Will of the above-
(Relationship) (Capacity)
named decedent, hereby renounces the right to administer the estate and respectfully requests that
Letters Testamentary be issued solely to GILBERT H. MITCHELL, Co- Executor
WITNESS my hand this ,/~ day of ~'"~~~- ,2004.
SWORN to and subscribed
before me this I B'r~, day of
~ ~ , 2004.
Notary Pu't~i~ -- '
My Commission Expires:
t
D~NI~I~ M-AbLAN~[~ '
161 E. Louther Street
Carlisle, PA 17013
- NOTARIAL SEAL
LOUIS J. LORE, Notary Public
MyCamp Hill Boro, Cumberland County
/
Commission Ex~r~__s April 14, 2007~
lflq.R0S RFV ')IR(,
This is to certify that the information here given is correctly copied from an original certificate of death duly filed with me as
Local Registrar. The original certificate will be forwarded to the State Vital Records Office for permanent filing.
WARNING: It is illogal to duplicato this copy by photostat or photograph.
Fee for this certificate, $2.00
P 98_1.274.1
No.
DEC 2 9 2003
Date
H105 143 Rev 2/87
NAME OF DECEDENT (First. Mk~le. Last)
DATE OF BIRTH
(Month. Day. Year)
889. Y""' 6-30-14
8.
COUNTY OF DEATH CITY. BORO. TWP OF DEATH
,,.Cumberland ~.P.. Pennsboro
DECEDENT': KIND OF BUSINESS I INDUSTRY
ti,. Clerical
DECEDENTS
425 Wesley Dr. ACTUAL
RESIDENCE
· (See ~stmctm~
~.echanicsburg, Pa. 17055 on0~er~de)
COMMONWEALTH OF PENNSYLVANIA · DEPARTMENT OF HEALTH · VITAL RECORDS
CERTIFICATE OF DEATH
[SEX I SOCIAL SECURITY NUMBER
BIRTHPLACE (City ancI ]zF'em~].L~. la. I RI-- 1 ? -- 77R1
· I::
?Lykens, Pa ~J ~"~°"~'"' E] ~o,E] o~
[11 not i~stil~on, give street and number) :)F HISPANIC ORIGIN?
No~] YeS [] If yes, specify Cuban. [RACE - American Indian, Black. V~3ite.
M ~n. Pue~lE Rican. tec. [?.~hi t e.
!pt. of Yes[~ ~ 1].5 t~u, t ..... ~ Di~'~"¢~"~'~) '
.. widowed 18.
l?s.S~te Pa Did lr~, I~ Ye.,~,,.di. Lowo_r A1 ] mn ~.
17b. County Cumho_r] and township? t?d.D No, decedeflt~ved
MOTHER"S NAME (First, Middle, Maiden Surname)
la, P, lama ~aurer
FATHER'S NAME (First, Middle. Last)
,. Vernon G. Mitchell
~o,.T.t.Col. Gilbert ~. N±tchell
DATE OF DISPOSITION
21m. Other(Specify) [] 21b.
DATE OF DEATH (Month. Day. Year)
IINFORMANT'S MAILING ADDRESS (Slreat, City/Town, Slate. Zip Co~,
'°b'412 Allendale Wav Camn I-lil]_P~ 17n1~
°PrinCE Opl~a~e~ SPOSlTIO N- N~qe(~l~ e. ~.rte, C~malory LDCATION - C tytfow,. State. zlP Code
~?~ary Un~ted Met~odi$~d. Wiconisco~ Pa.
S AS SUCH LICENSE NUMSER LN.,~ E AND *IXmESS OF FAC,UTY
,2~. 01124~ ~.sse.tr~,a,~n F,.H. & C-8n,Inc. 32~Hummel
Physician is nof avaliablaat tirneof deathto - .knowledge, Tedat the Urne daeandplaces ated r[l~;~54'E N,lZt~l~'~'~r'~' I ~u. · Ir'~TC C:I~JCn
perso~ who p~onounces death. TIME OF DEATH9 .~ i~ DATE PRONOUNCED --DEAD (Month, Day, YeaO / WAS CASE REFERRED TO A MEDICAL EXAMIINER/CORONER.
IMMEDIATE CAUSE (Final , interval ~ not resulting in the underlying cause g~en in
', on,et and deatr
res~,~ in ~ath) ~ a. W:~,~, ~ ~',,/a~ . ~ :
! list c~'ldiliofls b.
Enter UNDERLYING
DAUSE (Di~ ~ injury f:-
resulting o~ death ) LAST d.
/ I I^ccidant [] Pandinglnvestigation E, I I Ye,[] No[] I
' PTRoOt~ bU NeaCt I~f~mAvNk~D Co~E Rm~ FaY ~_O_ .P~ H_Y_ _?_L? .N ( .P.h.ysi~an Ix~.th ~ooo~nong death and cedifying t .... of death) LICENSE NUMBER DATE SIGNED (M0~h, Day, Year)
meanere..tedOnthebm~te°f~xamlnaU°nand/°rlnvasUgatl°n'lnm¥°plnt°n'deattl ........................... ...... d., ...__, date, andpl ..... . dduetoth ....... e~( ) d (dem 2,) Type or Print ./~t/~/~/./~-,~ .d..,~~
DATE FILED (MG'~, Dey, Year)
009396-00001/October 19, 1993/EGM/GMM/30162
OF
MARTHA E. MUCHER
I, MARTHA E. MUCHER, of the Borough of Len'loyne. Cura. berland County, Pennsylvania,
being of sound and disposing mind, memory and understanding, do hereby make, publish and declare
this as and for my Last Will and Testament, hereby revoking and making void any and all Wills or
Codicils at any time heretofore made by me.
ARTICLE I
I direct the payment of all my legal debts, and the expenses of my last illness and funeral from
my Estate as soon after my death as conveniently may be done. I direct that all taxes that may be
assessed in consequence of my death, of whatever nature and whatever jurisdiction imposed, shall be paid
from my Residuary Estate as part of the expense of the administration of my Estate.
ARTICLE II
I give and bequeath my automobile, household and personal effects and other tangible personalty
of like nature (not including cash or securities), together with any existing insurance thereon, unto my
nephew, GILBERT H. MITCHELL, provided he survives me.
ARTICLE III
I give and bequeath my shares of stock in Lykens Miners Bank unto my niece, DENISE
MacLANE, provided she survives me.
009396-00001/October 19, 1993/EGM/GMM/30162
ARTICLE IV
I give, devise and bequeath all the rest, residue, and remainder of my Estate, of whatsoever
nature and wheresoever situate, as follows:
A. Twenty (205) percent thereof unto my brother, ROBERT MITCHELL, provided he
survives me.
In the event my brother, ROBERT MITCHELL, predeceases me, I give, devise and bequeath
his share unto my remaining residuary legatees in the same proportions as each legacy bears to the others;
B. Sixty (60%) percent thereof in equal shares unto my nephews, GILBERT H.
MITCHELL and ROBERT R. MITCHELL and my nieces, MARILYN REEDINGER and NANCY
K. MITCHELL;
C. Ten (10%) percent thereof unto CALVARY UNITED METHODIST CHURCH, 700
Market Street, Lemoyne, Pennsylvania;
D. Five (5%) percent thereof unto ST. CHRISTOPHER'S LUTHERAN CHURCH,
Lykens, Pennsylvania; and
E. Five (5%) percent unto THE CARE ASSURANCE ENDOWMENT FUND, Bethany
Village Retirement Center, 325 Wesley Drive, Mechanicsburg, Pennsylvania.
ARTICLE V
I direct that all estate, inheritance, transfer and other taxes of a similar nature payable by reason
of my death, together with any interest and penalties thereon, and imposed with respect to any property,
whether or not disposed of by this Will, shall be paid out of the residue of my Estate. I further direct
that any and all such taxes shall be paid from and deducted from my residuary Estate prior to the
calculation of the shares of the residuary beneficiaries, so that each residuary beneficiary, charitable or
not, shall bear a portion of the burden of such taxes.
009396-00001/October 19, 1993/EGM/GMM/30162
ARTICLE VI
I name, constitute and appoint GILBERT H. MITCHELL and DENISE MacLANE, Co-
Executors of this my Last Will and Testament, and direct that neither shall be required to post bond for
the faithful discharge of the duties in any jurisdiction, and provided further that should either fail to
qualify or cease to so act, I direct that the other shall complete the administration of my Estate.
IN WITNESS W-HEREOF, I have hereunto set my hand and seal, this ~]ee':day of October,
1993.
~ 'Martha E. Mucher
Signed, sealed, published and declared by the above-named Testatrix, as and for her Last Will
and Testament, in the presence of us, who at her request, in her presence and in the presence of each
other, have hereunto subscribed our names as witnesses.
009396-00001/October 19, 1993/EGM/GMM/30162
ACKNOWLEDGMENT
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
:SS
the Testatrix and the witnesses, respectively, whose names are signed to the attached or foregoing
instrument, being first duly sworn, do hereby declare to the undersigned authority that the Testatrix
signed and executed the instrument as her Last Will and that she had signed willingly and that she
executed it as her free and voluntary act for the purposes therein expressed, and that each of the
witnesses, in the presence and hearing of the Testatrix, signed the Will as witness and that to the best of
his/her knowledge the Testatrix was at that time eighteen years of age or older, of sound mind and under
no constraint or undue influence.
Witness
Subscribed, sworn to and acknowledged before me by Martha E. Mucher, Testatrix, ~and
subscribed and sworn to before me by~_~0~,t.~,~ ~'/~oK~ and i~r~0~ ~[,Ex.-R~/~//a,.
witnesses, thisbe1[~' day of October, 1993.
BOI~INIE L. STARR, No!ary Public
Lemoyne Bom. Curnb~im'~d County
Nty._.~Comm..~t~.,sion Exgi~e~ ,iune a, 1997
,CERTIFICATION OF NOTICE UNDER RULE 5.6(a)
Name of Decedent: MARTHA E. MUCHER
Date of Death: December 26 2003
Will No.: 2004-00053
To the Register:
I certify that notice of beneficial interest required by Rule 5.6(a) of the Orphans' Court
Rules was served on or mailed to the following beneficiaries of the above-captioned estate on
February 4, 2004.
Name
NANCY K. MITCHELL
ROBERT R. MITCHELL
MARILYN REEDINGER
GILBERT H. MITCHELL
DENISE MacLANE
CALVARY UNITED METHODIST CHURCH
ST. CHRISTOPHER'S LUTHERAN CHURCH
THE CARE ASSURANCE ENDOWMENT FUND
Address
904 Pelican Drive
New Bern, North Carolina 28560
332 Covered Bridge Road
Ole_~__~, PA 19547
304 Market Street
Lk~,PA 17048
412 Allendale Way
Hi,, PA 17011
161 Louther Street
Carlisle, PA 17013
700 Market Street
_[._e_mo ne, PA 17043
635 North 2~
L k~, PA 17048
Bethany Village Retirement Center
325 Wesley Drive
Mechanicsburg, PA 17055
Notice has now been given to all persons entitled thereto under Rule 5.6(a) except None.
Date: February 4, 2004
Signature
Name EDMUND G. MYERS
Johnson, Duffle, Stewart & Weidner
Address 301 Market St.
P. O. Box 109
Lemoyne, PA 17043-0109
Telephone (717) 761-4540
Capacity:
Counsel for personal representative
CONHONREALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 180601
HARR/SBURG, PA 171Z8-060!
REV-1645 EX AFP C09-OD)
ZNFORNATZON NOTZCE
AND
TAXPAYER RESPONSE
FZLE NO. 21 04-0055
ACN 04125214
DATE 06-15-2004
GILBERT H MITCHELL
412 ALLENDALE WAY
CAMP HTLL PA 17011
EST. OF MARTHA E MUCHER
S.S. NO. 185-12-2781
DATE OF DEATH 12-26-2005
:,.,:,:CCUNT¥, CUMBERLAND
TYPE OF ACCOUNT
D SAVINGS
[] CHECKING
[] TRUST
[] CERTTF.
REHZT PAYHENT AND FORHS TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17015
SUSQUEHANNA VALLEY FCU has provided the Department with the information listed below which has been used in
calculating the potential tax due. Their records indicate that at the death of the above decedent, you were a joint owner/beneficiary of
this account. If you feel this information is incorrect, please obtain written correction from the financial institution, attach a copy
to this form and return it to the above address. This account is taxable in accordance aith the Inheritance Tax Laws of the Commonwealth
of Pennsylvania. Questions may be answered by calling (717) 787-8317.
COMPLETE PART 1 BELOW # # # SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Account No. 174-51-7465 Date 01-21-1985
Established
Account Balance 5,005.61
Percent Taxable X 50.000
Amount Sub&oct to Tax 1,501.81
Tax Rate X .15
Potential Tax Due ZZJ.Z7
To insure proper credit to your account, two
(Z) copies of this notice must accompany your
payment to the Register of Rills. Hake check
payable to: "Register of Rills, Agent".
NOTE: If tax payments ara made within three
(3) months of the decedant's date of death,
you may deduct a 5Z discount of the tax due.
Any inheritance tax dub Will become delinquent
nine (9) months after the date of death.
PART TAXPAYER RESPONSE
CHECK
ONE
BLOCK
ONLY
PART
L/NE
A. ~ The above information and tax due is correct.
1. You may choose to remit payment to the Register of Rills with too copies of this notice to obtain
a discount or avoid interest, or you may check box "A" and return this notice to the Register of
Rills and an official assessment mill be issued by the PA Department of Revenue.
B The above asset has been or will be reported and tax paid with the Pennsylvania Inheritance Tax return
B.
to be filed by the dscsdent's representative.
C. []The above information is incorrect and/or debts and deductions acre paid by you.
You must complete PART []and/or PART [~%'-]balow.
If you indicate a different tax rate, please state your
relationship to decedent:
RETURN - COHPUTATION OF TAX ON JOINT/TRUST ACCOUNTS
1. Date Established I
2. Account Balance 2
3. Percent Taxable 3 X
4. Amount Sub&eot to Tax ~
$. Debts and Deductions S
6. Amount Taxable 6.
7. Tax Rate 7 X
8. Tax Duo ~
PART
DATE PAID
DEBTS AND DEDUCTIONS CLAIMED
PAYEE
DESCRIPTION AMOUNT PAID
TOTAL (Enter on Line 5 of Tax Computation)
Under penalties of perjury, Z declare that ~he facts T have reported above are true, correct and
~.//~te to tho b. pst of my kno~edge and belief.
TAXPAYER SIGNATURE TELEPHONE NUHgER DATE
GENERAL INFORMATION
1. FAILURE TO RESPOND NZLL RESULT ZN AN OFFICIAL TAX ASSESSHENT aith applicable interest based on information
submitted by the financial institution.
Z. Inheritance tax becomes delinquent nine months after the decedant's date of death.
$. A joint account is taxable even though the dacedent's name ams added as a matter of convenience.
q. Accounts (including those held between husband and mile) which the decedent put in joint names within one year prior to
death are fully taxable as transfers.
5. Accounts established jointly betaeen husband and wife more than one year prior to death are not taxable.
6. Accounts held by a decedent "in trust for" another or others ara taxable fully.
REPORTING INSTRUCTIONS - PART I - TAXPAYER RESPONSE
1. BLOCK A - If the information and computation in the notice are correct and deductions ara not being claimed, place an
in block "A" cf Part I of the "Taxpayer Response" section. Sign two copies and submit thee with your check for the amount of
tax to the Register of Nills of the county indicated. The PA Department of Revenue will issue an official assessment
(Fora REV-ISqB EX) upon receipt of the return fr~a the Register of Nills.
Z. BLOCK B - if the asset specified on this notice has been or will be reported and tax paid with the Pennsylvania Inheritance
Tax Return filed by the dacedant's representative, place an "X" in block "B" of Part I of the "Taxpayer Response" section. Sign one
copy and return to the PA Department of Revenue, Bureau of Individual Taxes, Dapt zB060l, Harrisburg, PA 17128-0601 in the
envelope provided.
3. BLOCK C - If the notice information is incorrect and/or deductions are being claimed, check block "C" and coeplata Parts Z and
according to the instructions below. Sign tNo co~ias and submit thee aith your check for the amount of tax payable to the Register
of Nills of the county indicated. The PA Department of Revenue mill issue an official assessment (Form REV-15~8 EX) upon receipt
of the return from the Register of Nills.
TAX RETURN - PART 2 - TAX COHPUTATION
LINE
1. Enter the date the account originally was established or titled in the manner existing at date of death.
NOTE: For a decedent dying after 1Z/II/BI: Accounts which the decedent put in joint names within one (1) year of death ara
taxable fully as transfers. However, there is an exctusion not to exceed $3,000 per transferee regardless of the value of
the account or the number of accounts held.
If a double asterisk ("~) appears before ya~Jr first name in the address portion of this notice, the $3,00B exclusion
already has been deducted frae the account balance as reported by the financiaI institution.
Enter the total balance of the account incLuding interest accrued to the data of death.
3. The percent of the account that is taxable for each survivor is determined as follows:
A. The percent taxable far joint assets established more than one year prior to the decadent's death:
I DIVIDED BY TOTAL NUHBER OF DTVIDED BY TOTAL NUNBER OF X 100 = PERCENT TAXABLE
JOINT ONNERS SURVTVING JOINT ONNERS
Example: A joint asset registered in tho name of the decedent and two other persons.
I DIVIDED BY 3 (JOINT ONNERS) DIVIDED BY 2 (SURVIVORS) = .167 X 100 = 16.7Z (TAXABLE FOR EACH SURVIVOR)
B. The percent taxable for assets created Nithin One year of the decedent's death or accounts owned by the decedent but held
in trust for another individual(s) (trust beneficiaries):
I DIVIDED BY TOTAL NUMBER OF SURVTVING JOINT X lO0 = PERCENT TAXABLE
ONNERS OR TRUST BENEFICTARIES
Example: Joint account registered in the name of the decedent and too other persons and established within one year of death by
the decedent.
1 DIVIDED BY g (SURVIVORS) = .50 X 100 = SOl (TAXABLE FOR EACH SURVIVOR)
The amount subject to tax (line q) is determined by multiplying the account balance (line Z) by the percent taxable (line
5. Enter the total of the debts and deductions listed in Part $.
6. The amount taxable (line 6) is determined by subtracting the debts and deductions (line 5) from the amount subject to tax (line ~).
7. Enter the appropriate tax rata (line 7) as determined beloa.
Da~e of Death Spouse Lineal I Sibling Collateral
07/01/9q to 12/$1/9q SZ 61
01/01/95 '~o 06/$0/00 OX 6Z
07/01/00 ~o presen~ OX q.SZ~ 12Z
eTha tax rate imposed on the nat value of transfers from a younger at
death to or for the usa of a natural parent, an adoptive parent, or a stapparant of the child is
Tho lineal class of heirs includes grandparents, parents, children, and lineal descendents. "Children" includes natural children
whether or not they have been adopted by others, adopted children and stap children. "Lineal descendants" includes all children of the
neturaI parents and their descendants, whether or not they have been adopted by others, adopted descendents and their descendants
and step-descendants. "Siblings" are defined as individuals eho have at least one parent in common with the decedent, #hathar by blood
or adoption. The "Collateral" class of heirs includes all other beneficiaries.
CLAIMED DEDUCTIONS - PART $ - DEBTS AND DEDUCTIONS CLAIMED
Allomabla debts and deductions are determined as folloas:
A. You legally ara responsible for payment, or the estate subject to administration by a personal representative is ~nsufficiant
to pay the deductible items.
B. You actually paid the debts after death of the decedent and can furnish proof of payment.
C. Debts being claimed must be itemized fully in Part 3. If additional space is needed, usa pIain paper 8 l/Z" x Il". Proof of
payment may be requested by the PA Department of Revenue.
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
NO.
REV-1162 EX(11-96)
CD 0O4O68
MITCHELL GILBERT H
412 ALLENDALE WAY
CAMP HILL, PA 17011
........ fold
ESTATE INFORMATION: SSN: 183-12-2781
FILE NUMBER: 2104-0053
DECEDENT NAME: MUCHER MARTHA E
DATE OF PAYMENT: 06/21/2004
POSTMARK DATE: 06/21/2004
COUNTY: CUMBERLAND
DATE OF DEATH: 12/26/2003
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
04123214 $225.27
TOTAL AMOUNT PAID:
$225.27
REMARKS:
SEAL
CHECK#4537
INITIALS: JA
RECEIVED BY:
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
REGISTER OF WILLS
BUREAU OF INDIVIDUAL TAXES
I*HHERZTAHCE TAX DI*VZSTON
DEPT. 280601
HARRTSBURG, PA 171Z8-0601
GILBERT H MITCHELL
qlZ ALLENDALE WAY
CAMP HILL PA 17011
COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE
NOTICE OF /NHERZTANCE TAX
APPRATSEMENT. ALLOHANCE OR DISALLONANCE
OF DEDUCTIONS, AND ASSESSMENT OF TAX ON
JOINTLY HELD OR TRUST ASSETS
DATE 07-26-200q
ESTATE OF MUCHER MARTHA E
DATE OF DEATH 12-26-200:5
FILE NUMBER 21 0q-005:5
COUNTY CUMBERLAND
SSN/DC 18:5-12-2781
ACN Oq12:sglq
Amoun'~ Remi'H:ed I
HAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 1701:5
REV-15q8 EX AFP (Ol-OS)
CUT ALONG THIS LINE ~ RETAIN LONER PORTION FOR YOUR RECORDS ~
REV-Z548 EX AFP (01-03)
NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DZSALLONANCE OF
DEDUCTIONS, AND ASSESSMENT OF TAX ON dOZNTLY HELD OR TRUST ASSETS
DATE 07-26-ZOOq
ESTATE OF MUCHER
MARTHA E DATE OF DEATH 12-26-200:5 COUNTY CUMBERLAND
FILE NO. gl 0q-005:5 S.S/D.C. NO. 18:5-12-2781
TAX RETURN WAS: eX) ACCEPTED AS FILED ( ) CHANGED
ACN Oq12:521fi
JOINT OR TRUST ASSET INFORMATION
FINANCIAL INSTITUTION: SUSQUEHANNA VALLEY FCU ACCOUNT NO. 17q-51-7q65
TYPE OF ACCOUNT= ( ) SAVINGS ( ) CHECKING ( ) TRUST (~ TIME CERTIFICATE
DATE ESTABLISHED 01-21-1985
Account Balance
Percent Taxable
Amount Subject to Tax
Debts and Deductions
Taxable Amount
Tax Rate
Tax Due
:5,00:5.61 NOTE:
TAX CRED'rTS:
X 0.500
1,501.81
- .00
1,501.81
X .15
225.27
PAYMENT RECEIPT DISCOUNT (+) AMOUNT
DATE NUMBER INTEREST/PEN PAID (-)
PAYMENT MUST BE MADE BY 09-Z7-ZOOq~.
TO INSURE PROPER CREDIT TO
YOU~,COUNT, SUBMIT THE
UPPE~ORT~:B~ OF :EH]CJ5 NOTICE
WIT~UR ~ PA~_~,~E~T TO THE
REG~T'~R O~ILL?':',:~ THE
ABO_~: ADDRB~=S. ~'~E CHECK
OR ~NEY O~R PAyAbLE TO:
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST AND PEN.
TOTAL DUE
ZF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST.
ZF TOTAL DUE 1S LESS THAN $1, NO PAYMENT ZS REQUIRED.
ZF TOTAL DUE ZS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE A REFUND.
SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.
.00
225.27
.00
225.27
PURPOSE OF
NOTICE:
PAYMENT:
REFUND
OBJECTIONS:
ADMIN-
ISTRATIVE
CORRECTIONS:
DXSCOUNT:
PENALTY:
INTEREST:
To fulfill the requirements of Section 2140 of the Inheritance and Estate Tax Act, Act Z$ of 1000. (71 P.S.
Section 9140).
Detach the top portion of this Not[co and submit with your payment to the Register of Mills printed on the
reverse side.
-- Hake check or money order payable to: REGISTER OF NILLS, AGENT.
A refund of a tax credit, which wes not requested on the tax return, may be requested by completing an "Application
for Refund of Pennsylvanle Inheritance and Estate Tax" (REV-1313). Applications are available at tho Office of
the Register of Hills, any of the Z3 Revenue District Offices or by calling the special Z4-hour ansaering service
for forms ordering: 1-800-361-Z05D; services for taxpayers aith special hearing and or speaking needs:
1-800-447-3010 (TT only).
Any party in interest not satisfied eith the appraisement, a11oaance, or disalloaance of deductions or assessment
of tax (including discount or interest) as shown on this Notice may object eithin sixty (60) days of receipt of
this Notice by:
--written protest to the PA Department of Revenue, Board of Appeals, Dept. Z810Z1, Harrisburg, PA 17128-1021, OR
--electing to have the matter determined at the audit of the account of the personal representative, OR
--appeal to the Orphans' Court
Factual errors discovered on this assessment should be addressed in ariting to: PA Department of Revenue,
Bureau of Individual Taxes, ATTN: Post Assessment Review Unit, DEPT. ZEOS01, Harrisburg, PA 17118-0601
Phone (717) 787-6505. See page 5 of the booklet "Instructions for Inheritance Tax Return for a Resident
Decedent" (REV-1501) for an explanation of administratively correctable errors.
[f any tax due is paid aithin three (3) calendar months after the decedent's death, a five percent
discount of the tax paid is allowed.
The 151 tax amnesty non-participation penalty is computed an the total of tho tax and interest assessed, and not
paid before January 18, 1996, the first day after tho end of tho tax amnesty period. This non-participation
penalty is appealable in the same manner and in the the same tiaa period as you mould appeal tho tax and interest
that has been assessed as indicated on this notice.
Interest is charged beginning with first day of delinquency, or nine (9) months and one (1) day
from the date of death, to the date of payment. Taxes ahJch became delinquent before January 1, 1981
bear interest at the rate of six (6Z) percent per annum calculated at a daily rate of .000164.
All taxes Nh[ch became delinquent on or after January 1, [982 will bear interest at a rate which will vary from
calendar year to calendar year with that rate announced by the PA Department of Revenue. The applicable
interest rates for 1982 through 2004 are:
Interest OaiXy Xnterest DaiXy Xnterest DaiXy
Year Rate Factor Year Rate Factor Year Rate Factor
198'--'~ ZOZ .000548 1988-1991 11Z .000301 ZOO1 91 .000147
2001 61 .000119
1983 161 .000438 1991 9X ,000247
2003 5X .000137
1984 llZ .000301 1993-1994 7Z .00019Z
1985 13Z .000356 1995-1998 91 .000247 2004 41 .000110
1986 101 .000174 1999 7Z .000192
1987 9Z .000247 2000 81 .000119
--Interest is calculated as follows:
INTEREST = BALANCE OF TAX UNPAID X NUI~BER OF DAYS DELZN{~UENT X DAZLY 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. Xf payment is made after the interest computation date sheen on the
Notice, additional interest must be calculated.
COMMONWEALTH OF PENNSYLV/"NIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128 O601
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
NO. CD 004198
MITCHELL GILBERT H
412 ALLENDALE WAY
CAMP HILL, PA 17011
........ fold
ESTATE INFORMATION: SSN: 183-12-2781
FILE NUMBER: 2104- 0053
DECEDENT NAME: MUCHER MARTHA E
DATE OF PAYMENT: 07/27/2004
POSTMARK DATE: 07/27/2004
COUNTY: CUMBERLAND
DATE OF DEATH: 12/26/2003
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101
$225.27
REMARKS:
TOTAL AMOUNT PAID:
$225.27
SEAL
CHECK#4573
INITIALS: JA
RECEIVED BY:
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
REGISTER OF WILLS
BUREAU OF INDIVIDUAL TAXES
GZLBERT H HITCHELL
qZZ ALLENDALE NAY
CAHP HILL
COHHONNEALTH OF PENNSYLVANZA
DEPARTNENT OF REVENUE
NOTICE OF XNHERZTANCE TAX
APPRAXSERENT ALLORANCE OR D/SALLORAMCE
OF DEDUCTXON~ AND ASSESSRENT OF TAX ON
JOINTLY ~ELD OR TRUST ASSETS
PILE NUNBER 21 0q-0055
COUNTY
'~ J~L27 ~IT~/DC
PA 17011 (~,~r~, _
CUHBERLAND
183-12-2781
0~12521~
Amoun~
NARTHA E
HAKE CHECK PAYABLE AND REHZT PAYHENT TO:
REGISTER OF HILLS
CUHBERLAND CO COURT HOUSE
CARLISLE, PA 1701~
~_"r..~2_N_~_.T.H.~&~.__- ~ RETAZN LONER PORTZON FOR YOUR RECORDS "'~
REV-ISA8 EX AFP (01-0~' ...................................................................................
NOTZCE OF ZNHERZTANCE TAX APPRAXSENENT, ALLONANCE OR DZSALLOgANCE OF
DEDUCTIONS; AND ASSESSNENT OF TAX ON JOINTLY HELD OR TRUST ASSETS
DATE 07-26-200~
ESTATE OF NUCHER HARTHA E DATE OF DEATH 11-26-2005 COUNTY CUHBERLAND
FZLE NO. 21 0~-0055 S.S/D.C. NO. 185-12-2781 ACN O~12SZlq
TAX RETURN NAS: (X) ACCEPTED AS FILED ( ) CHANGED
JOINT OR TRUST ASSET ZNFORNATZON
FINANCIAL INSTITUTION: SUSQUEHANNA VALLEY FCU ACCOUNT NO. 17~-51-7~65
TYPE OF ACCOUNT: ( ) SAVINGS ( ) CHECKING ( ) TRUST (~ TINE CERTIFICATE
DATE ESTABLISHED 01-21-1985
Account Balance
Percent Taxable
Amoun~ Subject to Tax
Dabts and Deductions
Taxable A=ount
Tax Rate
Tax Due
TAX CREDZTS:
3,003.61
0.500
1,501.81
.00
1,501.81
.15
225.27
NOTE:
TO INSURE PROPER CREDIT TO
YOUR ACCOUNT, SUBMIT THE
UPPER PORTION OF THIS NOTICE
NZTH YOUR TAX PAYHENT TO THE
REGISTER OF HILLS AT THE
ABOVE ADDRESS. HAKE CHECK
OR HONEY ORDER PAYABLE TO:
"REGISTER OF HILLS, AGENT.**
PAYNENT
DATE
RECEIPT
NUMBER
DISCOUNT (+)
INTEREST/PEN PAID (-)
ANOUNT PAID
PAYMENT MUST BE MADE BY 09-27-200q~.
TOTAL TAX CREDIT r
BALANCE OF TAX DUEI
INTEREST AND PEN.
TOTAL DUE
IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL
( IF TOTAL DUE 1S LESS THAN $1~ NO PAYMENT IS REQUIRED.
IF TOTAL DUE ES REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE A REFUND.
SEE REVERSE SEDE OF THIS FORM FOR INSTRUCTIONS.
.00
125.27
.00
225.27
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
DEPT. ::'80601
HARRTSBURG,, PA 171Z8-0601
COHHONNEALTH OF PENNSYLVANIA
DEPARTHENT OF REVENUE
INHERITANCE TAX
STATEHENT OF ACCOUNT
REV-1607 EX &FP (gl-DS)
GILBERT H MITCHELL
412 ALLENDALE NAY
CARP HILL PA 17011
DATE 07-Z6-ZO04
ESTATE OF MUCHER
DATE OF DEATH 1Z-Z6-2005
FILE NUHBER Z1 04-0055
COUNTY CUHBERLAND
ACN O~123214
I Amoun'~ Remitted
MARTHA E
HAKE CHECK PAYABLE AND REHZT PAYMENT TO:
REGISTER OF gILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
NOTE: To insure proper- credit ~o your account, submi~ ~he upper portion of ~his for. wi~h your ~ax payment:.
CUT ALONG THIS LINE ~' RETAIN LONER PORTION FOR YOUR RECORDS -.~
REV-1607 EX AFP (01-03) ~-- INHERITANCE TAX STATEHENT OF ACCOUNT
ESTATE OF MUCHER MARTHA E F'rLE NO. 21 04-0053 ACN 0~12321~ DATE 07-26-200~
THIS STATEHENT ZS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN ZN THE NAHED ESTATE. SHO#N BELO#
ZSA SUHNARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYMENTS, THE CURRENT BALANCE., AND, ZF APPLICABLE,
A PROJECTED INTEREST FIGURE.
DATE OF LAST ASSESSMENT OR RECORD ADdUSTMENT: 07-26-Z00~
PRINCIPAL TAX DUE: ...........................................................................................................................................................................................................................
PAYMENTS (TAX CREDITS):
225.27
PAYNENT RECEIPT DISCOUNT (+)
DATE NUMBER INTEREST/PEN PAID (-) AMOUNT PAID
06-21-Z00~ CD00~068 .00
IF PAID AFTER THIS DATE, SEE REVERSE
SIDE FOR CALCULATION OF ADDITIONAL INTEREST.
( ZF TOTAL DUE IS LESS THAN $1,
NO PAYMENT ZS REQUIRED.
ZF TOTAL DUE ZS REFLECTED AS A 'CREDIT" (CR),
225.27
TOTAL TAX CREDIT 225.27
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
TOTAL DUE .00
YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.
JERRY R DUFFLE
RICHARD W, STEWART
C, ROY WEIDNEK JR
EDMUND G, MYERS
DAVID W DELUCE
JEFFERSON J SHIPMAN
RALPII H. WRIGHT, JR
MARl( C. DEFFIE
JOHN R. NINOSKY
MICtlAEL J. CASSIDY
MEIJSSA PEEL GREEVY
ROBERT M. WALKER
WADE D. MANLEY
LAW OFFICES
JONSON
DUFFIE
September 24, 2004
OF COUNSEL
HORACE 4. B)HNSON
F LEE SHIPMAN
BRUCE l GROSSMAN
Regis~rofWills Office
CumbedandCoun~Courthouse
OneCourthouse Square
CaHisle, PA17013
Dear Register of Wills Office:
Re:
i
Estate of Martha E. Mucher
SSN: 183-12-2781
Our File No. 9395-1 ::
Your File No. 21-04-00053 .,~:
Enclosed for filing please find the following documents for the above referenced decedent:
20dginal Pennsylvania Inheritance Tax Returns. There is tax due in the amount of $11,631.55.
Estate Check No. 1006 is attached to the Return.
Estate Check No. 1007 in the amount of $195.00 as follows:
a. $ 15.00 Inheritance Tax filing fee
b. $ 25.00 Inventory Fee
c. $155.00 for Additional Probate Fees
2 copies of Pages 1&2 of the Pa Inheritance tax return, which we ask that you time-stamp and return to
us in the enclosed envelope.
Inventory
Inventory copy, which we ask that you time stamp and return to us in the enclosed envelope.
Should you have any quesfions, please do not hesitate to contact our office. Thank you for you assistance in this
matter.
Very truly youm,
JOHNSON, DUFFLE, STEWART & WEIDNER
uan~ t. Wieseman ~
Legal Assistant
c: Gilbert H. Mitchell, Executor
~36054
301 MARKET STREET l~O. BOX 109 LEMOYNE, PENNSYLVANIA 17043-0109
WWW.JDSW. COM 717.761.4540 FAX: 717.761.3015 MAIL@JDSW. COM
JOHNSON, DUFFLE, STEWART & WEIDNER, P.C.
R Er- 1500 EX + (6-00)
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG, PA 17128-0601
D
E
C
E
D
E
N
T
REV-1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
MUCHER MARTHA E
DATE OF DEATH (MM-DD-YEAR) DATE OF BIRTH (MM-DD-YEAR)
12/26/2003 06/30/1914
(IF A~PLICABLE) SURV[VING SPOUSE'S NAME (LAST, F RST, AND MIDDLE INITIAL)
OFFICIAL USE ONLY
FILE NUMBER
2004-00053
COUNTYCODE YEAR NUMBER
SOCIAL SECURITY NUMBER
183-12-2781.
THIS RETURN MUST BE RLED IN DUPUCATE w';rH THE
REGISTER OF WILLS
SOCIAL SECURITY NUMBER
.~1. Original Return 2. SuppMmentalReturn
C A P B [ 4. Limited Estate 4a. Future Interest Compromise (date of death after 12-12-82)
HpRL ~
EplOl[~J6. DecedentDledTestate 7. D~de~tMaintai~daLivlngTrust
R
E
C
A
P
I
T
U
L
A
T
I
O
N
C
O
M
T
I
O
N
NAME
Edmund G. Myers
FIRM NAME (if Applicable)
Johnson, Duffie~ Stewart & Weidner
TELEPHONE NUMBER
3. Rema erReturn prlorto12-13-83)
5. Federal EstateTax RetumRequlred
0 S. Total Number of Safe Deposit Boxes
] 11. Election to tax under Sec. 9113(A)
(Attach Sch O)
717/761-4540
1. Real Estate (Schedule A) (1)
2. Stocks and Bonds (Schedule B) (2)
3. Closely Held Corporation, Partnership or (3)
Sole-Proprietorship
4. Mortgages & Notes Receivable (Schedule D) (4)
5. Cash, Bank Deposits & Miscellaneous Personal Property (5}
(Schedule E)
6. Jointly Owned Property (Schedule F) (6)
Separate Billing Requested
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7)
(Schedule G or L)
8. Total Gross Assets (total Lines 1-7)
9. Funeral Expenses & Administrative Costs (Schedule H) (9)
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule l) (10)
11. Total Deduetione (total Lines 9 & 10)
12. Net Value of Estate (Line 8 minus Line 11 )
13.
COMPLETE MNLING ADDRESS
P. O. Box 109
301 Market Street
Lemoyne, PA 17043-0109
Non_e
24,00~
l~ne
103,286~99
4,295.16
69,98ff~>12
1.6,492. O0
514.37
OFFICIAL USE ONLY
(5) 201,571.49
(11) 17,006.37
(12) 184,565.12
(13) 22,810.90
Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been
made (Schedule J)
14. Net Value Sub,act to Tax (Line 12 minus Line 13) (14) 161., 754.22
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
15. Amount of Line 14 taxable at the spousal tax
rate, or transfers under Sec. 9116(a)(1.2) O. O0 X .0 0 (15) O. O0
16. Amount of Line 14 taxable at lineal rate O. O0 X .0 45 (16) O. O0
17. Amount of Line 14 taxable at sibling rate O. O0 X .12 (17) O. O0
18. Amount of Line 14 taxable at collateral rate 161,754.22 X .15 (18) 24,263.13
19. Tax Due~, ·, (19) 24 ,263.13
Cop/rig ht (c) 2000 form software only T he Lackner Group, I nc+
Form REV-1500 EX (R,,v. s-oo)
Decedent's Complete Address:
STREETADORESS
425 Wesley Drive
CITY
Mechanicsbur~
STATE ZIP
PA 17055
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
0.00
12,000.00
631.58
Total Credits ( A + B + C ) (2)
3. Interest/Penalty if applicable D. Interest
E. Penalty
Total Intemsf/Penalty ( D + E ) (3)
4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT.
Check box on Page 1 Line 20 to requeat a refund (4)
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5)
A. Enter the interest on the tax due. (SA)
B. Enter the total of Line 5 + 5A. This is the BALANCE DUE.
Make Cheek Payable to: REGISTER OF WILLS, AGENT
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
1. Did decedent make a transfer and: Yea No
e. retain the use or incorne of the property transferredl .........................
b. retain the right to designate who shall use the property transferred or its income; ...........
c. retain a reversionary interest; or ....................................
d. receive the promise for life of either payments, benefits or care? ...................
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death
without receiving adequate consideration? ................................ [] []
3. Did decedent own an "in trust for" or payable upon death bank account or security at his
or her death? .............................................. [] []
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property
which contains a beneficiary designation? ................................ [] []
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES,
YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
24,263.13
12,631.58
0.00
0.00
11,631.55
0.00
11,631.55
U r',der penalties of perjury, I declare that I have examined this return, Including accompanying schedules and statements, and to the best of my knowledge and b~iief, it Is true,
correct and complete. DecLaration of p~pater other than the personal representative Is based on all Information of which preparer hag any knowledge.
SIGN~UREOFPER$O~R~ESPONSIBLE~ORFILINGRETURN Gilbert H. MITCHELL SATE
.~F.//~ .1//~,,~../I~.//.. /. 412 Allendale W~X
S~UREOFPREPAREROTHERTHANREPRESENTATIVE Johnson, D~ffie, Stewart & Weidner DATE
--~-~. P.O. Box 109 ~/_ /o~/
For d~ta~ of d~ath on or a~r ~ul~ 1, 1054 and b~fom Janua~ 1, 1~5, th* tax rata imposed on tho n~t valu~ of transfers to or ~or th* u~ of th*
surviving spouse is 3% [72 P.S. 9116 (a) (1.1) (i)].
For dates of death on or after Janua~ 1, 1995, the ~x rate imposed on the net value of transfers to or for the use of the surviving spouse is 0%
[72 P.S. 9116 (a) (1.1) (ii)]. The s~tuta does not exempt a transfer to a suwiving spouse from tax, and the statuto~ requirements for disclosure of assets
and filing a ~x return are still applicable even E the suwiving spouse is the only beneficial.
For dates of death on or after Ju~ 1, 2000:
The tax rate imposed on the net value of transfers from a deceased child twang-one years of age or younger at death to or for the use of a natural
parent, an adoptive parent, or a smpparent of the child is 0% [72 P.S. 9116 (a) (1.2)].
The tax rate imposed on the net value of transfers to or for the use ot the decedent's lineal beneficiaries is 4.5%, except as noted in 72 P.S. 9116(12)
[72 P.S. 9116(aX 1 )].
The ~x rate imposed on the net value o~ tmn~ers to or for the use of the decedent's siblings is 12% [72 P.S. 9116(a)(1.3)]. A sibling is defined, under
Section 9102, as an individual who has at leas{ one parent in common with the decedent, whether by blood or adoption.
Co.right (c) Z~0 form software only The Lac~ner Group, Inc. Form REV- I SOO EX (Rev. 6-~)
REV- 1503 EX * (1-9'/)
COMMONWEALTHOFPENNSYLVANIA
INHERITANCETAXRETURN
RESlDENTDECEDENT
ESTATE OF
SCHEDULE B
STOCKS & BONDS
FILE NUMBER
MARTHA E MUCHER SS~/ 183-12-2781 12/26/2003 2004-00053
All property jointly-owned with right of survivorship must be disclosed on Schedule F.
ITEM DESCRIPTION UNITVALUE VALUEATDATE
NUMBER OFDEATH
1 896.504 shares Federated Fund for US Government Secs 7.88 7,064.45
A/Fund Account No. 337/3526327
Valued using EstateVal. Such valuation is attached to
this Return, CUSIP #314182106
2 57 shares Metlife Inc. Common Stock. Valued using 33.105 1,886.99
EstateVal. Such valuation is attached to this Return.,
CUSIP #59156R108
3 207 shares Mid Penn Bancorp Stock, CUSIP #59540G10 - 23.98 4,963.86
Valued using EstateVal. Such valuation is attached to
this Return.
4 2 United States Series ~]~ Savings Bonds. $500 1,500.00
demonlnation and $1,000 demonination - Valued using
United States Savings Bond Calculator. Such calcuation
is attached this Return.
5 20 United States Savings Bonds Series E - Valued using 8,471.52
Savings Bond Calulator. Such calculation is attached
to this Return.
6 United States Series EE $100 Savings Bond - Valued 122.40
using United States Savings Bond Calculator. Such
calculation is attached to this Return.
TOTAL(Alsoenteronline2, Recapitulation) 24,009.22
(if more space is needed, insert additional sheets of the same size)
Copyright (c) 1996 form software only CPSystems, inc. Form REV-1503 E;X (Rev. 1-97)
REV-leO8 EX + (1-97)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
MARTHA E MUCfIER SS~ 183-12-2781 12/26/2003
Include the proceeds of litigation and the date the proceeds were received by the
survivorship must be disclosed on Schedule F.
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
FILE NUMBER
2004-00053
estate. All property jointly-owned with the right of
ITEM
NUMBER DESCRIPTION
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
3 $20.00 American Express Travelers Checks
5 MasterCard Travelers Checks with a $20 denomination
Conseco Annuity Assurance Company - Surrender of Policy No.
9002003160 Account No. 10030000
2003 Individual Federal Income Tax Refund
Conseco Annuity Assurance Company - Surrender of Insurance Polic'
No. 9002008220 Account No. 1003000
Fulton Baruk Certificate of Deposit Account No. 314-4133190
Guideposts Magazine Refund
Pennsylvania State Employee Credit Union Certificate of Deposit
Pennsylvania State Employee Credit Union Certificate of Deposit
Pennsylvania State Employees Credit Union Regular Share (S1)
Account
Pennsylvania State Employee Credit Union MoneyHandler Shares
PNC Bank Certificate of Deposit Account 21001015455
PNC Bank Certificate of Deposit Account 21001015797
PNC Bank Certificate of Deposit Account 21001019616
PNC Bank Certificate of Deposit Account 31400101401
PNC Bank Certificate of Deposit Account 31000211421
Susquehanna Valley Federal Credit Union Account 174-00
Travelers - Insurance Refund due to cancellation
Wachovia Bank Certificate of Deposit Account 247412063630414
Wachovia Bank Certificate of Deposit Account No. 247022066268682
Wachovia Bank Certificate of Deposit Account No. 3059950021187
Total of Continuation Schedule(s)
TOTAL (Aisc enter on line 5, Recapitulation)
{If more space is needed, insert add}tional sheets of the same size)
Copyright (c) 1996 form software only CPSystern$, Inc.
VALUE ATDATE
OF DEATH
60.00
100.00
10.00
376.00
14.50
11,905.91
11.23
1 , 193.66
2,358.30
3,537.34
867.22
5,000.72
5,006.59
4,011.41
3,706.51
15,460.60
594.29
125.00
2,394.12
1,996.15
2,934.32
41,623.12
$ 103,286.99
Form REV-1508 EX (Rev. 1-97)
Estate of: MART~A E MUC~IER
Soc Sec #: 183-12-2781
Date of Death: 12/26/2003
Continuation of Schedule E
(Cash, Bank Deposits & Miscellaneous Personal Property)
Item Description
Value at Date
of Death
22 Waypoint
23 Waypoint
24 Waypoint
25 Waypoint
26 Waypotnt
27 Waypoint
28 Waypoint
29 Waypotnt
30 Waypoint
31 Waypoint
32 Waypoint
33 Waypotnt
34
35
Bank Certificate of
Bank Certificate of
Bank Certificate of
Bank Certificate of
Bank Certificate of
Bank Certificate of
Bank Certificate of
Bank Certificate of
Bank Certificate of
Bank Certificate of
Deposit Account No. 416001987
Deposit Account No. 7100018703
Deposit Account No. 7100024849
Deposit Account No. 416005161
Deposit Account No. 416010068
Deposit Account No. 416010084
Deposit Account No. 416013017
Deposit Account No. 416030908
Deposit Account No. 460258908
Deposit Account 461289270
Bank Certificate of Deposit Account No. 7100017148
Bank Savings Account No. 10037489
1993 Mercury Sedan - Valued and appraised by L.B. Smith Ford
Personal property of Decedent valued and appraised by Chuck
Bricker, Auctioneer. Appraisal is attached
1 001.95
2 010.65
2 141.74
1 001.52
1 305.54
3 011.23
5,298.58
4,522.71
7,564.08
1,453.17
10,035.13
366.82
1,000.00
910.00
41,623.12
REV-tSO~EX.(t-~) SCHEDULE F
COMMONWEALTH OF PE "" SYLVANIA JOINTLY-OWNED PROPERTY
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
MARTHA E MUCHER SS~; 183-12-2781 12/26/2003
If mn asset was made joint within one year of the decedsnt's date of death, it must bs reportsd on Schedule G.
FILE NUMBER
2004-00053
SURVIVING JOINT TENANT(S) NAME ADDRESS RELATIONSHIP TO DECEDENT
A. Gilbert H. HITCh{ELL Nephew
412 Allendale Way
Camp Hill, PA 17011
JOINTLY-OWNED PROPERTY:
LETrER DATE DESCRIPTION OF PROPERTY % OF DATE OF DEATH
ITEM FOR JOINT MADE Include~ameof flrtanclallnstltutlonar~d bank DATE OF DEATH DECD'S VALUE OF
account number or similar identifying number.
NUMBER TENANT JOINT Attach deed forJolntly-held realestate. VALUE OF ASSET INTEREST )ECEDENT'S INTERE$
1 A 01/01/78 PNC Bank Checking Account 5,586.70 50.007, 2,793.35
No. 5140045107
2 A 01/21/85 Susquehanna Valley Federal 3,003.61 50.007, 1,501.81
Credit Union Certificate of
Deposit Account No.
174- 51 - 7465
TOTAL (Also enter on line 6, Recapitulation) $ 4,295.16
(If more space is needed insert additional sheets of the same size)
Copyright(c) 1996 formsoftware only CPSystems, Inc. Form REV-1509 EX (Rew 1-97~,
.~v-~sm~x~(~-sTi SCHEDULE G
INTER-VIVOS TRANSFERS &
COMMONWEALTH OF PENNSYLVANIA
INHERITANCETAXRETURN MISC. NON-PROBATE PROPERTY
RESIDENT DEt'E~I=NT
ESTATE OF FILE NUMBER
NARTF, A g NUCF, ER SS~/ 183-12-2781 12/26/2003 2004-00053
This schedule must be completed and filed if the answer to any of questions 1 through 4 on page 2 is yes,
DESCRIPTION OFPROPERTY % OF
INCLUDE?HENAMEOFTH TRANSFEREE HEIR
ITEM RELATIONSHIPTODECEDENTA~?HEDATEO~RANSFER. DATE OFDEATH DECD'S EXCLUSION TAXABLEVALUE
NUMBER ~TACHACOPYOFTHEDEEDFORREALSS?ATE. VALUE OFASSET NTEREST (IF~PLICABLE)
1 ING Life Insurance and 23,655.87 23,655.87
Annuity Company Contract
No.055119989
Beneficiary: Gilbert H.
Mitchell
2 ING Life Insurance and 11,724.71 11,724.71
Annuity Company. Annuity
Contract No. 02909989
Beneficiary: Gilbert H.
Mitchell
3 PNC Bank Annuity Account 34,599.54 34,599.54
for Metlife Investors
Annuity
Beneficiary: Gilbert H.
Mitchell
TOTAL(AlsoenteronlineT, Recapitulation) $ 69,980.12
(If more space is needed, insert additional sheets of the same size)
Copyright (c) 1996 form software onry CPSystems, Inc. Form REV-1510 EX {Rev. 1-97)
COMMONWEALTH OF PENNSYLVANIA
iNHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
MARTHA ~. MUCEER SS# 183-12-2781
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
12/26/2003
FILE NUMBER
2004-00053
Dabts of decedent must be raported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
Ao
1
2
3
4
4.
5.
6,
7.
2
4
5
FUNERALEXPENSES;
Bethany Village - Costs for Memorial Service
Calvary United Methodist Church - Gravesite Services
Evans Cemetery Memorials - Lettering of the Monument
James Browning - Funeral Service
Total of Continuation Schedule(s)
ADMINISTRATIVE COSTS:
Personal Representative's Commissions
Name of Personal Representative(s)
Social Security Number(s) / EIN Number of Personal Representative(s)
Street Address
City State __ Zip
Year(s) Commission Paid:
Afforney'sFees Johnson, Duff ia, Stewart & Weidner
Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant
Street Address
City State Zip
Relationship of Claimant to Decedent
Probate Fees Register of Wills
Accountant's Fees
Tax Return Preparer's Fees
Other Administrative Costs
Chuck Bricker, Auctioneer - Appraisal of personal property
Cumberland County Register of Wills Office - Additional Short
Certificates
Cumberland County Register of Wills Office - Filing Fees for
Inheritance Tax Return ($15.00) and Inventory ($25.00).
Ctunberland County Register of Wills Office - Additional Probate
Fees
PNC Bank fee for Medallion Guarantee
Total of Continuation Schedule(s)
TOTAL (Also enter on line 9, Recapitulation)
217.50
450.00
85.00
100.00
7,092.90
7,500.00
119.00
75.00
50.00
9.00
40.00
155.00
2.00
596.60
$ 16,492.00
(If more space is needed, insert additional sheets of the same size)
copyright (c) 1996 form software only CPSystems, Inc. Form REV-1511 EX (Rev. 1-97)
Estate of: MARTIiA E MUCF~R
Soc Sec ~: 183-12-2781
Date of Death: 12/26/2003
Item Description
Continuation of Schedule H-A
(Funeral Expenses)
Amount
5 Musselman Funeral Home and Cremation Services, Inc.
6 Rev. Robert Mitchell - Funeral Service
6,992.90
100.00
7,092.90
Estate of: MARTHA E MUCHER
Soe Sec #: 183-12-2781
Date of Death: 12/26/103
Item Description
Continuation of Schedule H-B5
(Accountant's Fees)
Amount
Richard S. Simpson, II CPA - Fee for preparation of 2003
Individual Returns
75.00
75.00
Estate of: MART~A E MUCKER
Soc Sec ~: 183-12-2781
Date of Death: 12/26/2003
Item Description
Continuation of Schedule H-B7
(Other Administrative Costs)
6 RESERVES held for additional administrative costs and expenses
7 The Cumberland Law Journal - Notice of Estate Administration
8 The Patriot News - Notice of Estate Administration
400.00
75.00
121.60
596.60
REV- 151Z EX + (1-97~
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
~RTH~ E MUCHE~
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, AND LIENS
183-12-2781 12/26/2003
FILE NUMBER
2004-00053
Include unreimbumed medical expenses.
ITEM
NUMBER DESCRIPTION AMOUNT
1
2
3
5
Lower Allen Township EMS - Check Clearin§ After Date of Death
Metlife Investors - Reimbursements to Metlife Investors for
payments made after the death of Decedent
PA State Employees' Retirement System - Repayment of Funds
Received after Death
The Patriot News - Subscription payment
Verizon Telephone - Final Payment of Telephone Service
TOTAL (Also enter on line 10, Recapitulation) $
50.00
376.35
65.23
6.35
16.44
514.37
(If more space is needed, insert additional sheets of the same size)
Copyright (c) 1996 form software only CPSystems, Inc. Form REV-1512 EX (Rev. 1-97)
REV- 1S13 EX
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
MARTHA E MUCHER SS~ 183-12-2781
NUMBER
SCHEDULE J
BENEFICIARIES
12/26/2003
NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY
TAXABLE DISTRIBUTIONS [l~l~e o~rlght spo~al dlstrlb~lons, and
Denise MacLa~e
161 Louther Street
Carlisle, PA 17013
Gilbert H. Mitchell
412 Allendale Way
Camp Hill, PA 17011
Nancy K. Mitchell
904 Pelican Drive
New Bern, NC 28560
Robert R. Mitchell
332 Covered Bridge Road
Olay, PA 19547
Il.
2
3
RELATIONSHIP TO DECEDENT
Do Not List Truste~(s)
Niece
Nephew
Niece
Nephew
FILE NUMBER
2004-00053
AMOUNT OR SHARE
OFESTATE
Ail Shares of
Mid-Penn Bank
Stock
Tangible
Personal
property &
18.75% of
Residue
18.75% of
Residue
18.75% of
Residue
ENTER DOLLAR AMTS. FOR DISTRIBUTIONS SHOWN ABOVE ON LN. 15 THRU 18, AS APPROPRIATE, ON REV 1500 COVER SHEET
NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SEC. 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
11,405.44
5,702.73
5,702.73
0.00
B. CHARITABLEAND GOVERNMENTALDISTRIBUTIONS
Calvary United Methodist Church (12.5% of Residue)_
700 Market Street
Lemoyne, PA 17043
St. Christopher's Lutheran Church (6.25% of Residue)
635 North 2nd Street
Lykens, PA 17048
The Care Assurance Endowment Fund (6.25% of Residue)
TOTAL OF PART Il - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV 1500 COVER SHEET $
22,810.90
(It more space is needed, insert additional sheets of the same size)
Copyright (c) 2000 form software only The Lackner Group, Inc. Form REV-1513 EX IRev. 9-
Estate of: MARTNA E MUCI{ER
Soc Sec #: 183-12-2781
Date of Death: 12/26/2003
Continuation of Schedule J, Part I
(Taxable Bequests)
Item
Name and Address of Beneficiary
Relationship
Amount or
Share of Estate
5
Marilyn Reedinger
304 Market Street
Lykens, PA 17048
Niece
18.75X of
Residue
Estate of: MARTHA E MUCHER
Soc Sec #: 183-12-2781
Date of Death: 12/26/2003
Continuation of Schedule J, Part II-B
(Charitable and Governmental Bequests)
Item Description
Share of Estate
Bethany Village Retirement Center
325 Wesley Drive
Mechanicsburg, PA 17055
0.00
LISTING OF EXHIBITS FOR
ESTATE OF MARTHA E. MUCHER
EXHIBIT
LAST WILL AND TESTAMENT SIGNED AND DATED
OCTOBER 21st, 1993.
EXHIBIT B
INHERITANCE TAX ALLOCATION PAGE
EXHIBIT C
ESTATEVAL VALUATION FOR STOCKS-SCHEDULE A:
I. MID PENN BANCORP INC.
2. FEDERATED INCOME SECS FUND
3. METLIFE STOCK
EXHIBIT D
INVENTORY REPORT- SERIES HH BONDS
EXHIBIT E
UNITED STATES SA VINGS BOND CALCULATOR
SHOWING VALUE OF 20 SERIES E BONDS
EXHIBIT F
UNITED STATES SA VINGS BOND CALCULATOR
SHOWING VALUE OF 1 SERIES EE BOND
-HIGHLIGHTED
EXHIBIT G
APPRAISAL BY L.B. SMITH FORD INC. FOR
DECEDENT'S .AUTOMOBILE
EXHIBIT H
PERSONAL PROPERIT APPRAISAL BY CHUCK
BRICKER, AUCTIONEER AUO94-L
:235962
OF
MARTHA E. MUCHER
I, MART}IA E. MUCHER, of the Borough of Lemoyne, Cumberland County, Pennsylvania,
being of sound and disposing mind, memory and understanding, do hereby make, publish and declare
this as and for my Last Will and Testament, hereby revoking and making void any and all Wills or
Codicils at any time heretofore made by me.
ARTICLE I
I direct the payment of all my legal debts, and the expenses of my last illness and funeral from
my Estate as soon after my death as conveniently may be done. I direct that all taxes that may be
assessed in consequence of my death, of whatever nature and whatever jurisdiction imposed, shall be paid
from my Residuary Estate as part of the expense of the administration of my Estate.
ARTICLE II
I give and bequeath my automobile, household and personal effects and other tangible personalty
of like nature (not including cash or securities), together with any existing insurance thereon, unto my
nephew, GILBERT H. MITCHELL, provided he survives me.
ARTICLE III
I give and bequeath my shares of stock in Lykens Miners Bank unto my niece, DENISE
MacLAN-E, provided she survives me.
ARTICLE IV
I give, devise and bequeath all the rest, residue, and remainder of my Estate, of whatsoever
nature and wheresoever situate, as follows:
A. Twenty (20%) percent thereof unto my brother, ROBERT MITCHELL, provided he
StlrvJves me.
In the evem my brother, ROBERT MITCHELL, predeceases me, I give, devise and bequeath
his share unto my remaining residuary legatees in the same proportions as each legacy bears to the others;
B. Sixty (60%) percent thereof in equal shares unto my nephews, GILBERT H.
MITCHELL and ROBERT R. MITCIIELL and my nieces, lVI~LYN REEDINGER and NANCY
K. MITCHELL;
C. Ten (10%) percent thereof unto CALVARY UNITED METHODIST CHURCH, 700
Market Street, Lemoyne, Pennsylvania;
D. Five (5%) percent thereof unto ST. CHRISTOPHER'S LUTHERAN CHURCH,
Lykens, Pennsylvania; and
E. Five (5%) percent unto THE CARE ASSURANCE ENDOWMENT FUND, Bethany
Village Retirement Center, 325 Wesley Drive, Mechanicsburg, Pennsylvania.
ARTICLE V
I direct that all estate, inheritance, transfer and other taxes of a similar nature payable by reason
of my death, together with any interest and penalties thereon, and imposed with respect to any property,
whether or not disposed of by this Will, shall be paid out of the residue of my Estate. I further direct
that any and all such taxes shall be paid from and deducted from my residuary Estate prior to the
calculation of the shares of the residuary beneficiaries, so that each residuary beneficiary, charitable or
not, shall bear a portion of the burden of such taxes.
ARTICLE VI
I name, constitute and appoint GILBERT H. MITCHELL and DENISE MacLANE, Co-
Executors of this my Last Will and Testament, and direct that neither shall be required to post bond for
the faithful discharge of the duties in any jurisdiction, and provided further that should either fail to
qualify or cease to so act, I direct that the other shall complete the administration of my Estate.
IN WITNESS WI-IEREOF. I have hereunto set mv hand and seal. this 7~-Cday of October.
1993.
.,. · ./ ~ ~ , z' ~: ~ · _ /9' ?'~/~--f.-,~b~.*.~ (SEAL)
lvlartha E. Muehef
Signed, sealed, published and declared by the above-named Testatrix. as and for her Last Will
and Testament, in the presence of us, who at her request, in her presence and in the presence of each
other, have hereunto subscribed our names as witnesses.
ACKNOWLEDGMENT
COMMONWEALTH OF PENNSYLVANIA :
:SS
COUNTY OF CUMBERLAND :
the Testatrix and the wimesses, respectively, whose names are signed to the attached or foregoing
instrument, being first duly sworn, do hereby declare to the undersigned authority that the Testatrix
signed and executed the instrument as her Last Will and that she had signed willingly and that she
executed it as her free and voluntary act for the purposes therein expressed, and that each of the
witnesses, in the presence and hearing of the Testatrix, signed the Will as witness and that to the best of
his/her knowledge the Testatrix was at that time eighteen years of age or older, of sound mind and under
no constraint or undue influence.
Martha E. Mucher
Witness
Wit~es~
Subscribed, sworn to and acknowledged before me by Martha E. Mucher, Testatrix, and
subscribed and sworn to before me by~ln~v~ ~-~/]l~n~__ and /~q(t0fi t{'~~,.
wim~s~, ~is~' day of October, 1993.
BONNIE L. STARER. Noisy/p~131tc ~ [
PA IN-HER TAX RTRN (DOD >= 7/1/2000)
PRE-RESID Sp/Par0fMinor 4.5%
Sched A-E
Sched F 0.00
Sched G 0.00
8 GRS ASSETS
9 Funer/Adm
10 Debts/Mrtg
11 TOTAL DED
12 NetVal Est
13 ChGvtgll3
14 SubJ to tx
15 Sp/PrOfMnr
16 Amt 4.5%
16 Amt 12%
18 Amt 15%
19 Princ Tax
201,571.49
16,492.00
514.37
17,006.37
184,565.12
22,810.90
161,754.22
0.00
0.00
0.00
161,754.22
24,263.13
<=ClearVal
[Estate of ]
12% 15% Exempt Total
6,873.86 6,873.86
4,295.16 4,295.16
69,980.12 69,980.12
Sch A-G: Pre-Residue Used. 81,149.14
Sch A-E: Total Available..
Sch A-E: Pre-Residue Used.
Sch A-E: Residue Available
110,289.84
6,873.86
103,415.98
Tax at
Tax at 4.5%
Tax at 12%
Tax at 15%
Principal Tax
0% (Spouse/Parent of Minor Child) ...... > 0.00
----> 0.00
.... > 0.00
....... > 24,263.13
...... > 24,263.13
Residue to 0% Spse
Residue to 4.5% Beny
Residue to 12% Beny
Residue to 15% Beny
Residue to Exempt Beny
Total
0.00% }
0.00% }
0.00% }
75.00% }<~Press <Fl> for Help
25.00% }
100.00%
RECAPITULATION
a Tot Gross
b less Ded
c lss PreRes
d Gross Res
e less PrnTx
f Net Resid
S~RY OF CALCULATIONS
201,571.49
17,006.37
81,149.14
103,415.98
24,263.13
79,152.85
PRE-RESIDUARY BEQUESTS
A
PRE - RES IDUE
RESIDUARY BEQUESTS
B C D E
TAX/PRE-RES GROSS RES TAX/RESID SHARE TAX
ON PRERES
Sps 0.00 0.00 0.00 0.00 0.00
4.5 0.00 0.00 0.00 0.00 0.00
12% 0.00 0.00 0.00 0.00 0.00
15% 81,149.14 12,172.37 80,605.08 12,090.76 9,487.46
Exm 0.00 0.00 22,810.90 0.00 2,684.91
81,149.14 12,172.37 103,415.98 12,090.76 12,172.37
F~D+E
SHARE OF
TOTAL TAX
0.00
0.00
0.00
21 , 578.22
2,684.91
24,263.13
PRE-RESIDUE
A
PRE - RES IDUE
Sps 0.00
4.5 0.00
12% 0.00
157. 81,149.14
Exm 0.00
81,149.14
RESIDUE
C F G = C - F
GROSS RES SHARE OF NET TO RES
TOTAL TAX BENYS
0.00 0.00 0.00
0.00 0.00 0.00
0.00 0.00 0.00
80,605.08 21,578.22 59,026.86
22,810.90 2,684.91 20,125.99
103,415.98 24,263.13 79,152.85
TOTAL
H=A+G
NET TO ALL
BENYS
0.00
0.00
0.00
140,176.00
20,125.99
160,301.99
Date of Death: 12/26/2003
Valuation Date: 12/26/2003
Processing Date: 09/23/2004
Shares Security
or Par Bescription
1) 207
2) 896.504
3) 57
Estate Valuation
High/Ask Low/Bid
Estate of: MUCSER, Martha
Account: 9396/1
Report Type: Date of Death
Number of Securities: 3
File ID: MUCEER
Mean and/or Div and Int Security
Adjustments Accruals Value
MID PENN BANCORP INC (59540G107)
COM
ASE
12/24/2003
12/29/2003
FEDERATED INCOME SECS TR (314182106)
FD FR USGVT A
NASDAQ
12/26/2003
METLIFE INC (59156H108)
COM
New York Stock Exchange
12/26/2003
24.00000 23.98000 8/L
23.97000 23.97000 8/L
7.88000 Mkt
33.29000 32.92000 H/L
23.980000 4,963.86
7.880000 7,064.45
33.105000 1,886.99
Total Value:
Total Accrual:
Total: $13,915.30
$0.00
$13,915.30
Page 1
This report was produced with EstateVal, a product of Estate Valuations & Pricing systems, Inc. If you have questions,
please contact EVP Systems at (818) 313-6300 or www.evpsys.com. {Revision 7.0.4)
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Sa, vings Bond Calculator
01/2004 iUP~
Page 1 of 2
Savin~
Series Denomination
E Bonds $ 50
Serial Number
# Bonds Total Price
21 $800.00
Serial Number
L659813376E
L655113157E
Total Value
$8,593.92
Issue Date Series Denom
11/1965
09/1965
L655102295E 07/1965
L646806887E 05/1965
Issue Interest
Price Interest Value Rate
E $50 $37.50 $306.34 $343.84 2.51%
E 50 37.50 310.66 348.16 2.34%
E 50 37.50 315.68 353.18 2.51%
E 50 37.50 365.14 402.64 4.00%
E 50 37.50 365.14 402.64 4.00%
E 50 37.50 408.10 445.60 4.00%
E 50 37.50 405.26 442.76 4.00%
E 50 37.50 414.10 451.60 4.00%
E 50 37.50 407.66 445.16 4.00%
L642735237E 05/1965
L637255258E 01/1965
L637255018E 11/1964
L633705809E 09/1964
L628357191E 07/1964
YTD ln~
$4.4
Next Final
Accrual Maturit3
02/2004 11/2005
06/2004 09/2005
04/2004 07/2005
02/2004 05/2005
02/2004 05/2005
04/2004 01/2005
02/2004 11/2004
06/2004 09/2004
04/2004 07/2004
L623353583E 05/1964 E 50 37.50
L616496323E 03/1964 E 50 37.50
L616496220E 01/1964 E 50 37.50
L616496164E 11/1963 E 50 37.50
L606680445 09/1963 E 50 37.50
L605143868E 07/1963 E 50 37.50
L603351110E 05/1963 E 50 37.50
L592017696E 03/1963 E 50 37.50
L590609190E 01/1963 E 50 37.50
L588442358E 11/1962 E 50 37.50
L584601080E 09/1962 E 50 37.50
C122123~1-3'5EE 04/L987 EE 100 50:00
~ I Viewing Bonds 1-21
Note Description
NI Not Issued
NE Not Eligible for Payment
P5 Includes 3-month interest penalty
ME Matured (Exchangeable for HH)
MN Matured (Not Exchangeable for HH)
404.70 442.20 4.00% 02/2004 05/2004
413.60 451.10 4:00% 03/2004 03/200,~
411.60 449.10 01/2004
408.84 446.34 11/2002
408.84 446.34 09/2002
402.40 439.90 07/2002
399.08 436.58 05/2002
399.14 436.64 03/2002
392.94 430.44 01/2002
39L16 428.66 11/2002
391.14 428.64 09/2002
72:40 [22;40 28
.
Please rate this service.
Sqvings Bond Calculator
:01/2004 ~:dateI
Page 1 of 2
5avinc
Series
E Bonds
Denomination
$ 50
Serial Number
Issue Date
# Bonds Total Price
21 $800.00
Serial Number Issue Date Series
L659813376E 11/1965 E
L655113157E 09/1965 E
L655102295E 07/1965 E
L646806887E 05/1965 E
L642735237E 05/1965 E
L637255258E 01/1965 E
L637255018E 11/1964 E
L633705809E 09/1964 E
L628357191E 07/1964 E
L623353583E 05/1964 E
L616496323E 03/1964 E
L616496220E 01/1964 E
L616496164E 11/1963 E
L606680445 09/1963 E
L605143868E 07/1963 E
L603351110E 05/1963 E
L592017696E 03/1963 E
L590609190E 01/1963 E
L588442358E 11/1962 E
L584601080E 09/1962 E
Denom Price
$50 $37.50
50 37.50
50 37.50
50 37.50
50 37.50
50 37.50
50 37.50
50 37.50
50 37.50
Total Value
$8,593.92
Interest
Interest Value Rate
$306.34 $343.84 2.51%
310.66 348.16 2.34%
315.68 353.18 2.51%
365.14 402.64 4.00%
3'65.14 402.64 4.00%
408.10 445.60 4.00%
405.26 442.76 4.00%
414.10 451.60 4.00%
407.66 445.16 4.00%
YTD In~
$4.4
Next Final
Accrual Maturit3
02/2004 11/2005
06/2004 09/2005
04/2004 07/2005
02/2004 05/2005
02/2004 05/2005
04/2004 01/2005
02/2004 11/2004
06/2004 09/2004
04/2004 07/2004
50 37.50
50 37.50
50 37.50
50 37.50
50 37.50
50 37.50
50 37.50
50 37.50
50 37.50
50 37.50
50 37.50
404.70 442.20
413.60 451.10
411.60 449.10
408.84 446.34
408.84 446.34
402.40 439.90
399.08 436.58
399.14 436.64
392.94 430.44
391.16 428.66
391.14 428.64
4.00% 02/2004 05/2004
4.00% 03/2004 03/2004,
O1/200;q
11/2002
09/2002
07/2002
05/2002
03/2002
01/2002
I 1/2002
09/200~
~l Viewing Bonds 1-21
Note Description
NI Not Issued
NE Not Eligible for Payment
P5 Includes 3-month interest penalty
ME Matured (Exchangeable for HH)
MN Matured (Not Exchangeable for HH)
Please rate this service.
The Winning
Combination
of Sales
and Service
L.B. Smith ~Ford, Inc.
1100 Market Street 4 Lemoyne, Pennsylvania 17043
Phone: (717) 761-6700 or (800) 422-3673 · FAX: (717) 761-3951
E-mail: fordsOIbsmlth.com
APPRAISAL
Personal Prope~yof I ~.,~, Lfl Iff ~.C/~ ,~,~/o ~,~ z,~,.~, - :'
D e~'?
Appraised by Chuck E. ~ricker AUOg4-L at /,~-~ ~ --
ITEM VALUE ITEM VALUE
Register of WIlls of
INVENTORY
County, Pennsylvania
Estate of I%~,RTHA E MUCHER
No. 2004-00053
Date of Death 12/26/2003
, Deceased Social Security No. 183-12-2781
Gilbert H. MITCHELL,
Personal Representative(s) of the above Estate, deceased, verify that the items appearing in the following Inventory include all of the
personal assets wherever situate and all of the real estate in the Commonwealth of Pennsytvania of said Decedent, that the valuation
placed opposite each item of said Inventory represents its fair value as of the date of the Decedent's death, and that Decedent owned
no real estate outs/de of the Commonwealth of Pennsylvania except that which appears in a memorandum at the end of this
Inventory. I AVe verify that the statements mede in this Inventory are true and correct, lAVe understand that false statements herein
are mede subject to the penalties of 18 Pa. C.S. Section 4904 relating to unsworn falsification to authorities.
Name of
Attorney: Edmund G. Myers
I,D, No.: 20558
Personal Representative
Signature: ~/~"//~.~--~
G~l'lbert H. MITCHELL
Signature:
Address: P.O. Box 109
Address: 412 Allendale Way
Lemoyae~ PA 17043-0109
Camp Hill, PA 17011
Telephone: 717/761-4540
Telephone: 717/737- 7204
Description
(See continuation page(s) attached)
(Attach additional sheets it necessary)
Total: 127,801.65
NOTE: The Memorandum of real estate outside the Commonwealth of Pennsylvania may, at the election of the personal representative,
include the value of each item, but such figures should not be extended into the total of the Inventory.
Prepared by the Pennsylvania Bar Association
Copyright (c) 1996 form software only CPSystems, Inc. Form #Ri-7 (1992)
Estate of:
Date of Death:
County:
MARTHA E MUCHER
12/26/2003
Cumberland
INVENTORY
CASH:
2003 Individual Federal Income
Tax Refund
3 $20.00 American Express
Travelers Checks
5 MasterCard Travelers Checks
with a $20 denomination
Conseco Annuity Assurance
Company - Surrender of
Policy No. 9002003160
Account No. 10030000
Conseco Annuity Assurance
Company - Surrender of
Insurance Policy No.
9002008220 Account No.
1003000
Fulton Bank Certificate of
Deposit Account No.
314-4133190
Guideposts Magazine Refund
Pennsylvania State Employee
Credit Union Certificate of
Deposit
Pennsylvania State Employee
Credit Union Certificate of
Deposit
376.00
60.00
100.00
10.00
14.50
11,905.91
11.23
1,193.66
2,358.30
-1-
Pennsylvania State Employees
Credit Union Regular Share
(S1) Account
Pennsylvania State Employee
Credit Union MoneyHandler
Shares
PNC Bank Certificate of
Deposit Account 21001015455
PNC Bank Certificate of
Deposit Account 21001015797
PNC Bank Certificate of
Deposit Account 21001019616
PNC Bank Certificate of
Deposit Account 31400101401
PNC Bank Certificate of
Deposit Account 31000211421
Susquehanna Valley Federal
Credit Union Account 174-00
Susquehanna Valley Federal
Credit Union - Life
Insurance Benefit
Travelers - Insurance Refund
due to cancellation
Wachovia Bank Certificate of
Deposit Account
247412063630414
Wachovia Bank Certificate of
Deposit Account No.
247022066268682
Wachovia Bank Certificate of
Deposit Account No.
3059950021187
3,537.34
867.22
5,000.72
5,006.59
4,011.41
3,706.51
15,460.60
594.29
505.44
125.00
2,394.12
1,996.15
2,934.32
-2-
~aypoint Bank Certificate of
Deposit Account No.
416001987
Waypoint Bank Certificate of
Deposit Account No.
7100018703
Waypoint Bank Certificate of
Deposit Account No.
7100024849
Waypoint Bank Certificate of
Deposit Account No.
416005161
Waypoint Bank Certificate of
Deposit Account No.
416010068
Waypoint Bank Certificate of
Deposit Account No.
416010084
Waypoint Bank Certificate of
Deposit Account No.
416013017
Waypoint Bank Certificate of
Deposit Account No.
416030908
Waypoint Bank Certificate of
Deposit Account No.
460258908
Waypoint Bank Certificate of
Deposit Account 461289270
Waypoint Bank Certificate of
Deposit Account No.
7100017148
Waypoint Bank Savings Account
No. 10037489
1,001.95
2,010.65
2,141.74
1,001.52
1,305.54
3,011.23
5,298.58
4,522.71
7,564.08
1,453.17
10,035.13
366.82
101,882.43
-3-
896.504
57.000
207.000
PERSONAL PROPERTY:
1993 Mercury Sedan - Valued
and appraised by L.B. Smith
Ford
Personal property of Decedent
valued and appraised by
Chuck Bricker, Auctioneer.
Appraisal is attached
STOCKS/LISTED:
shares Federated Fund for US
Government Secs A/Fund
Account No. 337/3526327
Valued using EstateVal. Such
valuation is attached to
this Return
shares Metlife Inc. Common
Stock. Valued using
EstateVal. Such valuation
is attached to this Return.
shares Mid Penn Bancorp Stock
- Valued using EstateVal.
Such valuation is attached
to this Return.
1,000.00
910.00
7,064.45
1,886.99
4,963.86
1,910.00
BONDS:
2 United States Series ~
Savings Bonds. $500
demonination and $1,000
demonination - Valued using
United States Savings Bond
Calculator. Such calcuation
is attached this Return.
1,500.00
13,915.30
-4'
20 United States Savings Bonds
Series E - Valued using
Savings Bond Calulator.
Such calculation is attached
to this Return.
United States Series EE $100
Savings Bond - Valued using
United States Savings Bond
Calculator. Such calculation
is attached to this Return.
8,471.52
122.40
TOTAL RECEIPTS OF PRINCIPAL ...............
10,093.92
127,801.65
-5-
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT 280601
HARRISBURG, PA 17128-O601
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
REV 1162 EX(11-96)
NO. CD 00443O
MYERS EDMUND G
301 MARKET STREET
P O BOX 109
LEMOYNE, PA 17043
ESTATE INFORMATION: SSN: 183-12-2781
FiLE NUMBER: 2104-0053
DECEDENT NAME: MUCHER MARTHA E
DATE OF PAYMENT: 09/27/2004
POSTMARK DATE: 09/27/2004
COUNTY: CUMBERLAND
I DATE OF DEATH: 12/26/2003
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 $11,631.55
TOTAL AMOUNT PAID:
$11,631.55
REMARKS:
SEAL
CHECK# 1006
INITIALS: JA
RECEIVED BY:
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
REGISTER OF WILLS
BUREAU OF ZNDZVZDUAL TAXES
INHERITA~.E T~X ~JIVI$ION
DEPT. Z~bOi
HARRZ~"~URG,, PA Z71ZS-0601
GILBERT H HITCHELL
R12 ALLENDALE WAY
CAHP HILL PA 17011
CONNONNEALTH OF PENNSYLVANIA
DEPARTNENT OF REVENUE
INHERITANCE TAX
RECORD ADdUSTHENT
dOZNTLY HELD OR TRUST ASSETS
DATE 09-27-200~
ESTATE OF HUCHER
DATE OF DEATH 12-26-2005
FILE NUHBER
COUNTY
SSN/DC
ACN
21 0~-0055
CUHBERLAND
185-12-2781
ORIZ3ZI~
Amount: Remi'U:ed
REV-I(;O*i EX AFP ¢DI-0S)
NARTHA E
HAKE CHECK PAYABLE AND REHZT PAYHENT TO:
REGISTER OF WILLS
CUHBERLAHD CO COURT HOUSE
CARLISLE, PA I7013
CUT ALONG THIS LINE
~* RETAIN LONER PORTION FOR YOUR RECORDS ~'~
REV-1604 EX AFP (01-03)
x~ INHERITANCE TAX RECORD ADJUSTNENT JOINTLY HELD OR TRUST ASSETS
DATE 09-Z7-200~
ESTATE OF HUCHER HARTHA E DATE OF DEATH 12-26-2003 COUNTY CUHBERLAND
FILE NO. Z1 0~-0053 S.S/D.C. NO. 183-12-2781 ACN Oq12321~
ADJUSTHENT BASED ON: ADHINISTRATIVE CORRECTION
JOINT OR TRUST ASSET ZNFORHATZON
FINANCIAL INSTITUTION: SUSQUEHANNA VALLEY FCU ACCOUNT NO.
17~-51-7~65
TYPE OF ACCOUNT: ( ) SAVINGS ( ) CHECKING
DATE ESTABLISHED 01-21-1985
Account Balance
Percent Taxable X
Amount Subject to Tax
Debts and Deductions -
Taxable Amount
Tax Rate X
Tax Due
( ) TRUST
.00 NOTE:
0.500
.00
.00
TAX CREDZTS:
.00
.15
.00
(X) TINE CERTIFICATE
TO ZNSURE PROPER CRED'rT TO YOUR
ACCOUNT, SUBHTT THE UPPER PORTTON
OF THIS NOTICE N'rTH YOUR TAX
PAYHENT TO THE REG/STER OF N'rLLS
AT THE ADDRESS SHONN ABOVE.
HAKE CH~--OR HONEY ORDER PAYABLE
TO: "RE6~STER ~F NZI;~LS~"' AGENT."
PAYHENT RECEIPT DISCOUNT (+) AHOUNT PAID
DATE NUHBER INTEREST/PEN PAID (-)
06-Z1-ZO0~ CD00~068 .00
ZZ5.Z7
TOTAL TAX CREDIT
BALANCE OF TAX DUEI
INTEREST AND PEN.
TOTAL DUE
225.27
ZZ5.Z7CR
.00
225.Z7CR
ZF PAID AFTER TH/S DATE, SEE REVERSE FOR CALCULATION OF ADD/T/ONAL INTEREST.
ZF TOTAL DUE /S LESS THAN $1, NO PAYNENT 1S RE~U/RED. /F TOTAL DUE /S REFLECTED AS A "CRED/T"
YOU NAY BE DUE A REFUND. SEE REVERSE S/DE OF TH/S FORN FOR /NSTRUCT/ONS.}
PAYMENT:
Detach the top portion of this Not[ca end submit with your payment made payable to the name and address
printed on the reverse side.
-- Make check or money order payable to: REGISTER OF #ILLS, AGENT.
REFUND (CR): A refund of a tax credit, ehich ems not requested on the Tax Return, may be requested by completing an
"Application for Refund of Pennsylvania Inheritance and Estate Tax" (REV-1515). Applications ere available at
the Office of the Register of N[lls, any of the Z5 Revenue District Offices or from the Department's Z0,-haur
answering service for forms ordering: 1-800-56Z-2050; services for taxpayers eith special hearing
and / or speaking needs: 1-800-0,0,7-5020 (TT only).
REPLY TO:
Questions regarding errors contained on this not[ce should be addressed to: PA Department of Revenue, Bureau
of Individual Taxes, ATTN: Post Assessment Review Unit, Dept. Z80601, Harrisburg, PA 171Z8-0601, Phone
(717) 787-6505.
DISCOUNT:
If any tax due [s paid e[th[n three [5) calendar months after the dacedent's death, a five percent (SZ) discount
of the tax paid is alioeed.
PENALTY:
The 15Z tax amnesty non-participation penalty is computed on the total of the tax and interest assessed, and not
paid before January 18, 1996, the first day after the end of the tax amnesty per[od.
INTEREST:
Interest is charged beginning with first day of delinquency er nine (9) months and one (1) day from the data of
death to the date of payment. Taxes eh[ch became delinquent before January l, 198Z bear interest at the rate of
six [6Z) percent per annum calculated at a daily rata of .000160,. All taxes eh[ch became delinquent on and after
January 1, 198Z mill bear interest et a rata ehich ell1 vary from calendar year to calendar year eith that rate
announced by the PA Department of Revenue. The applicable interest rates for 198Z through ZOO5 are:
Interest Daily Interest Daily Interest Daily
Year Rate Factor Year Rata Factor Year Rate Factor
198Z lOX .00050,8 1987 9Z .000Z0,7 1999 7Z . Oooxgz
1985 16Z .0000,~8 1988-1991 117. .000501 2000 8Z . O00Zl9
1980, 112 .000501 1992 9Z .00020,7 2001 92 . O00Z0,7
1985 I~Z .000556 1995-1990, 72 .000192 ZOOZ 62 .000160,
1986 XOZ . 000270, 1995-1998 9'/. . 000Z0,7 ZOOS 5Z .000157
--Interest is calculated as folloes:
INTEREST = BALANCE OF TAX UNPAID X NUNBER OF DAYS DELI*NQUENT X DAILY INTEREST FACTOR
--Any Not[ca issued after the tax becomes deXinquent ell1 reflect an interest calculation to fifteen (1S) days
beyond the date of the assessment. Xf payment is made after the interest computation date shown on the
Notice, additional interest must be calculated.
~EV.1470 EX (~-8~)
INHERITANCE TAX
EXPLANATION
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE OF CHANGES
BUREAU OF INDMDUAL TAXES
DEPT. 280601
HARRISBURG~ PA 17128-0601
DECEDENT'S NAME IFILE NUMBER
MARTHA E MUCHER 2t04-0053
F~EVIEVVED BY ACN
Karen Appleby 04125214
ITEM
SCHEDULE NO. EXPLANATION OF CHANGES
Above-referenced Can has been adjusted to reflect a tax due balance of zero. A refund has
been created and will be issued upon receipt of a refund request.
ROW Page 1
DUFFLE
ET STREET
PA 17043-0109
First Class Mail
REGISTER OF WTT,T~ OFFICE
CL~BERLAND COUNTY COURTHOUSE
ONE COURTHOUSE SQUARE
CARLISLEr PA 17013
BUREAU OF INDIVIDUAL TAXES
[HHERTTANCE TAX DZYTSTON
PO BOX ;'80601
HARRTSBURG, PA 17128-0601
COHHONWEALTH OF PENNSYLVANIA
DEPARTHENT OF REVENUE
INHERITANCE TAX
STATEHENT OF ACCOUNT
REV-lg07 EX AFP C09-04)
GILBERT H HITCHELL
412 ALLENDALE WAY
CAHP HILL ?OII
DATE 11-22-2004
ESTATE OF HUCHER
DATE OF DEATH 12-26-Z003
FILE NUHBER 21 04-0055
COUNTY CUHBERLAND
ACN 04125214
Amoun'l: Remi~ed
HARTHA E
HAKE CHECK PAYABLE AND REHIT PAYHENT TO:
REGISTER OF WILLS
CUHBERLAND CO COURT HOUSE
CARLISLE, PA 17015
NOTE: To insure proper credi~ ~o your account, subm/~ ~he upper portion of ~his form wi~h your ~ax payment.
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~
ESTATE OF HUCHER HARTHA E FILE NO. 21 04-0055 ACN 04125214 DATE 11-22-2004
THIS STATENENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACH TN THE NANED ESTATE. SHONN BELO#
IS A SUNNARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYNENTS, THE CURRENT BALANCE, AND, TF APPLICABLE,
A PROJECTED TNTEREST FIGURE.
DATE OF LAST ASSESSHENT OR RECORD ADJUSTHENT: 09-24-2004
PRINCIPAL TAX DUE: .................................................................................
PAYHENTS (TAX CREDITS):
.00
PAYHENT RECEIPT DISCOUNT (+) AHOUNT PAID
DATE NUNBER INTEREST/PEN PAID (-)
06-21-2004
07-27-2004
10-25-2004
11-16-2004
CD004068
CD004198
REFUND
REFUND
.00
.00
.00
.00
225.27
225.27
225.27-
225.27-
ZF PAID AFTER THIS DATE, SEE REVERSE
SIDE FOR CALCULATION OF ADDITIONAL INTEREST.
IF TOTAL DUE IS LESS THAN $1,
NO PAYHENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT"
TOTAL TAX CREDIT
.00
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
TOTAL DUE .00
YOU HAY BE DUE A REFUND. SEE REVERSE STDE OF THTS FORH FOR TNSTRUCTIONS. )
PAYMENT:
Detach the top portion of this Notice and submit aith your payment made payable to the name and address
printed on the reverse side.
-- If RESIDENT DECEDENT make check ar money order payable to: REGISTER OF NILLS, AGENT.
-- If NON-RESIDENT DECEDENT make check or money order payable to: COMMONNEALTH OF PENNSYLVANIA.
REFUND OCR): A refund of a tax credit, which was not requested an the Tax Return, may be requested by completing an
"Application for Refund of Pennsylvania Inheritance and Estate Tax" (REV-1313). Applications are available
online at mww.revanua.state.me.us, any Register of Nills or Revenue District Office, or from the Department's
Iq-hour answering service for forms orders: 1-SOO-36Z-Z050~ services for taxpayers aith special hearing and/or
speaking needs: 1-BgO-qqT-30Zg (TT only).
REPLY TD:
DZSCOUNT:
PENALTY:
Questions regarding errors contained on this notice should be addressed to: PA Department of Revenue, Bureau
of Individual Taxes, ATTN: Past Assessment Raviea Unit, P.O. Box ZS060I, Harrisburg, PA I7iZS-060i, phone
(717) 787-6S05.
If any tax due is paid within three (3) calendar months after the decadant's death, a five percent (SI) discount
of the tax paid is alloasd.
The 15Z tax amnesty nan-participation penalty is computed on the total of the tax and interest assessed, and not
paid before January 18, 1996, the first day after the end of the tax amnesty period.
INTEREST:
Interest is charged beginning with first day of delinquency, or nine (9) months and one (I) day from the date of
death, to the date of payment. Taxes which became delinquent before January l, 198Z bear interest at the rate of
six (61) percent par annum calculated at a daily rate of .00016~. All taxes uhich became delinquent on and after
January i, I98Z wiI1 bear interest at a rate uhich will vary from calendar year to calendar year with that rate
announced by the PA Department of Revenue.
The applicable interest rates for 198Z through gOOq are:
Interest Daily Interest Daily
Year Rate Factor Year Rate Factor Year
1982 goZ .000S~8 1988-1991 llZ .000~0X ZOOX
1985 16g .000q58 1992 9g .000Z~7 ZOOZ
198~ X1Z .000301 1993-199q 7X .00019Z 2003
1985 13Z .000356 1995-1998 9Z .O00Zq7 ZOOq
1986 lOX .O00g7q 1999 72 .O0019Z
1987 92 .O00Zq7 ZOO0 8Z .O00ZZ9
Interest Daily
Rate Factor
92 .0002q7
62 .O0016q
SX .000157
qZ .O00XlO
--Interest is calcuXeted as follows:
INTEREST = BALANCE OF TAX UNPAID X NUNBER OF DAYS DELINQUENT X DAILY ZNTERBST 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.
BUREAU OF INDTVIDUAL TAXES
TNHERTTANCE TAX DXVTSTDN
PO BOX 280601
HARRTSBURO, PA 17128-0601
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
NOTICE OF INHERITANCE TAX
APPRAISEMENT, ALLONANCE OR DZSALLONANCE
OF DEDUCT/OHS AND ASSESSMENT OF TAX
REV-I$¢7 EX AFP (09-0¢)
EDMUND G MYERS
JOHNSON ETAL
PO BOX 109
LEMOYNE PA ~043
DATE 11-29-200q
ESTATE OF MUCHER
DATE OF DEATH 12-26-2005
FILE NUMBER 21 0q-0055
COUNTY CUMBERLAND
ACH 101
Amoun~ Rami~ed
HARTHA E
HAKE CHECK PAYABLE AND REMIT PAYHENT TO:
REGISTER OF WILLS
CUMBERLAND C0 COURT HOUSE
CARLISLE, PA 17015
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF MUCHER MARTHA E FILE NO. 21 0~-0055 ACN 101 DATE 11-29-200~
TAX RETURN NAS: (X) ACCEPTED AS F/LED ( ) CHANGED
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Real Esta*e (Schedule A) (1)
2. S*ocks and Bonds (Schedule B) (2)
$. Closely Held S~ock/Par~nership Zn~eras~ (Schedule C) ($)
q. Mortgages/No,as Receivable (Schedule D) (q)
5. Cash/Bank Daposi~s/Hisc. Personal Propar~y (Schedule E) (5)
6. Jointly Owned Propar~y (Schedule F) (6)
7. Transfers (Schedule G) (7)
8. To,aL Assa~s
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expansas/Ad.. Costs/Misc. Expenses (Schedule H) (9)
10. Deb*s/Hor~gage Liabilities/Liens (Schedule 1) (10)
11. To,al Daduc*ions
12. Nat Value of Tax Re~urn
O0
24t 009.22
O0
O0
105;286.99
4t295.16
69~980 12
16,q92.00
51q.37
(11)
(12)
15.
lq.
NOTE:
Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) (13)
Ne~ Value of Estate Subject ~o Tax (lq)
Zf an assessment vas lssued previously, 11nee 14, 15 and/er 16, 17,
reflect flgures that /nclude the total of ALL returns assessed to date.
· O0 x O0 =
. O0 x Oq5 =
· O0 x 12 =
161,75q.22 x 15 =
(19)~
ASSESSHENT OF TAX:
15. Amount of Line
16. Amount of Line lq ~axabla at Lineal/Class A ra*a (16)
17. Amoun~ of Line lq a~ Sibling ra~e (17)
18. Amoun~ of Line lq ~axabla at Collateral/Class B ra~a (18)
19. Princi}al Tax Due
TAX CREDITS
PAYMENT RECEZPT 015COUNT
DATE
03-29-200fi
09-27-200q
NUHBER
CD00375q
CD00qq~0
INTEREST/PEN PAID (-)
.00
.00
INTEREST IS CHARGED THROUGH 12-1~-ZOOq
AT THE RATES APPLICABLE AS OUTLINED ON THE
REVERSE SIDE OF THIS FORM
AHOUNT PAID
12,000.00
11,651.55
TOTAL TAX CREDIT
BALANCE OF TAX DUEI
INTEREST AND PEN.
TOTAL DUE
NOTE: To insure proper
cradi~ *o your account,
submi* ~he upper per*ion
of ~his form wi~h your
tax payment.
201,571 .q9
17.006.37
18~,565.12
22,810.90
161,75q.22
18 and 19 ~ill
.00
.00
.00
2q,263.13
2q,Z63.13
23,651.55
631.58
6.77
6S8.35
ZF PAID AFTER DATE INDICATED, SEE REVERSE ( ZF TOTAL DUE ZS LESS THAN $1, NO PAYMENT ZS REQUIRED.
FOR CALCULATION OF ADD/TIONAL INTEREST.
IF TOTAL DUE 1S REFLECTED AS A "CREDIT" (CR), YOU HAY BE DUE
A REFUND. SEE REVERSE S/DE OF THIS FORH FOR INSTRUCTIONS.)
RESERVATION:
PURPOSE OF
NOTICE:
PAYHENT:
REFUND (CR):
OBJECTIONS:
ADNIN-
ISTRATIVE
CORRECTIONS:
DISCOUNT:
PENALTY:
INTEREST:
Estates of decedents dying on or before December 1Z, 198Z -- if any future interest in the estate is transferred
in possession or enjoyment to Class B (collateral) 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 laaful Class B (collateral) rate on any such futura interest.
To fulfill the requirements of Section 2140 of the Inheritance and Estate Tax Act, Act Z5 of ZOO0. (TZ P.S.
Section 9140).
Detach the top portion of this Notice and submit aith your payment to the Register of Nills printed on the reverse side.
--Hake check or money order payable to: REGISTER OF NILES, AGENT
A refund of a tax credit, ahich ams not requested on the Tax Return, may ba requested by completing an
"Application for Refund of Pennsylvania Inheritance and Estate Tax" (REV-1315). Applications ara available
online at waw.revenue.state.pa.us~ any Register of Nills or Revenue District Office, or from the Department's
Z4-hour ansaering service for fores orders: 1-800-:56Z-Z050~ services for taxpayers with special hearing and/or
speaking needs: 1-800-447-3020 (TT only).
Any party in interest not satisfied with the appraisment, allowance or disallowance of deductions or assessment of tax
(including discount or interest) as sheen on this Notice may object eithin 60 days of the date of receipt of this notice
by filing one of the following:
A) Protest to the PA Department of Revenue, Board of Appeals. You may object by filing a protest online at
waa.boardofappeals.state.pa.us on or before the expiration of the sixty-day appeal period. In order for
an electronic protest to be valid, you must receive a confirmation number and processed date from the
Board of Appeals eabsite. You may also send a arittan protest to PA Department of Revenue, Board of Appeals
P.O. Box 281021, Harrisburg, PA 171ZB-iOZI. Petitions may not be faxed.
B) Election to have the matter determined at the audit of the account of tho personal representative.
C) Appeal to the Orphans' Court.
Factual errors discovered on this assessment should be addressed in writing to: PA Department of Ravanue~
Sursau of Individual Taxes, ATTN: Post Assessment Review Unit, P.O. Box Z80601, Harrisburg, PA 171Z8-0601
Phone (7173 787-6505. See page S of the booklet "Instructions for Inheritance Tax Return for a Resident
Decedent" (REV-/SOl) for an explanation of administratively correctable errors.
If any tax due is paid within three (3) calendar months after the dacadent's death, a five percent (SI) discount of
the tax paid is allowed.
The 15Z tax amnesty non-participation penalty is computed on the toter of the tax and interest assessed, and not
paid before January 18, 1996, the first day after tho end of the tax amnesty period. This non-participation
penalty is appealable in the same manner and in the the same time period as you mould appeal the tax and interest
that has been assessed as indicated on this notice.
Interest is charged beginning with first day of delinquency, or nine (9) months and one (1) day from the date of
death, to the date of payment. Taxes ahich became delinquent before January l, 1982 bear interest at the rate of
six (GZ) percent per annum calculated at a daily rate of .000164. All taxes which became delinquent on and after
January 1, 1982 wil! bear interest at a rate ehich will vary from calendar year to calendar year with that rate
announced by the PA Department of Revenue. The applicable interest rates for 19&2 through 2004 ara:
Interest Daily Interest Daily
Year Rate Factor Year Rate Factor
~ ZOZ .000548 ~)'~- 1991 11Z .000301
196:5 162 .000438 199Z 9Z .000247
1964 llZ .000301 1993-1994 7Z . O0019Z
1985 132 .000:556 1995-1998 9Z .000247
1986 lOZ .000274 1999 72 . O0019Z
1987 IOZ .000274 ZOO0 72 .000192
--Interest is calculated as folloas:
INTEREST = BALANCE OF TAX UNPAID
Interest Daily
Year Rate Factor
~ 9Z .000247
2002 6Z .O001&4
2003 5Z .000137
2004 4Z .000110
X NUNBER OF DAYS DELTNQUENT X DALLY 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 sheen on the
Notice, additional interest must be calculated.
BUREAU OF TNDTVTDUAL TAXES
INHERITANCE TAX DIVISION
PO BOX 280601
HARRISBURG, PA 171ZB-0601
COMMONNEALTH OF PENNSYLVANTA
DEPARTMENT OF REVENUE
INHERITANCE TAX
STATEHENT OF ACCOUNT
REV-li07 EX AFP (09-04)
i_:_~ 'ti!
EDHUND $ HYERS
JOHNSON ETAL
PO BOX 109 ..
LEMOYNE ~i~pA 170~$
DATE 11-29-200~
ESTATE OF NUCHER
DATE OF DEATH 12-26-2005
FILE NUMBER 21 0~-0055
COUNTY CUMBERLAND
ACM 101
Amoun'l= Rem i'l:'l:ed
MARTHA E
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF MILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17015
NOTE: To Ansure proper credA~ ~;o your account, submi~ ~:he upper por~:ion of ~:his form wi~h your ~ax payment.
CUT ALONG THIS L'rNE ~ RETA'rN LONER PORT'rON FOR YOUR RECORDS ~
ESTATE OF HUCHER MARTHA E FILE NO. 21 0~-0055 ACN 101 DATE 11-29-200~
TH'rS STATEHENT 'rs PROVTDED TO ADV'rSE OF THE CURRENT STATUS OF THE STATED ACN 'rN THE NAMED ESTATE. SHO#N BELO#
'rS A SUHHARY OF THE PRTNCZPAL TAX DUE, APpLTCAT.rON OF ALL PAYHENTS, THE CURRENT BALANCE, AND, 'rF APPL'rCABLE,
A PROJECTED 'rNTEREST F[GURE.
DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 11-Z9-200~
PRINCIPAL TAX DUE:.
PAYMENTS (TAX CREDITS):
2~,265.15
PAYHENT RECEIPT DISCOUNT (+)
DATE NUHBER INTEREST/PEN PAID (-) AHOUNT PAID
05-29-200~
09-27-200R
CD00575~
CDO0~$O
.00
.00
12,000.00
11,651.55
INTEREST IS CHARGED THROUGH 12-1~-200~
AT THE RATES APPLICABLE AS OUTLINED ON THE
REVERSE SIDE OF THIS FORM.~
TOTAL TAX CREDIT
'rF PA'rD AFTER THIS DATE, SEE REVERSE
S'rDE FOR CALCULAT'rON OF ADD'rT'rONAL 'rNTEREST.
'rF TOTAL DUE 'rS LESS THAN $1,
NO PAYHENT 'rS REQU'rRED.
'rF TOTAL DUE 'rS REFLECTED AS A "CREDZT" (CR),
YOU HAY BE DUE A REFUND. SEE REVERSE S'rDE OF TH'rS FORH FOR INSTRUCTIONS.
25,651.55
BALANCE OF TAX DUE 631.58
INTEREST AND PEN. 6.77
TOTAL DUE 658.55
PAYMENT:
Detach the top portion oF this Notice and submit with your payment made payable to the name and address
printed on the reverse side.
-- If RESIDENT DECEDENT make check or monay order payable to: REGISTER OF NZLLS, AGENT.
-- If NON-RESIDENT DECEDENT make check or money order payable to: COMHONNEALTH OF PENNSYLVANIA.
REFUND (CR): A refund of a tax credit, which was not requested on the Tax Return, may be requested by completing an
"Application for Refund of Pennsylvania Inheritance and Estate Tax" (RE¥-1315). Applications are available
online at www.revanue.stats.oa.us, any Register of Ni118 or Revenue District Offica, or from the Department's
Zq-hour answering sarvice for forms orders: 1-800-561-2050~ services for taxpayers with specie! hearing and/or
speaking needs: 1-800-qq?-50ZO (TT only).
REPLY TO:
DISCOUNT:
PENALTY:
guastions regarding errors contained on this notice should be addressed to: PA Oeparteant of Revenue, Bureau
of Individual Taxes, ATTN: Post Assessment Review Unit, P.O. Box 180601, Harrisburg, PA 17118-0601, phone
(717) 787-6505.
If any tax due is paid within three (5) calendar months after the decadent's death, a five percent (SX) discount
of the tax paid is allowed.
The 1SI tax amnesty non-participation penalty is computed on the total of the tax and interest asswssed~ and not
paid before January 18, 1996, the first day after the and of the tax amnesty period.
INTEREST:
Interest is charged beginning with first day of delinquency, or nine (9) months and one (1) day from the date of
daath, to tha date of payment. Taxes which became daIinquent before January 1, 1982 bear interest at the rata of
six (61) percent per annum calculated at a daily rate of .OOOI6q. A11 taxes which became delinquent on and after
January 1, 1982 will bear intarest at a rate which will vary from calendar year to calendar year with that rate
announced by the PA Department of Revenue. Tha applicabla interest rates for 198Z through Z004 ara:
Interest Daily Interest Daily
Year Rate Factor Year Rate Factor Year
1982 20X .0005q8 1988-1991 11Z .000301 2001
1985 161 .000~38 1991 9Z .0002~7 ZOOZ
1984 llZ .O0050X 1995-199q 7Z .000192 Z003
1985 15Z .000356 1995-1998 9Z .0001~7 ZOOq
1986 101 .000174 1999 71 .000191
1987 9Z .O00Zq7 ZOO0 8Z .O00ZZ9
Interest Daily
Rate Factor
91 .0001~7
61 .00016q
51 .000157
qZ .000110
--Interest is calculated as follows:
INTEREST = BALANCE OF TAX UNPAID X NUHBBR OF DAYS DELINQUENT X DALLY INTEREST FACTOR
--Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fiftaen (15) days
beyond the date of the assessment. If payment is wade after tha interest computation date shown on the
Notice, additional interest must be calculated.
BUREAU OF ZNDZVZDUAL TAXES
ZNHERZTANCE TAX DZVTS1'ON
PO BOX 280601
HARRZSBURG, PA 17128-0601
COMMON#EALTH OF PENNSYLVAN'rA
DEPARTMENT OF REVENUE
ZNHERZTANCE TAX
STATEMENT OF ACCOUNT
GZLBERT H MZTCHELL
qlZ ALLENDALE NAY
CAHP HZLL PA~7011
DATE 11-15-200q
ESTATE OF MUCHER
DATE OF DEATH 12-26-2005
FZLE NUNBER 21 0~-0055
COUNTY CUHBERLAHD
ACN 0~12521~
Amount Remi'~ed
REV-I&07 EX AFP
MARTHA E
HAKE CHECK PAYABLE AND RENZT PAYMENT TO:
REGTSTER OF NTLLS
CUMBERLAND CO COURT HOUSE
CARLTSLE, PA 1701:5
NOTE: To insure proper credit to your account, submit the upper portion of this form with your tax payment.
CUT ALONG THZS LZNE I~ RETAZN LO#ER PORT'rON FOR YOUR RECORDS ~
I~'::t'~,~Y' 'i~" 'E~' '~'81.'-'g:]1 ...... '~;~' 't'Rr.l~l~t YA'Ri}~"Y~ '~ t'AYgR~IT "b'P' '~1~'E'60~ ' ' ~ .....................
ESTATE OF MUCHER MARTHA E FZLE NO. 21 0q-0055 ACM Oq12521q DATE 11-15-200~
THZS STATEMENT ZS PROVZDED TO ADV'rSE OF THE CURRENT STATUS OF THE STATED ACM ZN THE NAMED ESTATE. SHO~/N BELO#
ZS A SUMMARY OF THE PRZNCZPAL TAX DUE,, APPL'rCATZON OF ALL PAYMENTS,, THE CURRENT BALANCE,, AND,, ZF APPLZCABLE,,
A PROdECTED ZNTEREST FZGURE.
DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 09-Zq-ZOOq
PRZNCZPAL TAX DUE: ..............................................................................
PAYMENTS (TAX CREDZTS):
.00
PAYMENT RECEZPT D~SCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PA~D ¢-)
06-21-200q
10-25-200q
CDOOq068
REFUND
.00
.00
225.27
225.27-
ZF PAZD AFTER THZS DATE~ SEE REVERSE
SZDE FOR CALCULATZON OF ADDZTZONAL ZNTEREST.
( ZF TOTAL DUE ZS LESS THAN $1~
NO PAYMENT ZS RE~UZRED.
ZF TOTAL DUE ZS REFLECTED AS A "CREDZT" (CR)~
TOTAL TAX CREDZT .00
BALANCE OF TAX DUE .00
ZNTEREST AND PEN. .00
TOTAL DUE .00
YOU MAY BE DUE A REFUND. SEE REVERSE SZDE OF THZS FORM FOR ZNSTRUCTZONS.
PAYMENT:
Detach the top portion of this Notice and submit with your payment made payable to the name and address
printed on tho reverse side.
-- Zf RESIDENT DECEDENT make check or money order payable to: REGISTER OF NZLLS, AGENT.
-- If NON-RESIDENT DECEDENT make check or money order payable to: COMMON#EALTH OF PENNSYLVANIA.
REFUND (CA): A refund of a tax credit, which was not requested on the Tax Return, may be requested by completing an
"Application for Refund of Pennsylvania Inheritance and Estate Tax" (REV-IS13). Applications arm available
online at wew.revenue.statm.ea.us, any Register of Nills or Revenue District Office, or from the Department's
Iq-hour answering service for forms orders: 1-800-36Z-ZOSO; services for taxpayers with special hearing and/or
speaking needs: 1-800-q&7-30ZO (TT only}.
REPLY TO:
DISCOUNT:
PENALTY:
guestions regarding errors contained on this notice should be addressed to: PA Department of Rmvenua, Bureau
of Individual Taxes, ATTN: Post Assessment Review Unit, P.O. Box Z80601, Harrisburg, PA 171Z8-0601, phone
(717) 787-6505.
If any tax due is paid within three (3) calendar months after the decedent's death, a five percent (SI) discount
of the tax paid is allowed.
The 15Z tax amnesty non-participation penalty is computed on the total of the tax and interest assessed, and not
paid before January 18, 1996, the first day after the end of the tax amnesty period.
INTEREST:
Interest is charged beginning with first day of delinquancy~ or nine (9) months and one (1) day from the date of
death, to the date of payment. Taxes which became delinquent before January 1, 198Z bear interest at the rate of
six (6Z) percent per annum calculated at a daily rate of .O0016q. All taxes which became delinquent on and after
January 1, 1982 will bear interest at a rate which will vary from calendar year to calendar year with that rate
announced by the PA Department of Revenue.
The applicable interest rates for 198Z through ZO0~ are:
Interest Daily Interest Dally
Year Rate Factor Year Rate Factor Year
198Z ZOZ .0005q8 1988-1991 11Z .000301 ZOO1
1983 16Z .O00fi38 199Z 9Z .0002~7 ZOOZ
198q 11Z .000301 1993-199q 7Z .00019Z ZOO3
1985 132 .000~56 1995-1998 9Z .0002~7 200fi
1986 102 .O00Z7q 1999 7Z .00019Z
1987 9Z .O00gq7 ZOO0 8Z .000219
Interest Daily
Rate Factor
9Z .OOOZq7
6Z .00016q
5Z .0001~7
qZ .000110
--Interest is calculatmd as follows:
TNTEREST = BALANCE OF TAX UNPATD X NUHBER OF DAYS DELI'NQUENT X DATL¥ TNTEREST 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 tho
Notice, additional interest must bm calculated.
BUREAU OF INDIVIDUAL TAXES
TNHERZTAHCE TAX DZyTSTON
PO BOX 280601
HARRXSBURG, PA 17128-0601
COMMONNEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
L,,!*'?iUL. t~'~' ZNHEF/ZTANCE TAX
I O
~?'....0 RECORD ADdUSTHENT
REV-1Gg$ EX ~FP C09-0~)
EDMUND $ MYERS
JOHNSON ETAL
PO BOX 109
LEMOYNE
ESTATE OF MUCHER
DATE OF DEATH I2-26-2005
FZLE NUMBER 21 0~-0055
COUNTY CUMBERLAND
ACN 101
PA 170q$
Amoun'l: Remi~ed
MARTHA
MAKE CHECK PAYASLE AND REMZT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17015
NOTE: To insure proper credit ~o your account, submi~ ~he upper por~ion of this form wi~h your ~ax payment.
CUT ALONG THIS LINE ~ RETAIN LONER PORTION FOR YOUR RECORDS ~
REV-1593 EX AFP (01-03) NN INHERITANCE TAX RECORD ADJUSTMENT
ESTATE OF MUCHER
MARTHA E F/LE NO. 21 0q-0055 ACN 101 DATE 1Z-Z$-ZOOq
ADJUSTMENT BASED ON:
ADMINISTRATIVE CORRECTION
VALUE OF ESTATE:
1. Real Es~ca~ce (Schedule A) (1)
2. S~ocks and Bonds (Schedule B) (2)
:5. Closely HeZd S~cock/Par~nership In~eras~ (Schedule C) ($)
q. Mor~gages/No~as Receivable (Schedule D) (q)
$. Cash/Bank Deposits/Misc. Personal Proper~y (Schedule E) (E)
6. Jointly Owned Proper~y (Schedule F) (6)
7. Transfers (Schedule g) (7}
B. To,al Assa~s
DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Administrative Costs/
Miscellaneous Expenses (Schedule H) (9)
10. Dab~s/Mor~gaga Liabilities/Liens (Schedule T) (10)
11. To,al Deductions
12. Ne'l: Value of Tax Ra~urn
0O
2q/009 22
O0
O0
105/286.99
q/295.16
69~980 12
(B)
16,q92.00
51q.$7
201,571.~9
(21) 17/006.$7
(12) 18q/565.12
15.
lq.
TAX:
15.
16.
TAX
17.
16.
19.
CREDTTS:
PAY II[" N I
DATE
Chari~abZa/governmen~al Bequests; Non-elected 9115 Trusts (Schedule J}
Na~ Value of Es~a~e Subjec~ ~o Tax
Amoun~ of Line lq a~ Spousal ra~e
Amoun~ of L/ne lq ~axebla a~ Lineal/Class A ra~e
Amoun~ of Line lq a~ Sibling ra~e
Amoun~ of Line lq taxable a~ Collateral/Class B rate
Pr~ncipal Tax Due
K~C~II' I UI~CUUN I { +J
NUHBER INTEREST/PEN PAID (-)
CDOO~7~q 6~1.58
CDOOqq~O . O0
0~-26-200q
09-Z7-ZOOq
BALANCE OF UNPAID INTEREST/PENALTY AS OF
(~$) 22/810.90
(1~) 161;75q.22
IF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION DF ADDZTZONAL ZNTEREST.
(is) .OOX O0 = .00
(16) .OOX OqS= .00
(17) . O0 x 12 = . O0
(lB) 161/75q.ZZX 15 = 2q~265.15
(~9) 2q~Z65.l$
09-28-200q
AMOUNT PAID
12,000.00
11,651.55
TOTAL TAX CREDIT I 2q,265.13
~ALANCE OF TAX DUEl . O0
INTEREST AND PEN. 1.28
TOTAL DUE I .28
( ZF TOTAL DUE ZS LESS THAN $1~ NO PAYMENT ZS REgUZRED.
ZF TOTAL DUE ZS REFLECTED AS A 'CREDIT' (CR)z YOU MAY BE DUE
A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.)
;~EV-1470 EX (6-88)
INH'ERITANCE TAX
EXPLANATION
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE OF CHANGES
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
DECEDENT'S NAME FILE NUMBER
MARTHA MUCHER 2104-0053
REVIEWED BY ACN
Dianne McClain 101
ITEM
SCHEDULE NO. EXPLANATION OF CHANGES
The Notice of Inheritance Tax Appraisement, Allowance or Disallowance of Deductions
and Assessment of Tax has been adjusted to reflect the correct postmark date.
ROW Pa.qe 1
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
INHERITANCE TAX
0- STATEMENT OF ACCOUNT
*'
BUREAU OF INOIVIOUAL "PlJl1l~'!)r:" :'\
INHERITANCE TAX DIVISION I '-.....n....':... L
PO BOX 280601
HARRISBURG PA 17128-0601
--""'i"'
REV-IU7 EX AFP n2~a~)
"00" I"') ';'1
, "'",,, ;
.... 'W'.! ...101' L.,.-
I:i: 3: 21
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
01-10-2005
MUCHER
12-26-2003
21 04-0053
CUMBERLAND
101
MARTHA
E
CU]::I( OF
DFiF' ",,,,,,,
EDMUND G f1'l<RJl~n:'i,;
JOHNSON ETII[
PO BOX 109
LEMOYNE PA 17043
Allount Re..itted
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER DF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
NOTE: To insure proper credit to your account~ submit the upper portion of this form with your tax pay.ent.
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~
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ESTATE OF MUCHER MARTHA E FILE NO.21 04-0053 ACN 101 DATE 01-10-2005
THIS STATEHENT IS PROVIOED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAMEO ESTATE. SHOWN BELOW
IS A SUMMARY OF THE PRINCIPAL TAX OUE, APPLICATION OF ALL PAYMENTS, THE CURRENT BALANCE, AND, IF APPLICABLE,
A PROJECTEO INTEREST FIGURE.
DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 12-22-2004
PRINCIPAL TAX DUE:.
24,263.13
PAYMENTS (TAX CREDITS):
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
03-26-2004 CD003734 631.58 12,000.00
09-27-2004 CD004430 .00 11,631. 55
12-27-2004 WRITEDFF .00 1.28
TOTAL TAX CREDIT 24,263.13
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
. IF PAID AFTER THIS DATE~ see REVERSE TOTAL DUE .00
SlOE FOR CALCULATION OF ADDITIONAL INTEREST.
( IF TOTAL DUE IS LESS THAN $lJ
NO PAYMENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT"r (CR)"
YOU MAY BE DUE A REFUNO. SEE REVERSE SlOE OF THIS FORM FOR INSTRUCTIONS. ]
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STATUS REPORT UNDER RULE 6.12
Name of Decedent: MARTHA E. MUCHER
Date of Death: December 26.2003
Will No. 2004-00053
Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rule, I report the
following with respect to completion of the administration ofthe above-captioned estate:
1. State whether administration of the Estate is complete:
Yes X
No
2. If the answer is No, state when the personal representative reasonably
believes that the administration will be complete:
3. Ifthe answer to No. I is Yes, state the following:
a. Did the personal representative file a final account with the Court?
Yes
No
X
b. The separate Orphans' Court No. (if any) for the personal
representative's Account is:
c.
parties of interest?
Did the personal representative state an account informally to the
Yes X No
d. Copies of receipts, releases, joinders and approvals offormal or
informal accounts may be filed with the Clerk of the Orphans' Court and may be attached
to this report.
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~JJ~
EDMUND G. MYERS
JOHNSON, DUFFIE, STEWART & WEIDNER
301 Market Street
P.O. Box 109
Lemoyne, P A 17043
(717) 761-4540
Capacity: Personal Representative
(x) Counsel for Personal
Representative
Date: February 21,2005
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