HomeMy WebLinkAbout03-0838COMMONNEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 180601
HARRZSDURG, PA 17118-0601
RE¥-15~15 EX AFp [09-00)
ZNFORNATZON NOTZCE
AND
TAXPAYER RESPONSE
RICHARD TAYLOR
216 STONEHOUSE RD
CARLISLE PA 17013
I FZLE NO. 21-42:~:~-c~
ACN 03135535
DATE 10-02-2003
TYPE OF ACCOUNT
~.ST. OF DOROTHY J TAYLOR [] SAV/NBS
S.S. NO. 186-16-q528 [] CHECKTNG
DATE OF DEATH 07-17-2003 ~ TRUST
COUgT~ CUHBERLAND ~ CERTZF.
REHZT PAYHENT AND FORHS TO:
REGISTER OF HILLS
CUHBERLAND CO COURT HOUSE
CARLISLE, PA 1701~
PHC BANK has provided the Department with the information listed below which has been used in
calculating the potential tax due. Their records indicate that et the death of the above decedent, you were a joint owner/beneficiary of
this account. If you feel this inforlation is incorrect, please obtain .rattan correction frol the financial institution, attach a copy
to this ~ora and return it to the above address. This account is taxable in accordance .ith the Inheritance Tax Laws of the Commonwealth
of Pennsylvania. Questions lay be anseered by calZing (717) 787-8317.
COMPLETE PART I BELOW # # # SEE REVERSE SZDE FOR FZLZNG AND PAYMENT ZNSTRUCTZONS
Account No. 5130366898 Date 05-18-1993
Establ/shmd%
Account Balance ~3,8~5.61
Percent Taxable X y 8.333
Aaount Subject to Tax
Tax Rata X
Potentia! Tax Due 173.'31
To insure proper credit to your account, two
(Z) copies of this notice must accompany your
payment to the Register of Hills. Make check
payable to: "Register of gills, Agent".
NOTE: If tax payments are made within three
(3) months of the decedent's date of death,
you ely deduct a 51 discount of the tax due.
Any inheritance tax due will become delinquent
nine (93 months after the date of death.
PART TAXPAYER RESPONSE
A. [] The above information and tax due is correct.
1. You ely choose to remit paylent to the Register of Hills eith teo copies of this notice to obtain
CHECK -~ a discount or avoid interest, or you amy check box "R" and return this notice to the eagistar of
ONE Hills and an official assessment ell1 be issued by the PA Department of Revenue.
BLOCK J a. [] The above asset has been or will be reported and tax paid with the Pennsylvania Inheritance Tax return
ONLY to be filed by the decedent's representative.
C. [] The above information is incorrect and/or debts end deductions .ere paid by you.
You must complete PART [] and/or PART []
PART
TAX
LINE
1. Date Established
2. Account Balance
3. Percent Taxable
q. Amount Subject to Tax
S. Debts and Deductions
6. Amount Taxable
7. Tax Rate
8. Tax Due
Zf you indicate e different tax rate, please state your
relationship to decedent:
RETURN - COMPUTATION OF TAX ON JOZNT/TRUST ACCOUNTS
//~-. ¥ ~-
2
$ X
S -
6
7 X
PART
DATE PAID
DEBTS AND DEDUCTIONS CLAZMED
PAYEE DESCRIPTION AMOUNT PAID
TOTAL (Enter on Line $ of Tax Computation)
Under penalties of perjury) Z decZere that the facts T have reported above are true, correct and
complete to the bes~: of ay knowledge and belief. HOME (
WORK (
TAXPAVER SIGNATURE TELEPHONE NUHBER DATE
GENERAL INFORHATION
1. FAILURE TO RESPOND WILL RESULT ~N AN OFFICIAL TAX ASSESSNENT aith applicable interest based an information
submitted by the financial institution.
Z. Inheritance tax becomes delinquent nine months after the decmdant's date of death.
5. A joint account is taxable even though the decadant's name Nas added as a .attar of convenience.
~. Accounts (including those held bat.men husband and ,ifa) mhich the decedent put in joint names ,1thin one year prior to
death ara fully taxable as transfers.
5. Accounts established jointly bet"men husband and eife more than one year prior to death are not taxable.
&. Accounts held by a decedent "in trust for" another or others ara taxable ~ully.
REPORTING iNSTRUCTIONS - PART 1 TAXPAYER RESPONSE
1. BLOCK A - If the information and camputation in the notlca are correct and deductions are not being claim.d, place an
in block "A" of Part 1 of the "Taxpayer Response" section. Sign tee copies and submit them with your check for the amount of
tax to the Register of Wills of the county indicated. The PA Department of Revenue ail1 issue an official assessment
(Form REV-15~8 EX) upon receipt of the return from the Register of Rills.
2. BLOCK B - if the asset specified on this notice has been or mill be reported and tax paid aith the Pennsylvania Inheritance
Tax Return filed by the decedant's representative, place an "X" in block "B" of Part 1 of the "Taxpayer Response" section. Sign one
copy and return to the PA Department of Revenue, Bureau of Individual Tax.s, Oept ZOO601, Harrisburg, PA 171Z8-0601 in the
envelope provided.
5. BLOCK C - If the notice information is incorrect and/or deductions are being claimed, check block "C" and complete Parts Z and
according to the instructions balca. Sign too copies and submit them with your check for the amount of tax payable to the Register
of Rills of the county indicated. The PA Department of Revenue ail1 issue an official assessment (Form REV-lSd8 EX) upon receipt
of the return from the Register of #ills.
TAX RETURN - PART Z - 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/IZ/BZ: Accounts ahich the decedent put in joint names mithin one (1) year of death are
taxable fully as transfers. Ho.aver, there is an exclusion not to exceed $3,000 par transferee regardless of the value of
the account or the number of accounts held.
If a double asterisk (~N) appears before your first name in the address portion of this notice, the $$,000 exclusion
already has been deducted from the account balance as reported by the financial institution.
Z. Enter the total balance of the account including interest accrued to the date of death.
5. The percent of the account that is taxable for each survivor is determined as follows:
A. The percent taxable for joint assets established more than one year prior to the decadent's death:
I DIVIDED BY TOTAL NUHBER OF DIVIDED BY TOTAL NUNBER OF X lO0 = PERCENT TAXABLE
JOINT OHNERS SURVTVING JOINT DARERS
Example: A joint asset registered in the name of the decedent and t"o other persons.
I DIVIDED BY 3 (JOINT ONNERS) DIVIDED BY Z (SURVIVORS) = .167 X 100 16.7Z (TAXABLE FOR EACH SURVIVOR)
B.The percent taxable for assets created ,1thin one year of the decedent's death or accounts oanad by the decedent but held
in trust for another individual(s) (trust beneficiaries):
1 DIVIDED BY TOTAL NUHBER OF SURVIVING JOINT X 100 = PERCENT TAXABLE
DHNERS OR TRUST BENEFICIARIES
Example: Joint account registered in the name of the decedent and two other parsons and established within one year of death by
the decedent.
i DzVIDED BY Z (SURVIVORS) = .50 X 100 = SOX (TAXABLE FOR EACH SURVIVOR)
The amount subject to tax (line 4) is determined by multiplying the account balance (line 2) by the percent taxable (line 3).
S. Enter the total of tho debts and deductions listed in Part 3.
6. The amount taxable (line 6) is determined by subtracting the debts and deductions (Iine 5) from the amount subject to tax (line
7. Enter tho appropriate tax rate (line 7) as determined bela,.
Da~o of Death Spouse Lineal Sibling Cella*oral
07/01/9~ ~o 12/$1/9~
01/01/95 *~o 06/30/00 OX 6Z
07/01/00 ~o presen~ OX ~.5X~ 12X
mThe tax rate imposed on thi net value of transfers from a mu=se younger at
death to or for the use of a natural parent, an adoptive parent, or a stapparant of the child is OZ.
Tho lineal class of heirs includes grandparents, parents, children, and lineal descendents. "Children" includes natural children
ah.that or not they have been adopted by others, adopted children and step children. "Lineal descendents" includes a11 children of the
natural parents and th.ir descendents, ah. that or not they have been adopted by others, adopted descendents and th.ir descendants
and step-descendants. "Siblings" are defined as individuals #ho have at la.st one parent in common aith the decedent, ah.that by blood
or adoption. The "Collateral" class of heirs includes al1 other beneficiaries.
CLAIHED DEDUCTIONS - PART $ - DEBTS AND DEDUCTIONS CLAZHED
Alia.able debts and deductions are determined as follows:
A. You legally ara responsible for payment, or the estate subject to administration by a personal representative is insufficient
to pay the deductible items.
B. You actually paid the debts after death of the decedent and cmn furnish proof of payment.
C. Debts being clalmed lust be itemized fully in Part 5. If additional space is needed, use plain paper S l/Z" x 11". Proof of
payment may be requested by the PA Department of Revenue.
COHHONNEALTH OF PENNSYLVANIA
DEPARTHENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. Z80601
HARRISBURG, PA 171Z8-0601
RE¥-15¢5 EX AFP (09-BO)
ZNFORHATZON NOTICE
AND
TAXPAYER RESPONSE
FZLE NO. 21-~
ACH 03135536
DATE 10-02-2003
THOMAS TAYLOR
216 STONEHOUSE RD
CARLISLE PA 17013
TYPE OF ACCOUNT
EST. OF DOROTHY J TAYLOR [] SAVINGS
S.S. NO. 186-16-4528 [] CHECKING
DATE OF DEATH 07-17-2003 [] TRUST
COUNTY CUMBERLAND [] CERTIF.
REHIT PAYHENT AND FORHS TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
PNC BANK has provided the Department with the information listed baloe 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 with the Inheritance Tax Laws of the Commonwealth
of Pennsylvania. Questions may be answered by calling (717) 787-8327.
COMPLETE PART !BELON # # # SEE REVERSE SZDE FOR FZLZNG AND PAYMENT ZNSTRUCTZONS
Account No. 5150366898 Date 05-18-1993
Established
Account Balance 13,865.61
Percent Taxable X 8.333
Amount Subjoc* to Tax 1,155.42
Tax Re~e X .045
Potential Tax Due 51.99
To insure proper credit to your account, two
(Z) copies of this notice must accompany your
payment to the Register of Hills. Hake check
payable to: "Register of Hills, Agent".
NOTE: If tax payments ara made within three
($) months cf the decedent's date of death,
you may deduct a 5Z discount of the tax due.
Any inheritance tax due will become delinquent
nine (9) months after the data of death.
PART TAXPAYER RESPONSE
CHECK
ONE
BLOCK
ONLY
PART
TAX
LINE
A. [ The above information and tax due is correct.
1. You may choose to remit payment to the Register of Hills with tee 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
gills and an official assessment will be issued by the PA Department of Revenue.
B. [] The above asset has been or aiZ1 bo reported and tax paid with the Pennsylvania Inheritance Tax return
to bm filed by the decadent's representative.
C. []The above information is incorrect and/or debts and deductions were paid by you. You must complete PART []and/or PART ~below.
If you indicate a d[fferen~ tax rate, please s~a~a your
relationship to decedent:
RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS
1. Date Estebi/shed I
2. Accoun~ BeZance 2
3. Percen~ Taxable 3 ~
q. Amount Sub5ec~ ~o Tax ¢
~. Debts end Deductions 5. -
6. Aaoun~ TexabZe 6
7. Tax Ra~e 7 ~
8. Tax Due 8
PART
DATE PAID
DEBTS AND DEDUCTIONS CLAIMED
PAYEE DESCRIPTION AMOUNT PAID
TOTAL (Enter on Line 5 of Tax Computation)
Under penalties of parSury, Z declare ~he~ the facJ:s I have report:ed above arm ~rua, correct end
comple'l:e to the bes~ of my knowledge and belief. HOME ( )
WORK ( )
TAXPAVER SIGNATURE TELEPHONE NUMBER DATE
GENERAL INFORMATION
1. FAILURE TO RESPOND NZLL RESULT IN AN OFFICIAL TAX ASSESSHENT eith applicable interest based on infaraation
submitted by the financial institution.
Z. Inheritance tax becomes delinquent nine months after the decedent's date of death.
3. A joint account is taxable even though the decadent's name ems added as a ;attar of convenience.
4. Accounts (including those haId between husband and wife) which the decedent put in joint names within one year prior to
da;th are fully taxable as transfers. -
S. Accounts established jointly between husband and wi~e more than one year prior to death are.not taxable.
6. Accounts held by a decedent "in trust for" another or others are taxable fully.
REPORTING INSTRUCTIONS - PART I TAXPAYER RESPONSE
1. BLOCK A - If the information and computation in the notice are correct and deductions are not being claimed, place an
in block "A" of Part I of the "Taxpayer Response" section. Sign two copies and submit thee ~ith your check for the amount of
tax to the Register of Hills of the county indicated. The PA Department of Revenue will issue an official assessment
(Form REV-1548 EX) upon receipt of the return from the Register of Hills.
Z. BLOCK D - 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 decadent'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, Dept 280601, Harrisburg, PA 171Z8-0601 in the
envelope provided.
3. BLOCK C - If the notice information is incorrect and/or deductions ara being claimed, check block "C" and complete Parts Z and 3
according to the instructions below. Sign two copies and submit them with your check for the amount of tax payable to the Register
of Hills of the county indicated. The PA Department of Revenue will issue an official assessment (Fora REV-1548 EX) upon race[pt
of the return from the Register of Hills.
TAX RETURN - PART 2 - TAX COMPUTATION
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/1Z/eZ: Accounts which the decedent put in joint names within one (I) year of death are
taxable fulty as transfers. However, there is an exclusion not to exceed S3,000 per transferee regardless of the value of
the account or the number of accounts held.
If a double asterisk (xw) appears before your first name in the address portion of this notice, the $$,000 exclusion
already has been deducted from the account balance as reported by the financial institution.
Z. Enter the total balance of the account including interest accrued to the date of death.
3. The percent of the account that is taxable for each survivor is determined as follows:
A. The percent taxabIe ~or joint assets estabtished more than one year prior to the decedent's death:
I DIVIDED BY TOTAL NUMBER OF DIVIDED BY TOTAL NUMBER OF X 100 = PERCENT TAXABLE
JOINT ONNERS SURVIVING JOINT ONNERS
Example: A joint asset registered in tho name of the decedent and two other persons.
1 DIVIDED BY 3 (JOINT O#NERS) DIVIDED BY Z (SURVIVORS) = .167 X 100 = 16.7Z (TAXABLE FOR EACH SURVIVOR)
B. The percent taxable for assets created within 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 SURVIVING JOINT X 100 = PERCENT TAXABLE
ONNERS OR TRUST BENEFICIARIES
Example: Joint account registered in the name of the decedent and two other persons and established within one year of death by
the decedent.
I DIVIDED BY Z (SURVIVORS) = .50 X 100 = 50Z (TAXABLE FOR EACH SURVIVOR)
The amount subject to tax (line 4) is determined by multiplying the account balance (line Z) by the percent taxable (line $).
S. Enter the total of the debts and deductions listed in Part 3.
6. The amount taxable (line 6) is determined by subtracting the debts and deductions (line S) from the amount subject to tax (line
7. Enter the appropriate tax rate (line 7) as determined betow.
Oa~e of Death I Spouse I Lineal Sibling Collateral
07/01/94 ~o 12/$1/94 SX 6X 15Z 15Z
01/01/95 to 06/30/00 OZ 6Z
07/01/00 ~o presen~ OX
~The tax rate imposed on th; met value of tr ; younger at
death to or for the usa of a natural parent, an adoptive arent, or a stepparent of the child is OX.
The lineaI class of heirs incIudes grandparents, parents, children, and lineal descendents. "Children" includes naturaI children
whether or not they have been adopted by others, adopted children and step children. "Lineal descendents" includes all children of the
natural parents and their descendents, whether or not they have been adopted by others, adopted descendents and their descendants
and step-descendants. "SlbIings" are defined as individuaIs who have at least one parent in common with the decedent, whether by blood
or adoption. The "CoIIateral" ciasa of heirs inoIudes all other beneficiaries.
CLAIMED DEDUCTIONS PART 5 - DEBTS AND DEDUCTIONS CLAIMED
Allowable debts end deductions ere determined as follows:
A. You legally are responsible for payment, or the estate subject to administration by a personal representative is insufficient
to pay the deductible items.
B. You actually paid the debts after death of the decedent and can RJrnish proof of pay;ant.
C. Debts being clailed must be itemized fully in Part 3. If additional space is needed, use plain paper 8 l/Z" x 11". Proof of
payment /ay be requested by the PA Department of Revenue.
COHHONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. Z80601
HARRISBURG, PA 17128-0601
REV-1645 EX ~FP
ZNFORHATZON NOTICE
AND
TAXPAYER RESPONSE
FILE NO.
ACN 05155555
DATE 10-02-2005
ANNA M HOOVER
216 STONEHOUSE RD
CARLISLE PA 17015
TYPE OF ACCOUNT
EST. OF DOROTHY J TAYLOR [] SAVZN$S
S.S. NO. 186-16-q528 [] CHECKING
DATE OF DEATH 07-17-2005 [] TRUST
COUNTY CUMBERLAND [] CERTZF.
REIIZT PAYHENT AND FORHS TO:
REGISTER OF gILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17015
PNC BANK has provided the Department with the information llstad below which has been used in
calculating the potantiaI 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 with the Inheritance Tax Laws of the Commonwealth
of Pennsylvania. Questions may be answered by calling (717) 787-8327.
COMPLETE PART i BELON ~ # ~ SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Account No. 51qO~Z708~ Data 05-07-1985
Established
Account Balance 16,189.75
Percent Taxable X 5 0 . 0 0 0
Amount Subject to Tax 8,09~.88
Tax Rata X .15
Potential Tax Due 1,Z1~.25
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 Hills, Agent".
NOTE: If tax payments are made within three
(3) months of the dacadant's date of death,
you may deduct · 5Z discount of the tax due.
Any inheritance tax due will become delinquent
nine (9) months after the date of death.
PART TAXPAYER RESPONSE
A. ~ The above information and tax due is correct.
1. You may choose to remit payment to the Register of Wills wi~ two copies of this notice to obtain
CHECK
ONE
BLOCK
ONLY
PART
TAX
L/NE
a discount or avoid interest, or you may check box "A" and return this notice to the Register of
giXls end an official assessment will be issued by the PA Department of Revenue.
B. D The above asset has been or will be reported and tax paid with the Pennsylvania Inheritance Tax return
to ba filed by the dscedent's representative.
C. ~ The above inforeetion is incorrect and/or debts end deductions were paid by you. You lust complete PART ~ and/or PART ~balou.
Zf you indicate a different tax rate, please state your
relationship to decedent:
i. Data Established
3. Percent Taxable $ X ~-~'-'~
q. Amount Subject to Tax
5. Debts and Deductions 5
6. Amoun~ TaxabZe 6
7. Tax Ea~e 7 X
8. Tax Du. 8
PART
DATE PAID
RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS
DEBTS AND DEDUCTIONS CLAIMED
PAYEE DESCRIPTION AMOUNT PAID
TOTAL (Enter on Ltna 5 of Tax Coe,~u~ation)
Under penalties of perjury, I declare that the facts Z have reported above ara true, correct and
complete to the best of ay knowledge and belief. HOME (
NORK ( )
TAXPAYER SIGNATURE TELEPHONE NUMBER DATE
GENERAL INFORHATZON
1. FAILURE TO RESPOND #/LL RESULT IN AN OFF/C/AL TAX ASSESSNENT eith applicable interest based on information
submitted by the financial institution.
Z. Inheritance tax becomes delinquent nine months after the dacedant's data of death.
$. A joint account is taxable even though the dacadent's name ams added as a matter of convenience.
~. Accounts (including those held between husband and wife) which the decedent put in joint names within one year prior to
death ara fully taxable as transfers.
5. Accounts established jointly bat, eon husband and wife lore than one year prior to death are not taxable.
6. Accounts held by a decedent "in trust for" another or others ara taxable ~ully.
REPORTIN$ INSTRUCTIONS - PART 1 - TAXPAYER RESPONSE
1. BLOCK A - If the information and computation in the notice ara correct and deductions are not being claimed, place an
in block "A" of Part 1 of the "Taxpayer Response" section. Sign two copies and sublit thai with your check for the amount
tax to the Rag[star of Nills of the county indicated. The PA Department of Revenue will issue an officio! assessment
(Form REV-IS~B EX) upon receipt of the return from the Register of Hills.
Z. BLOCK B - If the asset specified on this notice has been or will be reported and tax paid aith the Pennsylvania Inheritance
Tax Return filed by the decedent"s representative, place an "X" in block "B" of Part 1 of the "Taxpayer Response" sect[on. Sign one
copy and return to the PA Department of Revenue, Bureau of Individual Taxes, Dapt 280601, Harrisburg, PA 171Z8-0601 in the
envelope provided.
3. BLOCK C - If the notice information is incorrect and/or deductions ara being claimed, check block "C" and coapZeta Parts Z and 3
according to the instructions below. Sign t~o copies and submit thee with your check for the amount of tax payable to tho Register
of Nills of the county indicated. The PA Department of Revenue will issue an official assessment (Form REV-15~8 EX) upon receipt
of the return from the Register of Nills.
TAX RETURN - PART 2 TAX CONPUTATION
LINE
1. Enter the date the account originaZly was established or titZad in the manner existing at date of death.
NOTE: For a decedent dying after 1Z/II/BI: Accounts ,hich the decedent put in joint names within one (1) year of death ara
taxable fully as transfers. However, there [s an exclusion not to exceed $3,000 par transferee regardless of the value
tho account or tho nulbar of accounts held.
If a double asterisk (xx) appears before your first name in the address portion of this notice, the $3,000 exclusion
already has been deducted frae the account balance as reported by the financial institution.
Enter the tote! balance of the account including interest accrued to the date of death.
The percent of the account that is taxable for each survivor [s determined as follows:
A. The percent taxable ~or joint assets established more than one year prior to the decedent's death:
! DIVIDED BY TOTAL NUNBER OF DIVIDED BY TOTAL NUNBER OF X IO0 PERCENT TAXABLE
JOINT O#NERS SURVIVIN; JOINT O#NERS
Example: A joint asset registered in the name of tho decedent and two other persons.
1 DIVIDED BY 3 (JOINT ONNERS) DIVIDED BY Z (SURVIVORS) = .167 X lO0 = 16.7Z (TAXABLE FOR EACH SURVIVOR)
B. The percent taxable for assets created ~ithin one year of the decedant's death or accounts owned by the decedent but held
in trust for another individual(s) (trust beneficiaries):
1 DIVIDED BY TOTAL NUNBER OF SURVIVING JOINT X IO0 PERCENT TAXABLE
O#NERS OR TRUST BENEFICIARIES
Example: Joint account registered in the name of the decedent and tad other persons and established within Dna year of death by
the decedent.
1 DIVIDED BY Z (SURVIVORS) = .50 X 100 = 50Z (TAXABLE FOR EACH SURVIVOR)
The amount subject to tax (line ~) 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 3.
6. The amount taxable (l[na 6) is determined by subtracting the debts and deductions (line 5) from the alount subject to tax (line ~).
7. Enter the appropriate tax rata (ZJna 7) as leterained belo~.
Da~e of _~_~h Spouse Lineal Sibling Collateral
07/01/9q to 12/$1/9'~ SI 6l lSZ lSZ
01/01/95 ~o 06/50/00 OX 6X 15Z 15X
07/01/00 ~o presen~ OX
xTha tax rata imposed on tb net value =,,s younger at
death to or far the usa of a natural parent, an adoptive parent, or a stepparent of the child is OZ.
The lineal class of heirs includes grandparents, parents, children, and lineal descendents. "Children" includes natural children
Hhethar or not they have been adopted by others, adopted children and step children. "Lineal descendents" includes all children of the
natural parents and their descendants, whether or not they have been adopted bY others~ adopted descendents and ~e~r descendants
and step-descendants. "S~blJngs" are de~ned as individuals ~ho have at least one parent [n common ~[th the decedent~ ~hether by blood
or adopt[on. The "Collateral" class o~ he[rs ~ncludes al1 other bene;[c~ar[es.
CLAIHED DEDUCTIONS - PART 5 - DEBTS AND DEDUCTIONS CLA[HED
Allo~able debts and deduct[one are determined as ~ollo~s:
A. You Zegally are responsible ~or payment, or the estate subject to administration by a personal representative is insufficient
to pay the deductible items.
B. You actually paid ~e debts after death o~ the decedent and can furnish proo~ o~ payment.
C. Debts being claimed lust be itemized ~ully in Part ~. I~ additional space is needed~ use plain paper 8 l/Z" x 11". Proo~ o~
payment may be requested by ~e PA Department o~ Revenue.
CONNONNEALTH OF PENNSYLVANIA
DEPARTNENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. Z80601
HARRISBURG, PA 17128-0601
REV-Z$~i5 EX AFP
ANNA H HOOVER
216 STONEHOUSE RD
CARLISLE PA 17013
ZNFORHATZON NOTZCE
AND
TAXPAYER RESPONSE
FZLE NO.
ACN 0313553~
DATE 10-02-2003
TYPE OF ACCOUNT
EST. OF DOROTHY J TAYLOR [] SAVTNSS
S.S. NO. 186-16-q528 [] CHECKING
DATE OF DEATH 07-17-2003 [] TRUST
COUNTY CUMBERLAND [] CERTIF.
REMIT PAYHENT AND FORMS TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
PNC BANK has provided the Department aith the information listed baloe ahich has bean used in
calculating the potential tax due. Their records indicate that at the death of the above decedent, you acrs a joint owner/beneficiary of
this account. If you faa! this information is incorrect, please obtain written correction from the financial institution, attach a copy
to this fore and return it to the above address. This account is taxable in accordance with the Inheritance Tax Lams of the Coaaoneaalth
of Pennsylvania. Questions may be answered by calling (717) 787-83Z7.
COMPLETE PART ! BELOW ~ # ~ SEE REVERSE SIDE FOR FZLZNG AND PAYMENT INSTRUCTIONS
Account No. 5130366898 Date 05-18-1995
Established
Account Balance 13,865.61
Percent Taxable X 8.333
Amount Subject to Tax 1,155.q2
Tax Rate X .15
Potential Tax Due 173.31
To insure proper credit to your account, teo
(Z) copies of this notice must accompany your
payment to the Register of Hills. Hake check
payable to: "Register of Hills, Agent".
NOTE: If tax payments are made aithin three
(3) months of the dacedant's date of death,
you amy deduct a 5X discount of the tax due.
Any inheritance tax due mill become delinquent
nine (9) months after the date of death.
PART
TAX
LINE
PART TAXPAYER RESPONSE
A. D The above information and tax due is correct.
I. You nay choose to remit payment to the Register of Hills eith tho copies of this notice to obtain
CHECK -~ a discount or avoid interest, or you may check box "A" and return this notice to the Register of
ONE Hills and an official assessment mill be issued by the PA Department of Revenue.
BLOCK J B. [] The above asset has been or ail1 be reported and tax paid aith the Pennsylvania Inheritance Tax return
ONLY to be filed by the decedant's representative.
C. []The above information is incorrect and/or debts and deductions mere paid by you.
You must complete PART [] and/or PART [] below.
If you indicate a differen~c_,tax rate, please sta~e your
relationship to decedent: -~/~ ~
RETURN - COMPUTATION OF TAX ON JOZNT/TRUST ACCOUNTS
1. Date Established
2. Account Balance
3. Percent Taxable
q. Amount Sub~ect to
S. Debts and De~c~ions
6. A.oun~ Taxable
7. Tax
a. Tax ~,
PART
DATE PAID
DEBTS AND DEDUCTIONS CLAIMED
PAYEE
DESCRIPTION AMOUNT PAID
TOTAL (Enter on Line $ of Tax C_~_-_r~,jtetion) $
Under penalties of perjury, T declare that th~ facts I have reported above ere true, correct and
complete to the best of ay knowledge and belief. HOME ( )
WORK ( )
TAXPAYER SIGNATURE TELEPHONE NUHBER ~
GENERAL [NFORHATION
1. FA/LURE TO RESPOND #ILL RESULT ZN AN OFFICIAL TAX ASSESSNENT eith applicable interest based on inforaation
submitted by the financial institution.
Z. Inheritance tax becomes delinquent nine months after the decadent's date of death.
3. A joint account is taxable even though the decedent's name was added ss a matter of convenience.
4. Accounts [including those held bateaan husband and wife) which the decedent put in joint names within one year prior to
death ere fully taxable as transfers.
S, Accounts established jointly batsman 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 are 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 "X"
in block "A" of Part I cf the "Taxpayer Response" section. Sign two copies and submit thee with your check for the amount of
tax to the Register of #ills of the county indicated. The PA Department of Revenue will issue an official assessment
(Form REV-Z54B EX) upon receipt of the return from the Register of Rills.
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 decedent's representative, place an "X" in block "B" of Part I of the "Taxpayer Response" sect[on. Sign one
copy and return to the PA Department of Revenue, Bureau of Individual Taxes, Dept ZBOB01, Harrisburg, PA 171Z8-0601 in the
envelope provided.
3. BLOCK C - If the notice information is incorrect and/or deductions ara being claimed, check block "C" and complete Parts Z and 3
according to the instructions below. Sign two copies and submit thee with your check for the amount of tax payable to the Register
of Rills of the countY indicated. The PA Department of Revenue mill issue an official assessment (Fore REV-1548 EX) upon receipt
of the return from the Register of Rills.
TAX RETURN - PART Z - TAX COHPUTAT~ON
LINE
1. Enter the date the account originally ems 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 are
taxable fully as transfers. However, there is an exclusion not to exceed $3,000 per transferee regardless of the value of
the account or the number of accounts held.
If a double asterisk (mx) appears before your first name in the address portion of this notice, the $5,000 exclusion
already has been deducted from the account balance as reported by the financial institution.
Enter the total balance of the account including interest accrued to the date of death.
3. The percent of tho account that is taxable for each survivor is determined as folloes:
A. The percent taxable for joint assets established more than one year prior to the decedant's death:
I D/VIDEO BY TOTAL NUNBER OF DIVIDED BY TOTAL NUNBER OF X 100 = PERCENT TAXABLE
JOINT ONNERS SURVIVING JOINT ONNERS
Example: A joint asset registered in the name cf the decedent and two other persons.
I DIVIBED BY 3 [JOINT ONNERS) BIVIDED BY Z (SURVIVORS) = .[67 X lOO = I6.7X (TAXABLE FOR EACH SURVIVOR)
B. The percent taxable for assets created eithin one year of the decadant's death or accounts caned by the decedent but held
in trust for another individual[s) [trust beneficiaries):
I DIVIDED BY TOTAL NUMBER OF SURVIVING JOINT X 100 = PERCENT TAXABLE
ONNERS OR TRUST BENEFICIARIES
Example: Joint account registered in the name of the decedent and two other persons and established aithin one year of death by
the decedent.
I DIVZDED BY Z (SURVIVORS) = .SO X 100 5gl (TAXABLE FOR EACH SURVIVOR)
The amount subject to tax (line 4) is determined by multiplying the account balance (line Z) by the percent taxable [line 5).
5. Enter the total of the debts end deductions listed in Part 3.
6. The amount taxable (line 63 is determined by subtracting the debts and deductions (line S) from the amount subject to tax (Line 4).
7. Enter the appropriate tax rate (Zine 7) as laterainsd below.
Da~e of Death Spouse Lineal Sibltng Collateral
07/01/9q ~o 12/51/9q SX 6X 15X 157.
01/01/95 '~o 06/SO/O0 OX 6X 157. 1.67.
07/01/00 ~o presen~ OX q.BX~ 12Z 15Z
.... ~ ..-~ .... z ~ ..... g..e ~en. a deceased child tHenty-u~a years of age or"
wTha tax rate imposed on t~ r ,conger at
death to or for the usa of a natural parent, an adoptive parent, or a stepparent of the child is OX.
The lineal class of ha[rs includes grandparents, parents, children, and linea! descendants. "Children" includes natural children
whether or not they have been adapted by others, adapted children and step children. "Lineal descendents" includes all children of the
natural parents and their descendents, whether or not they have been adopted by others, adopted descendents and their descendants
and step-descendants. "SibLings" are defined es individuals who have at least one parent in common with the decedent, whether by blood
or adoption. The "Collateral" class of hairs Includes a11 other beneficiaries.
CLAZMED DEDUCTZONS - PART 5 - DEBTS AND DEDUCTIONS CLAZMED
Allowable debts and deductions are determined as follows:
A. You legally ara responsible for payment, or the estate subject to administration by a personal representative is insufficient
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 cZaiaad must be itemized fully in Part 3. If additional space is needed, usa plain paper 8 l/Z" x 11". 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 003127
HOOVER ANNA M
216 STONEHOUSE ROAD
CARLISLE, PA 17013
........ fold
ESTATE INFORMATION: SSN: 186-16-4528
FILE NUMBER: 2103-0838
DECEDENT NAME: TAYLOR DOROTHY J
DATE OF PAYMENT: 1 O/15/2003
POSTMARK DATE: 00/00/0000
COUNTY: CUMBERLAND
DATE OF DEATH: 07/17/2003
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
03135534 8131.72
03135533 8922.82
REMARKS:
ANNA M HOOVER
TOTAL AMOUNT PAID:
81,054.54
SEAL
CHECK# 708
INITIALS: AC
RECEIVED BY:
DONNA M. OTTO
DEPUTY REGISTER OF WILLS
REGISTER OF WILLS
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 003126
HOOVER ANNA M
216 STONEHOUSE ROAD
CARLISLE, PA 17013
........ fold
ESTATE INFORMATION: SSN: 186-16-4528
FILE NUMBER: 2103-0838
DECEDENT NAME: TAYLOR DOROTHY J
DATE OF PAYMENT: 10/15/2003
POSTMARK DATE: 00/00/0000
COUNTY: CUMBERLAND
DATE OF DEATH: 07/17/2003
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
03135535 $49.39
03135536 $49.39
REMARKS:
TOTAL AMOUNT PAID:
RICHARD TAYLOR & THOMAS TAYLOR
C/O ANNA M HOOVER
$98.78
SEAL
CHECK# 709
INITIALS: AC
RECEIVED BY:
DONNA M. OTTO
DEPUTY REGISTER OF WILLS
REGISTER OF WILLS
BUREAU OF ZNDZVTDUAL TAXES
XNHERZTANCE TAX DTV/STON
DEPT. 280601
HARRTSBURG, PA 17128-0601
COHNONNEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
NOTICE OF INHERITANCE TAX
APPRAXSEMENT. ALLONANCE OR DXSALLONANCE
OF DEDUCTIONS, AND ASSESSHENT OF TAX ON
JOINTLY HELD OR TRUST ASSETS
REV-1548 EX AFP (01-05)
RICHARD TAYLOR
216 STONEHOUSE RD
CARLISLE p~A_ 17013
FILE NUMBER
COUNTY
SSN/DC
ACM
DATE 05-10-200q
ESTATE OF TAYLOR DOROTHY
DATE OF DEATH 07-17-2003
21 03-0838
CUMBERLAND
186-16-4528
03135535
Amoun~ Rem~ed I
HAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF MILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
J
CUT ALONG THIS LINE ~ RETAIN LONER PORTION FOR YOUR RECORDS ~
REV-1548 EX AFP (01-03)
NOTICE OF XNHERXTANCE TAX APPRAISEMENT, ALLONANCE OR DXSALLONANCE OF
DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS
DATE 05-10-2004
ESTATE OF TAYLOR
DOROTHY J DATE OF DEATH 07-17-2003 COUNTY CUMBERLAND
FILE NO. 21 03-0858 S.S/D.C. NO. 186-16-4528 ACN 03155535
TAX RETURN WAS: eX) ACCEPTED AS FILED ( ) CHANGED
JOINT OR TRUST ASSET INFORMATION
FINANCIAL INSTITUTION: PNC BANK ACCOUNT NO. 5130366898
TYPE OF ACCOUNT: (~ SAVINGS ( ) CHECKING ¢ ) TRUST ¢ ) TIME CERTIFICATE
DATE ESTABLISHED 05-18-1993
Account Balance
Percent Taxable X 0.083
Amount Subject to Tax 1,155.42
Debts and Deductions - .00
TaxabZe Amount 1,155.42
Tax Rate X .45
Tax Due 51.99
TAX CREDZTS:
13,865.61 NOTE:
TO INSURE PROPER CREDIT TO
YOUR ACCOUNT, SUBMIT THE
UPPER PORTION OF THIS NOTICE
WITH YOUR TAX PAYMENT TO THE
REGISTER OF WILLS AT THE
ABOVE ADDRESS. MAKE CHECK
OR MONEY ORDER PAYABLE TO:
m'REGISTER OF WILLS, AGENT."
PAYMENT
DATE
10-15-2003
RECEIPT
NUMBER
CD003126
DISCOUNT (+)
INTEREST/PEN PAID (-
2.60
AMOUNT PAID
49.39
TOTAL TAX CREDZT
BALANCE OF TAX DUE
INTEREST AND PEN.
TOTAL DUE
XF PAID AFTER TNTS DATE, SEE REVERSE FOR CALCULATION OF ADDITTONAL TNTEREST. a
( XF TOTAL DUE XS LESS THAN $1, NO PAYMENT TS REI~U/RED.
IF TOTAL DUE IS REFLECTED AS A **CREDIT** ( CR)j YOU MAY BE DUE A REFUND.
SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. )
51.99
.00
.00
.00
PURPOSE OF
NOTICE:
PAYMENT:
REFUND (CA):
OBJECTIONS:
ADMIN-
ISTRATZVE
CORRECTIONS:
DISCOUNT:
PENALTY:
/NTEREST:
To fulfill the requirements of Section 21q0 of the inheritance and Estate Tax Act, Act 23 of ZOO0. (72 P.S.
Section 91qO).
Detach the tap portion of this Notice and submit eith your payment to the Register of Rills printed on the
reverse side.
-- Make check or money order payable to: REGISTER OF NILLS, AGENT.
A refund of a tax credit, which was not requested on the tax return, may ba requested by completing an "Application
for Refund of Pennsylvania Inheritance and Estate Tax" (REV-1313). Applications ara available at the Office of
the Register of Nills, any of the 23 Revenue District Offices or by calling the special Zq-hour answering service
for forms ordering: 1-B00-$62-Z050; services for taxpayers with special hearing and or speaking needs:
1-BOO-4q7-$OZO [TT only).
Any party in interest not satisfied with the appraisement, allowance, or disallowance of deductions or assessment
of tax (including discount or interest) as shown on this Notice may object within sixty (60) days of receipt of
this Notice by:
--arittan protest to the PA Department of Revenue, Board of Appeals, Dept. 281021, 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 writing to: PA Department of Revenue,
Bureau of Individua! Taxes, ATTN: Post Assessment Review Unit, DEPT. 280601, Harrisburg, PA 17128-0601
Phone (717) 787-6505. See page S of the booklet "Instructions for Inheritance Tax Return for a Resident
Decedent" (REV-1501) for an explanation of administratively correctable errors.
If any tax due is paid within three (3) calendar months after the decadant's death, a five percent (5Z)
discount of the tax paid is allowed.
The 1Si tax amnesty non-participation penalty is computed on the total of the tax and interest assessed, and not
paid before January lB, 1996, the first day after the and of the tax amnesty period. This non-participation
penalty is appealable in the same manner and in the the same time period as you would 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 data of death, to the date of payment. Taxes which became delinquent before January 1, 1982
bear interest at the rate of six (6X) percent per annum calculated at a daily rate of .000164.
All taxes which became delinquent on or after January 1, 1982 will bear interest at a rate ahich will vary from
calendar year to calendar year aith that rate announced by the PA
Department of Revenue.
The applicable
interest rates for 1982 through ZO0~ ere:
Interest Daily Interest Daily Interest Daily
Year Rate Factor Year Rate Factor Year Rate Factor
19B-'~ ZOX .0005~8 1986-1991 llX .000301 Z001 92 .000247
1983 162 .O00qSB 1992 92 .000247 ZOOZ 62 .000219
198fi 112 .000301 1995-199fi 72 .000192 2003 52 .000137
1985 132 .000356 1995-1998 92 .000247 2004 fix .O0011O
1986 102 .O00Z7q 1999 72 .O0019Z
1987 92 .0002~7 ZOO0 8Z .000219
--Intarest is calculated as follows:
'rNTEREST = BALANCE OF TAX UNPA'rD X NUHBER OF DAYS DELIHQUEHT X DAIL~Z 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 shown on the
Notice, additional interest must be calculated.
BUREAU OF ZNDTVTDUAL TAXES
TNHERTTANCE TAX DTVTSION
DEPT. 280601
HARRISBURG, PA 17128-0601
THOMAS TAYLOR
216 STONEHOUSE RD
CARLISLE
PA ~17013
CONNONWEALTH OF PENNSYLVANIA DEPARTNENT OF REVENUE
NOT/CE OF /NHER/TANCE TAX
APPRATSEHENT. ALLO#ANCE OR DTSALLO#ANCE
OF DEDUCTIONS, AND ASSESSHENT OF TAX OH
JOTNTL¥ HELD OR TRUST ASSETS
DATE 05-10-2004
ESTATE OF TAYLOR
DATE OF DEATH 07-17-2003
FILE NUMBER 21 03-0838
COUNTY CUMBERLAND
SSN/DC 186-16-4528
ACN 03135536
Amoun~
DOROTHY J
HAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~
REV-1548 EX AFP (01-03)
NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF
DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS
DATE 05-10-Z004
ESTATE OF TAYLOR DOROTHY J DATE OF DEATH 07-17-2003 COUNTY CUHBERLAND
FILE NO. 21 03-0838 S.S/D.C. NO. 186-16-4528 ACN 03135536
TAX RETURN WAS: tX) ACCEPTED AS FILED ( ) CHANGED
JOINT OR TRUST ASSET INFORMATION
FINANCIAL INSTITUTION: PNC BANK ACCOUNT NO. 5130366898
TYPE OF ACCOUNT: (~ SAVINGS ( ) CHECKING ( ) TRUST ( ) TIME CERTIFICATE
DATE ESTABLISHED 05-18-1993
Account Balance 13,865.61
Percent Taxable X 0.083
Amount Subject to Tax 1,155.42
Debts and Deductions .00
Taxable Amount 1,155.42
Tax Rate
Tax Due 51.99
TAX CREDITS:
NOTE=
TO INSURE PROPER CREDIT TO
YOUR ACCOUNT, SUBMIT THE
UPPER PORTION OF THIS NOTICE
WITH YOUR TAX PAYMENT TO THE
REGISTER OF WILLS AT THE
ABOVE ADDRESS. HAKE CHECK
OR HONEY ORDER PAYABLE TO:
"REGISTER OF WILLS, AGENT."
PAYHENT RECEIPT DISCOUNT (+)
DATE NUMBER INTEREST/PEN PAID (-) AHOUNT PAID
10-15-2003 CD003126 2.60 49.39
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST AND PEN.
TOTAL DUE
TF PATD AFTER THTS DATE, SEE REVERSE FOR CALCULATTON OF ADDTTTONAL TNTEREST.
IF TOTAL DUE TS LESS THAN $1, NO PAYMENT TS REI~UTRED.
IF TOTAL DUE TS REFLECTED AS A "CREDTT" (CR), YOU HAY BE DUE A REFUND.
SEE REVERSE S/DE OF THTS FORM FOR TNSTRUCTTONS.
51.99
.00
.00
.00
PURPOSE OF
NOTICE:
PAYMENT:
REFUND (CR):
OBJECTIONS:
ADMIN-
ISTRATIVE
CORRECTIONS:
DISCOUNT:
PENALTY:
INTEREST:
To fulfill the requirements of Section ZlqO of the Inheritance end Estate Tax Act, Act 25 of ZOO0. (72 P.S.
Section 91q0).
Detach the top portion of this Notice and submit with your payment to the Register of Rills printed on the
reverse side.
-- Make check or money order payable to: REGISTER OF NILLS) AGENT.
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-1513). Applications are available at the Office of
the Register of Hills, any of the Z3 Revenue District Offices or by calling the special Zq-hour answering service
for forms ordering: 1-OOO-56Z-ZOSO; services for taxpayers with special hearing and or speaking needs:
i-8OO-~qT-SOZO (TT only).
Any party in interest not satisfied with the appraisement, allowance, or disallowance of deductions or assessment
of tax iincluding discount or interest) as shown on this Notice may object within sixty I60) days of receipt of
this Notice by:
--written protest to the PA Department of Revenue, Board of Appeals, Dept. 281021, Harrisburg) PA 17128-lOgl, 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 writing to: PA Department of Revenue,
Bureau of Individual Taxes, ATTN: Post Assessment Review Unit, DEPT. 280601, Harrisburg, PA 171Z8-0601
Phone 17173 787-6505. See page 5 of the booklet "Instructions for inheritance Tax Return for a Resident
Decedent" (REV-lSD1) for an explanation of administratively correctable errors.
If any tax due is paid within three (5) calendar months after the decedent's death, a five percent (SI)
discount of the tax paid is allowed.
The 15X tax amnesty non-participation penalty is computed on the total of the tax and interest assessed, and not
paid before January lB, 1996, the first day after the 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 would 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 il) day
from the date of death, to the date of payment. Taxes which became delinquent before January 1, 19BI
bear interest at the rate of six (BZ) percent per annum calculated at a daily rate of .00016q.
All taxes which became delinquent on or after January 1, 19aZ 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 rotes for 1982 through ZO0~ are:
Interest Daily Interest Daily lnterest Daily
Year Rate Factor Year Rate Factor Year Rate Factor
198~ 2OZ .0005~8 198~-1991 llZ .000501 ZOO--'~ 9X .O00Zq7
1985 16Z .000~58 199Z 9Z .000Z47 200Z 6Z .OOOZX9
I9B~ llZ .000501 1995-199~ 7Z .OO019Z ZOO5 5Z .a00157
1985 132 .000556 1995-1998 9Z .O00Z~7 2004 qZ .000110
1986 lOX .O00Z7q 1999 7Z .00019Z
1987 9X .O00Zq7 ZOOO 8Z .000Z19
--Interest is calculated as follows:
ZNTERESI' = BALANCE; OF 1'AX UNPAZD X NUHBBR OF DAYS DELTNQUENT X DA'[L~ '[NTERE:ST F&CTOR
--Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fifteen IlS) 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 TNDTV/DUAL TAXES
TNHERTTANCE TAX DXVTSXON
DEPT. ZB060Z
HARRISBURG, PA 171Z8-0601
'04
ANNA M HOOVER
216 STONEHOUSE RD
CARLISLE PA
COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE
NOT/CE OF TNHERTTANCE TAX
APPRA'rSEI~ENT, ALLORANCE OR DISALLONANCE
OF DEDUCT/ONS, AND ASSESSHENT OF TAX ON
JO'rNTLY HELD OR TRUST ASSETS
DATE 05-10-2004
ESTATE OF TAYLOR
DATE OF DEATH 07-17-2003
FILE NUMBER 21 03-0838
l'iiiY -7 P} :{)3COUNTY CUMBERLAND
SSN/DC 186 - 16 - 4528
ACN 03135533
Amoun'~
REV-1548 EX AFP (91-0S~
DOROTHY J
HAKE CHECK PAYABLE AND RENIT PAYNENT TO=
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
CUT ALONG THIS LINE ~" RETAIN LOWER PORTION FOR YOUR RECORDS
REV-1548 EX AFP
NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF
DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS
DATE 05-10-2004
ESTATE OF TAYLOR
DOROTHY J DATE OF DEATH 07-17-2003 COUNTY CUHBERLAND
FILE NO. 21 03-0838 S.S/D.C. NO. 186-16-4528 ACN
TAX RETURN WAS: (X) ACCEPTED AS FILED ( ) CHANGED
03135533
dOZNT OR TRUST ASSET ZNFORNATION
FINANCIAL INSTITUTION: PNC BANK ACCOUNT NO. 5140427084
TYPE OF ACCOUNT: ( ) SAVINGS ¢~ CHECKING ( ) TRUST ( ) TIME CERTIFICATE
DATE ESTABLISHED 05-07-1985
Account Balance
Percent Taxable X 0.500
Amount Subject to Tax 8,094.88
Debts and Deductions .00
Taxable Amount 8,094.88
Tax Rate X .12
Tax Due 971.39
TAX CREDZTS:
16,189.75 NOTE:
TO INSURE PROPER CREDIT TO
YOUR ACCOUNT, SUBMIT THE
UPPER PORTION OF THIS NOTICE
WITH YOUR TAX PAYHENT TO THE
REGISTER OF WILLS AT THE
ABOVE ADDRESS. HAKE CHECK
OR HONEY ORDER PAYABLE TO:
"REGISTER OF WILLS, AGENT."
PAYMENT RECEIPT DISCOUNT (+)
DATE NUHBER INTEREST/PEN PAID (-) AMOUNT PAID
10-15-2003 CD003127 48.57 922.82
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST AND PEN.
TOTAL DUE
971.39
IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULAT/ON OF ADD/TIONAL INTEREST.
IF TOTAL DUE 15 LESS THAN $1, NO PAYHENT 15 REQUIRED.
IF TOTAL DUE ~S REFLECTED AS A "CRED/T" ( CR); YOU HAY BE DUE A REFUND.
SEE REVERSE S/DE OF THIS FORH FOR INSTRUCTIONS. )
.00
.00
.00
PURPOSE OF
NOTICE:
To fulfill the requirements of Section Z140 of the Inheritance end Estate Tax Act, Act Z3 of ZOO0. (TZ P.S.
Section
PAYNENT:
REFUND (CR):
OBJECTIONS:
ADMIN-
ISTRATIVE
CORRECTIONS:
DISCOUNT:
PENALTY:
INTEREST:
Detach the top portion of this Notice and submit with your payment to the Register of Hills printed on the
reverse side.
-- Hake check or money order payable to: REGISTER OF NILLS, AGENT.
A refund of e tax credit, which was not requested on the tax return, may be requested by completing an "Application
far Refund of Pennsylvania Inheritance and Estate Tax" (REV-1513). Applications are available at the Office of
the Register of Nills, any of the Z3 Revenue District Offices or by calling the special Z~-hour answering service
for forms erdering: 1-DOO-$6Z-Z050~ services for taxpayers with special hearing and or speaking needs:
1-&OO-~7-30ZO (TT only).
Any party in interest not satisfied eith the appraisement, allowance, or disallowance of deductions or assessment
of tax (including discount or interest) as shown on this Notice may object within sixty [60) days of receipt of
thls 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 persona! representative, OR
--appea! to the Orphans' Court
Factual errors discovered on this assessment should be addressed in writing to: PA Department of Revenue,
Bureau of Individual Taxes, ATTN: Post Assessment Review Unit, DEPT. Z80601, Harrisburg, PA 171Z8-0601
Phone (717) 787-6S0S. See page S of the booklet "instructions for Xnheritanca Tax Return for a Resident
Decedent" (REV-IS01) for an expLanation of administratively correctable errors.
If any tax due is paid within three (5) calendar months after the decedent's death, a five percent (ex)
discount of the tax paid is allowed.
The leg 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. This non-participation
penalty is appealable in the same manner and in the the same time period as you would 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 which became delinquent before January 1, 1982
bear interest at the rate of six (6Z) percent par annum calculated at e daily rate of .00016~.
All taxes which became delinquent on or after January 1, 198Z w111 bear interest at a rate which will vary free
calendar year to calendar year with that rate announced by the PA
Department of Revenue.
The applicable
interest rates for 1982 through 200q are:
Interest Daily Interest Daily Interest Daily
Year Rate Factor Year Rate Factor Year Rate Factor
198Z lOX .0005q8 198'~8-1991 /1Z .000301 ZOOZ 9Z .OOOZfi7
1983 16Z .000~38 199Z 9X .OOOZq7 ZOOZ 6Z .OOOZ19
198q llZ .000301 199~-1996 72 .OO019Z 2003 52 .000137
1985 13Z .000356 1995-1998 9Z .OOOZq7 ZO0~ qZ .000110
1986 IOZ .O00g7fi 1999 72 .O00lgz
1987 9Z .O00Z~7 2000 8Z .OOOZ19
--Tnterest is calculated as follows:
ZNTEREST = BALANCE OF TAX UNPAZD X NUNBER OF DAYS DELZNQUEtiT X DATLY /NTEREST 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 an the
Notice, additional interest must be calculated.
BUREAU OF THDZVTDUAL TAXES
INHERITANCE TAX DIVISION
DEPT. 280601
HARRISBURG., PA 17128-0601
ANNA H HOOVER
216 STONEHOUSE RD
CARLISLE
COHNONHEALTH OF PENNSYLVANIA
DEPARTNENT OF REVENUE
NOTICE OF INHERITANCE TAX
APPRAISEHBNT, ALLO#ANCE OR D/SALLO#ANCE
OF DEDUCTIONS, AND ASSESSHENT OF TAX ON
JOKNTL¥ HELD OR TRUST ASSETS
DATE 05-10-200~
ESTATE OF TAYLOR
DATE OF DEATH 07-17-2003
FILE NUHBER
COUNTY
ACN
21 03-0838
CUHBERLAND
186-16-~528
0313553~
Amount Rem/fred
REV-1548 EX ~'FP (01-03)
DOROTHY J
HAKE CHECK PAYABLE AND RENZT PAYHENT TO=
REGISTER OF HILLS
CUHBERLAND CO COURT HOUSE
CARLISLE, PA 17013
CUT ALONG THIS LINE ~-* RETAIN LONER PORTION FOR YOUR RECORDS *"~
REV-1548 EX AFP (01-03)
NOTICE OF INHERITANCE TAX APPRAISEHENT, ALLOHANCE OR DISALLOHANCE OF
DEDUCTIONS, AND ASSESSHENT OF TAX ON JOINTLY HELD OR TRUST ASSETS
DATE 05-10-Z00R
ESTATE OF TAYLOR
DOROTHY J DATE OF DEATH 07-17-2003 COUNTY CUHBERLAND
FILE NO. 21 03-0838 S.S/D.C. NO. 186-16-~528 ACN
TAX RETURN HAS: (X) ACCEPTED AS FILED ( ) CHANGED
JOINT OR TRUST ASSET INFORNATION
0313553~
FINANCIAL INSTITUTION: PNC BANK
ACCOUNT NO. 5130366898
TYPE OF ACCOUNT: (~ SAVINGS ( ) CHECKING ( ) TRUST ( ) TIHE CERTIFICATE
DATE ESTABLISHED 05-18-1993
Accoun~ Balance
Percent Taxable
Amount Subject to Tax
Debts and Deductions
Taxable Amount
Tax Rate
Tax Due
TAX CREDTTS:
13,865.61 NOTE:
X 0.083
1,155.~2
- .00
1,155.~Z
X .12
138.65
TO INSURE PROPER CREDIT TO
YOUR ACCOUNT, SUBMIT THE
UPPER PORTION OF THIS NOTICE
HITH YOUR TAX PAYMENT TO THE
REGISTER OF HILLS AT THE
ABOVE ADDRESS. MAKE CHECK
OR MONEY ORDER PAYABLE TO:
"REGISTER OF HILLS, AGENT."
PAYHENT RECEIPT DISCOUNT (+) AHOUNT PAID
DATE NUHBER INTEREST/PEN PAID (-)
10-15-Z003 CD003127 6.93 131.72
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST AND PEN.
TOTAL DUE
TF pATD AFTER THTS DATE, SEE REVERSE FOR CALCULATTON OF ADDTTKONAL TNTEREST. ~
( KF TOTAL DUE KS LESS THAN $1, NO PAYNENT KS REI~UKRED.
TF TOTAL DUE TS REFLECTED AS A "CREDKT" (CR), YOU HAY BE DUE A REFUND.
SEE REVERSE STDE OF THTS FORH FOR KNSTRUCTKONS. )
138.65
.00
.00
.00
PURPOSE OF
NOTICE:
To fulfill the requirements of Section 21qO of the Inheritance and Estate Tax Act, Act Z3 of 2000. (72 P.S.
Section
PAYMENT:
REFUND (CR):
OBJECTIONS:
ADH/N-
ISTRATIVE
CORRECTIONS:
DISCOUNT:
PENALTY:
INTEREST:
Detach the top portion of this Notice and submit with your payment to the Register of Hills printed on the
reverse side.
-- Make check or money order payable to: REGISTER OF HILLS, AGENT.
A refund of a tax credit, ehich was not requested on the tax return, amy be requested by completing an "Application
for Refund of Pennsylvania Inheritance and Estate Tax" (REV-1313). AppLications ara available at the Office of
the Register of Nills, any of the Z3 Revenue District Offices or by calling the special gq-hour answering service
for fores ordering: 1-800-362-Z050; services for taxpayers eith special hearing and or speaking needs:
l-BOO-qq7-3OZO (TT only).
Any party in interest not satisfied ~ith the appraisement, allowance, or disallowance of deductions ar assessment
of tax (including discount or interest) as she~n on this Notice may object ~ithin sixty (60) days of receipt of
this Notice by:
--~rittan protest to the PA Department of Revenue, Board of Appeals, Dept. Z810Z1, Harrisburg, PA 171lB-lOll, 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 ba addressed in ~riting to: PA Department of Revenue,
Bureau of Individual Taxes, ATTN: Post Assessment Review Unit, DEPT. gB06Ol, Harrisburg, PA 1712B-0601
Phone (717) 787-6505. Sam page 5 of the booklet "Instructions for Inheritance Tax Return for a Resident
Decedent" (REV-IS01) for an explanation of administratively correctable errors.
If any tax due is paid eithin three (5) calendar months after the decedent's death, a five percent (SI)
discount of the tax paid is allo~ed.
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 and of the tax amnesty period. This non-participation
penalty is appealable in the same manner and in the the same tiaa period as you woula 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 (13 day
from the date of death, to the date of payment. Taxes Nhich became delinquent before January 1, 198Z
bear interest at the rate of six (6g) percent par annum calculated at a daily rate of .OOgi6q.
Ali taxes ~hich became delinquent on or after January 1, 198Z ~i11 bear interest at a rate ~hich ~ill vary from
calendar year to calendar year ~ith that rate announced by the PA Department of Revenue. The applicable
interest rates for 1982 through gOOq are:
Interest Daily Interest Daily Interest Daily
Year Rate Factor Year Rate Factor Year Rate Factor
1982 2OZ .O005q8 198'~8-1991 llZ .000S01 Zoo1 9Z .OOOgq7
1983 16Z .000q58 199Z 9Z .O00Zq7 200Z 6Z .000Z19
198~ llZ .000301 1993-199~ 7Z .000192 2003 5Z .000137
1985 lSZ .000356 1995-1998 9Z .O00Zq7 ZOOq qZ .000110
1986 lOX .00027q 1999 72 .O00Zgz
1987 9Z .0002q7 ZOO0 8Z .O00Z19
--Interest is calculated as folloes:
ZNTE:RE:ST = BALANCE: OF TAX UNPATD X NUNBE:R OF DAYS DELTNQUENT X DAILY INTE:RE:ST 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.
. . _
� �es�c
PETITI{}N FQR GRA]vT UF LETTERS
REGISTER OF WILLS C?F CUMBERLAND COUNTY,PENNSYLVANIA
Petitioner(s) named below, who is/are 18 years af age or alder, apply(ies) far Letters as specified below, and in
support thereof aver(s}the following a�nd respectfuily request(s}the grant of Letters in the appropriate form:
Decedent's Informat�an �r}
Name: DOROTHY J.TAYLOR File No: �„L I �(� " � �,��
a!kla: {Assigned by Register)
alk/a.
alk/a: 3ocial Security No: 186-16-4528
Date of Death. .TULY 17 2003 Age at death: 81
Decedent was damiciied at death in CUMBERI.AND Cc�uniy, pENNSYI,V��vIA! (stare)with hisllier last
principal residet�ce at 216 STONE HOUSE ROAD.CARLISLE 17013 DICKINSON TOWNSHIP CUM�ERLAND
Street address,Post Office and Zip Code City,Tawnship ar Boraugh Ceue#y
Decedent died at 216 STOI�►E HOUSE ROAD CARLISLE 17013 DICKINSON TOVJNSHIP CUMBERLAND PA
Street address,Post Office and Zip Code Ctty,Tawnship or Btrrough County State
Estirnate of value of decedent's pcoperty at death:
If domzcited in Pennsytvania............................ All personal property $ SQr000.00
If nnt domicited in Pennsylvania. . . ....... . . ...... ...... Personal property in Pennsylvania $
Ijno#domiciled in Pennsylvania. ............ ...... .. ... Personal property in County $
�islue of rea!estate in Pennsylvania......................................................... $
TOTAL ESTIMATED VALUE. . .. $ 50,000.00
Real estate in Pennsylvania situated at: 216 STONE HOUSE R4AD CARLISLE 17013 DICI�:INSON TWP CUMBERLAND
(Attach additronal sheets,if necessary.� Street address,Past Oftice and Zip Code City,Township or Borough County
� A. Petition for Probate and Grant of Letters Testamentarv
Petitioner(s)aver(s)he/she/they is/are the Executor(s)named in the last Will of the Decedent,dated and Codicil{s)
thereto dated � ' � =p��
___. .�r
._.ne
� �-r--T-,
e^e
State relevant circamstances(e.g.rertunciakan,death af executor,etc.)� "?=� � ' -`
� - �,_
Except as follows: after the execution of the instrument(s)offered for probate Decedent did not marry,was d''�rir�ed,w�s ibt a party ttl a pending
divorce praceeding wherein the graunds for divarce had been established as defined in 23 Pa.C.S.§33�3{�and did�have a child barn or
adopted;and Decedent was neither the victirn of a killing nar ever adjudicated an incapaoitated person. � ~ ��
t,:� ,.,�, ,
{�NO EXCEM'It1NS �}EXCEPTIQNS c-� �? --3 -
c_:, _ .
_:�a c.t: � ,�
� B. Petitian for Grant of Letters af Administratian (If appiicable) RENLJNCIATION +E.C�R-RICHARD W.TA��.,OR
c.t.a.,d.b.n.,d,b.n.c.t.a.,pendenie lit�turante abse�ttil,durant�tinoritate
If Administration,c�a. or d.b.n.c.�u,,enter date of WiIl in Section A above and complete iist of heirs.
Except as follows: Llecedent was nat a party to a pending divorce proceeding wherein the grouttds for divorce had been established as defined
in 23 Pa.C.S.§3323{g}and was neither the victim af a killing nor ever adjudicated an incagacitated person.
�NQ EXCEPTIONS a EXCEPTIONS
Petitioner{s},after a proper search hastt►ave ascertainefl that Decedent left no W ill and was survived by the follawing spause(if any}and heirs(attach
additional sheets, if necessary):
Name Relationshi Address
THOMAS W.TAYLOR SON 8837 PEDERNALES TRAIL,FT.WORTH,TX 76118
RICHAR.D W.TAYLOR SC1N 340 E. STONEQUARRY ROAD,VANDALIA,OH 45377
Fa,�nw az rev. lD/11/20// Page 1 af 2
Oath of Personal Representative Official Use Only
COMMONWEALTH OF PENNSYI;VANIA }
} SS:
COUNTY OF CUMBERLAND }
Petitioner(s)Printed Name Petirioner(s)Printed Address
THOMAS W.TAYLOR 8837 PEDERNALES TRAIL FT.WORTH TX 76118
T'he Petitioner(s)above-named swear(s)or affirm(s)the stateme ts' t e foregoing Peri on are true and correct to the best of the lrnowledge and belief
of Petitioner(s)and thzt,as Personal Representative(s)of the D c e ,the Petiti¢ner will well d truly administer the estate according to law.
Sworn to or a£firmed an subscri ed before � � Date � �'a�' �3
me ���day of ,c� Date
By�- , �,1, Date
For the Regisrer Date
BOND Required: Q YES Q NO To the Register of R'ills:
FEES: Please enter my appearance by my signature betow:
Letters . . . . . . . . . . . . . . . . . . . . . . $ 90.00 Attorney Signa e:
( ) Short Certificate(s).. . . . .
( 1 )Renunciation(s).. . . . . . . . 5.00 � �
( )Codicil(s). . . . . . . . . . . . .
( )Affidavit(s).. . . . . . . . . . .
Bond.. . . . . . . . . . . . . . . . . . . . . . . Printed Na e: MARCUS A.McKNIGHT, II
Commission. . . . . . . . . . . . . . . . . . Supreme C urt
Other . . . . . . . . ID Number: 25476
INVENTORY . . . . . . . . 15.00
INH TAX RETURN . . . . . . . . 15.00 Firm Name: IRWIN&McKNIGHT,P.C.
. . . . . . . . Address: 60 WEST POMFRET STREET
:_ . .,,.�
. . . . . . . . ('ARI.iSI.F.,PAr�17013 -- �..< --
� �.� - �
. . . . . . . m � _ �
. . . . . . . . Phone: (717)249-2353� :: �� .' ' : `•
Automation Fee. . . . . . . . . . . . . 5.00 Fax: (7171249-6354r- ` ' '
d r�
JCS Fee. . . . . . . . . . . . . . . . . . . . . 23.50 Ema�l: �= �} �
TOTAL. . . . . . . . . . . . . . . . . . . . . $ 153.50 c:a c-.. ". -,, �` ._
ti:-; C.W ��:�
DECREE OF THE REGISTER ` "`' `�`� '`'
y j � "`" �_-i
=-a
Estate of DOROTHY J.TAYLOR File No:
a/k/a:
AND NOW, , , in consideration of the foregoing Petition,
satisfactory proof having been presented before me, IT IS DECREED that Letters OF ADMINISTRATION
are hereby granted to THOMAS W.TAYLOR
in the above estate and(if applicable)that
the instrument(s)dated
described in the Petition be admitted to probate and filed of record as the last Will (and Codicil(s))of Decedent.
Register of Wills
Form RW-Ol rev. /0/11/2011 Page 2 of 2
H705.S05 REV 9/86
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 illegal to dupiicate this copy by photostat or photograph.
Fee for this certificate, $2�)��,'', , ;m � ;�, "" ..� _,,,,.�
_ �,,�p,Z F PF'' �� c��,�,��-�'
�- �,�� N�Y`- �,s�.�r/ C �
�'t`:�f ,,.��� -_ J'�._ �
,�`� __ __ = l= Local Registrar
'�:i3 r.�� C9 ,* y *�
��
P 9 2 6 8 6 4 3 �,� _:,�.�_-_`��9r s ��.a����°�� J U L 1 9 2003
� ;�;.�, „T,Q�„���'''
No. �k��'��'�� Date
CUMBERLAN� C�., PA
+3Hnv vai COMMONWEALTH OF PENNSYLVANIA•DEPAHTMENT OF HEALTH•VITAL RECORDS
CERTIFICATE OF DEATH
STATE flLE WMBER
NAME Of DECEOENT 1Fus�,Mbtlle.�av) SEX SOC�AL SECURITY NUMBER OA7E F DEATH,MCrnn,Oay,'2aq
,. �r +�� � . T iC� :. Fema.Pe �. 186 — 16 — 4528 .. �,1� ' � 1,
AGE�LaR 8inhtlay) UNDER 1 Y ,UNOEp 1 OAY DATE OF BIRTHPUCE ICny a� PLACE OF DEdH�C�eck oNy one--we m�ncuam nn qnn snx�
Manths � Dap Hou� . M4xnaa �.MOnm.Oay.'ee�� StaiaaFCrugnCwMry� MOSPITAI.: OTHER:
: S 81 rn s 1-20-1922 � (V�(.e{2Qd Bal!/te�P "w�"^`❑ ewoww��.��❑ ow❑ "�Q R..w,K..�1 °isv��»❑
� CAUNTY OF DE(fH CfTY,BORO.TWP Of OEATH FACILT'NAME 01 no1 ms�auuun.give sueat arW num0eri NNS OECEDENT OF HISPANIC ORIGIN4 RACE-Amwcan InOian,Bleck,IM�M�.�1c.
� No� W�0 q M.WKMCuEan. (9Gec9y)
' ,,. Cumbvc.�and .�, D�.cfz�n�un Tw . .,. 216 S�tane Hou�e Raad ;•�"'".Pe"°R"'"."` „ Glh�.�e
DE EDEHT'SUSUALOCCUPRION KIND�BUSINES&INDUSTRY WASDECEDENTEVENIN DECEDENT'SEDUCQION MARITALSTdUS-MarrnO $URVIVINGSPOUSE
(GrrakuMdwakup�etlwNtg rtwm U.S.MMEDFOR�qCE59 i n sc com WwrManiW,WidowW, �NwJO.�wmabennamel
olwofkinqlfN:OOndue��e6t00.) Yst❑ Nold [NmYntaryl:N<onCU1 COCaw DivorC1015V��Y)
- �,.. Co��w.inde�c ,,,. In�.t�umen.t Ca. ,:. ,,. '°,Z� 12 "•a5ij ,.. D�.vanced ,,.
OECEDENT'SMNIINGAODNE5S�5ve�l.Ciry/favn.SU�e.ZipCOdel �TUAINTS 17�.SIan Penn�y.�van�.a pid 17c.0`M.tNCWMVGwOin n,ir.h.in,�on ,,,,p.
216 S.tane Howse Road AESIDENCE o.�.a.m
u.L'WC�,tl�.ee� �A 11013 «��n��ei`„ ne.c ('�mb 1c r�l 'a""`"'°' »a.�m�';�.,��oi
Gn�.
FdHER'S NAME�FirsL Mroaw.Laa�) MOTHER'S NAME 1Fns1.Mioale.Matlen Swnama�
,,. Ree�se A. Ta�h.e�c ,,. Mabe� RavUSOm
INFORMANT'S NAME(fype�Print) INFORMANT'S MAILIN6 ADDRESS(Slreel.Gly/fown,SIeN.2ip CoW)
2a, R�.Chal[d W. T �on ,,,. 340 �a�.t S.tone ucvcn Road, Vanda��.a, UH 45377
MEfHOD OF DISVOSITION �y} DATE OF DISPOSITION PLACE OF OISPO ITION-Na pl C�mal�ry Cru�a LOCAT�ON•Cily/TOwn,SWI�.Ip CoM
Burw❑ Cr«natianYJ R�movallromSlau❑ IM°"'n.0ay.'�arl «Otnwv�ac� �helnLi�t.OVt JOC�(.e� Ob
• �,��^❑ �����-- �?e. Ju.ey 18, 2003 :,�. Penn� .�van�a Cnema.tan :,,. Nwcn�bwc , PA 17109
' S U OFFUNE S,F,. E PERSON T UCH LICENSENUMBER NAAIEANOAOORESSOFFACIUTY J[Qm ,(,Q{�, QC,,j,Q , 0 ennecI var..ca
• , :,„ 2,�, 4100 Jane�.tawn Raad, Hcvcn.i.�bun A 171 U9
itwns 23ac wMn � To IM 'k wNCqs,Malh occurreA at a rrr,tlj u ana plue s�ate0. \� LICENSE NUMBEH DATE SIGH�E,�Oar
uu..aaa�.' i z .. l�! V :/��� i-'�(J 7ad�'l �..�l.l�7 �(� Z— �Maw,.w�{ � �� �/�
is nd,vai a�um�ol w I�9�ewi � i-.
I
kams 242!mup Cy - IME OF �cf1� OATE RO OUyCED DEAD!/��.1ontn.Day,riarl^ wAS CASE REFERREO TO��ET/1AINEWCORONER7 �
• p�non�rtaWaaWwe�0aa1N. �/� /. /�
�/� 1 �/ JL
2�. �✓V M. t5. 1 �-X 3{. �
47.►AWT 1: E�f IM Oisaaf�s.injunes a CompGtaliona w�ich caused Ihe 0ea1�.Do rot aMer IM ol yirq,suc as car0iac or respira�ory arrnl,sMClc or hasrt la�lun. �Apprwimab P�qT 11: O�I�M sqnillpaM con�M�wns ooMnDWhq W AeaN,bR
lat oMy ar uua�m�atl�Iwr. �inwrvY hNwrn na ns�Y�inq n iM wiOeMyag uuM 9��n n MRf I.
�orwl a'b OW�
1MMEOIATE CAUSE(Fww 1
disease a condaon �
rnWwpncNaml—► a. '
DUE RASACON OUE OF1� � �
SpwnlilNy YY WnONOna D. �
aa�ry,Nadnp�oimmWiab UE (ORnS SE UEN EOF1: 1
Gua�.EMx UtlOERLYINO I
C+WSEIOise�e�a�ryury c �
• nat uutiatao ewrw �1 A .
rawMuq n awTl�T . i
C.
• WI1S AN AUTOPSV WERE AUTDPSY FiNdNGS MANNER OF DEA H DATE OF INJURY TIME OF INJURV IWURY AT WORK7 DESCRIBE HOW INJURY OCCURRED.
PERFORMED? A�MILwBLE PRIOR 70 �Mmm.Day.Yearl
C�MPLEf10N Of CAUSE
OFDE�OM9 Natwsl /bmKiG ❑
'Ns ❑ No❑
ACCitlBM ❑ PB(WUgInWllgelbn ❑
M.
Yp ❑ No Vn ❑ No S�ciM ❑ Could nW M detwmine0 ❑ PLACE OF IWUPV-A1 Mm�,tarm,S�reN,laclay.olflc� LOCATION iSlree�. /iown.Slala)
DuiWirq.wc.ISpec�wl
3M. ZlO. 29. JM. �Ol. �
CERTIFIERICMCkanfyonel SIGNA TI7LE CERTI I q /���/�''�`/ Y(
'CERTIFYINQ PNY8/GIAN�P�rycian cerldyxiq cause d oeaN wnen arroiner physican has pawuncea aeain ano canpeiea�tem 231
Te IM MA ot my knowNdp��Oe�N occurtW Ou�b tM cauw(ai a�tl ma��r���u1W..................................................... ❑ 310. �
�' • LICENS 8ER � DATESW DI .DsY. � �
�
'i1qNOUNCINOANOCERTiFY1NOPHY4IGAN�PAyvcanbuN;xona.ncingueatnarbceniM�+9�causedaeaNl �` ` D � � 'a � � �
.. . ' To NH bnt ol my knowNdqe.darlh oeewnd�t IM Gm�.O�b.anE Pl�c�.and Au�b tM uu�el�l and manmr u n��e0..........................
� � NAME AND ADOAESS OF P ON WMp COMM E C US�O DEAT .�
� Item 27�T �
-� • 'MEDICAL E%AMINENCORONER ( Y�Prinl . y� � � � /-��j" � Y".�� /�
ii �
On Ihe W�4 of�:amin�tlon snd/w inveatigatioa,in my opinion,duth occurrad at the time:dale�and plaea:and dw lo Ine causep)snd �J�(� ( �y j� ��,� '�
mNm�r as ita1W....................................... • � I./C!J i `7-T � • �� t rH�
�ta. ' •
]2.
REGISTMR'SS�G�HEANDNUMBER , � OATEfIIEDIMOnM.Day.Yeail
� ���...- � / �
oa. !r.or.!.... /��.G::K��✓-��° _._.� a..
�� /
�'�
. ��
� �� �..,.6
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1t�NiTNCIATION � �' {:'r , : �
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I, RICHARD W.TAYLOR . .in mp c��p�.city/relationship as
(Print NmireJ
S4N ofthe abave Deceden#,hereby renounce the right to
administer the Estaie of the Decedent and respe�ctfully request th�t Letters be issued to
THOMAS W.TAYLOR •
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Sworn to or affirme�and subscribed Before the und�rsigne�d personatlY apl�ea�'ed th�
befo me this � day pariy e�cecuting this nenunciation and certified
of " �,i,�,�__ that he or she executed the renunei�tio for the
purpo s tated ' ' an this,��,�G���F-----daY
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Deputy for Register af Wills Na ,—
�I Commission E�ires:�j���I�
{S�nahu�e a�Seat of Nota�y a other afficiat qualifiod tio
admin�ccr of oxp�tian af No#ary's Commission.}
o�P°'�'j�jv��.
�':�\ f`f.�•:� MARISSA L. BARDO�iARO
:� :
F�,��v-o� .�rn rs.n�s *� ,�;* �'otary Pubiic,State af Ohio
:��„i°=- �.�:: �Ay Camm�ssion Expires
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: BEFORE THE REGISTER OF WILLS OF
: CUMBERLAND COUNTY, PENNSYLVANIA
ESTATE OF DOROTHY J. TAYLOR, :
DECEASED :
: NO 21-03-0838
DECREE OF THE REGISTER OF WILLS
AND NOW,this 30th day of August,2013, upon consideration of the Petition for
Probate and Grant of Letters filed by Thomas W. Taylor, dated and filed on August 29,
2013, far the estate of Dorothy J. Taylor, IT IS HEREBY DECREED that the Petitioner
shall post surety bond in the amount of$100,000.00 in the name of the
Commonwealth. Pursuant to Cumberland County Local Rule 359, any corporation
acting as surety shall have filed in the office of the Prothonotary, a copy of its last
annual statement to the Insurance Commissioner of the Commonwealth of
Pennsylvania.
IT IS FURTHER DECREED that upon proper filing the Bond of Personal
Representative, Letters of Adminstration shall be granted to Thomas W. Taylor.
' Glenda Farner Strasbaugh, Register ills
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: {,�RPHANS' COURT DNISION
. COURT OF COMMON PLEAS OF
In Re: Dorothy J.Taylor . CUMBERLAND COUNTY
. PENNSYLVANIA
. N0.21-03-4838
CERTI�ICATE C1F SERVICE C}F CIRDER
ORDER DATE: 8l30113
NDGE'S 1NITIALS: GFS
TIME STAMP DATE: 9/4/13
IN RE: Decree of the Register of Wills
......................�......�..,.......,...............,.........�...............�...,,.,�...«..�............�............
SERVICE TO: Marcus A.McKni�;htIII 60 West Pomfret Street Carlisle PA 17013
METHOD QF MAILING: ENVELOPES PROVIDED BY:
�USPS ❑PETITIONER
❑RRR ❑ JUDGE
❑HAND DELIVERED �CLERK C}F ORPHANS COURT
❑OTHER
MAILED:9/5/13
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SERVTCE TO:
METHC}D flF MAILING: ENVELC}PES PRC}VIDED BY:
❑USPS ❑P'ETITIONER
❑RRR. ❑JUDGE
❑HAND DELIVBRED ❑CLERK OF ORPHANS COURT
❑OTHER
MAILED:
�
Deputy
Clerk of Qrphans' Court
CERTIFICATION OF NOTICE UNDER Pa. O.C. Rule 5.6(a)
REGISTER OF WILLS
CUMBERLAND COUNTY, PENNSYLVANIA
Name of Decedent: DOROTHY J. TAYLOR
Date of Death: JULY 17, 2003 File Number: 21-03-0838
Date Letters Granted: SEPTEMBER 30, 2013
To the Register:
1 certify that Notice of Estate Administration required by Pa. O.C. Rule 5.6(a)of the Orphans' Court
Rules was served on or mailed to the following beneficiaries of the above-captioned estate on
OCTOBER 1 2013
Name: Address:
THOMAS W.TAYLOR 8837 PEDERNALES TR. FT WORTH TX 76118
RICHARD W. TAYLOR 340 E. STONEQUARRY RD, VANDALIA OH 45377
(If mare space is needed, attach separate sheet.)
Notice has now been given to alt persons entitled thereto under Pa.O.C. Rule 5.6(a)except:
u bb
n N pat,O&OBER 1, 2013
J C� CZ Signature if Person F' " g his Form
O f.>
<7 U_ c3 c.3 o Capacity: Personal Representativ 0Counsel
n cr: ' MARCUS
C] h- -J Q LC Name ofPersan Filing this Form
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� ca 60 WEST POMFRET STREET
Uj � �,.� 4 � Address
CARLISLE,PA 17013
(717) 249-2353
Telephone
Form RFi'-Q$ rev.J0.13.06 \
___ _
CERTIFICATION OF NOTICE UNDER Pa. O.C. Rule 5.6(a)
REGISTER OF WILLS
CUMBERLAND COUNTY,PENNSYLVANIA
Name of Decedent: DOROTHY J. TAYLOR
Date of Death: NLY 17,2003 File Number: 21-03-0838
Date Letters Granted: SEPTEMBER 30, 2013
T ' the Register:
I ertify that Notice of Estate Administration required by Pa.O.C.Rule 5.6(a)of the Orphans' Court
Rules was served on or mailed to the following beneficiaries of the above-captioned estate on
OCTOBER 1 , 2013
Name: Address:
THOMAS W. TAYLOR 8837 PEDERNALES TR. FT WORTH TX 76118
RICHARD VV. TAYLOR 340 E. STONEQUARRY RD,VANDALIA OH 45377
(If more space is needed, attach separate sheet.)
Notice has now been given to all persons entitled thereto under Pa.O.C.Rule 5.6(a)except:
� � � C
._.., �,,,Q�f OBER 1,2013 ' �
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�,�, ""� �'� C�C ; Signature f Person F''g is Form
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� }�.- -J "Ct Name of Person Filing this Form
pr U� H._ C.� � � .
� � � � o� 60 WEST POMFRET STREET
� �W � � � Address
� �' CARLISLE,PA 17013
(717)249-2353
Telephone
Form RW-08 rev.10.13.06
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Bond No. 98-BC-x582-9
v BOND OF EXEZUTOR,ADMINISTRATOR
OR GUARDIAN
A ° �u
StateFarm C= M rn m
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STATE FARM FIRE AND CASUALTY COMF9- kNC ° -
BLOOMINGTON, ILLINOIS v v T
COMMONWEALTH OF PENNSYLVANIA o L'OURT:bP COMMON PLEAS
ss.
COUNTY OF CUMERLAND rn
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® Estate " c
IN THE MATTER OF THE ❑ Guardianship m "' ''
OF DOROTHY J TAYLOR D -�
® Deceased ❑ Ex ut� TI
❑ Incompetent Bond of ® Adrmiristrator=3
❑ Minor ❑ Guardian ;
❑ ro _
KNOW ALL PERSONS BY THESE PRESENTS: G
That we, THOMAS W TAYLOR
as Principal, and State Farm Fire and Casualty Company, a corporation of Illinois, as surety, are held firmly bound unto
the Commonwealth of Pennsylvania, in the penal Sum Of ONE HUNDRED THOUSAND AND NO 1100
Dollars ($ 100, 000.00 ),
for the payment of which we jointly and severally bind ourselves, our heirs, executors, administrators, successors, and
assigns.
THE CONDITION OF THE ABOVE OBLIGATION IS SUCH, that if the above bound principal shall faithfully
discharge the duties of his, her, their trust as ADMINISTRATOR , of the estate of
(EXECUTOR,ADMINISTRATOR,GUARDIAN,ETC.)
DOROTHY J TAYLOR according to law, then the above obligation is to be void, else to
remain in full force.
Dated, signed and sealed with our seals this 12TH day of SEPTEMBER , 2013
r..yxy,p,i
!t AY C4U
Principal
9E1E j'r1 STAT M FIRE AND 'ASU LTY COMPANY
ANomey-in-lad
Approved this day of
Attest:
COMMONWEALTH OF PENNSYLVANIA _
I swear that I will faithfully discharge the duties of my trust as
(EXECUTOR,ADMINIS ATOR.GUARDIAN,ETC.)
of the person and estate of DOROTHY J TAYLOR accor ing o law; so help me God.
3�� I PrincipeI
Subscribed and sworn to before me the day
COMMONWEALTH OF PENNSY�-SAN
Notarial seer
1005654 Caril9le swo,cum and Coan1Y 127144.1 07-05-2013
My Commis5ia0 E�Ins Dec 8 201S ES
MEMBER,PENN S'A.VA'NA ABia
ACKNOWLEDGMENT OF SURETY
ILLINOIS Y
SS V
County of MCLEAN
I, KAREN WEBER in and for said county in the state
aforesaid, do hereby certify that ALICE SCHULER , Attorney-in-Fact of STATE
FARM FIRE AND CASUALTY COMPANY of Bloomington, Illinois, a corporation duly organized and existing under the
laws of the State of Illinois, personally known to me to be the same person whose name is subscribed to the foregoing
instrument as Attorney-in-Fact of STATE FARM FIRE AND CASUALTY COMPANY, appeared before me this day in
person and acknowledged that he signed and delivered the said instrument as his and State Farm Fire and Casualty
Company's free and voluntary act for the uses and purposes therein set forth.
Given under my hand and official seal this 12TH day of SEPTEMBER , 2013
My Commission Expires
JULY 24 , 2014
ACKNOWLEDGMENT OF PRINCI A OFFICIAL SEAL
Karen Weber
COMMONWEALTH OF PENNSYLVANIA 1 NOTARY PUBLIC•STATE OF ILLINOIS
y SS my Commission Exom Duty 24,2014
County of ' �/ J
� � n i/Notary Public County Clerk
in and for said County, do hereby certify that �'Vy/'"Y
personally known to me to be the same person(s)whose name t�j subscribed to the foregoing
instrument as Principal, appeared before me this day in person and acknowledged that k e,
signed, sealed and delivered said instrument as 6 1 S free and voluntary act, for the uses and
purposes therein set forth.
Given under my han LTH OF PENNSYLVADt da of /f6 d
ood,Noa Y
Karen S.Nod,Notary Public
My Commission Expires Cedme Som,timberland Cou dy
Cpmmisxal ExPtres Oec a,20is
MtMSM PENNSYLVANIA AfiSlx]A 1O OP N AR16
Notary Public E] County Clerk
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Power of�„Attorney
I �
Y
STATE FARM FIRE AND CASUALTY COMPANY
KNOW ALL PERSONS BY THESE PRESENTS:That STATE FARM FIRE AND CASUALTY COMPANY,an Illinois corporation,with Its principal office in
Bloomington,Illinois,does hereby constitute and appoint:Jennifer Bless,Eugina Brant,Amanda J.Clifton,Ceola Campbell,Pamela Chancellor,Julie
Fehrman,Mark Fink,Julie Freed,Matthew J.Gibbons,John R.Horton,Cynthia Johnson,Susan K.Johnson,Connie S.Knox,Christine Macdonneii,Lori
McDowell,Melissa L.Morris,Mary Ann Nix,Vicki Redman,Leann Rees,Suzanne M.Robertson,Alice Schuler, Karen Sparks,Mary A.Spotts,Steven M.
Straub,Heidi Stevens,Perry Tracy,Karen Weber,Jennifer Wyant,Kadi Yoder of Bloomington,Illinois its true and lawful Attomey(s)-in-Fact,to make,
execute,seal and deliver for,and on its behalf as surety,any and all bands,undertakings or other writings obligatory in the nature of a bond as follows:
Any such obligation in any amount
This appointment is made under and b the author of a resolution which was assed.b A`eEitenutive Committee of the Board of
PP Y authority P )�,,..
Directors of State Farm Fire and Casualty Company on the 8 th day of June,2009, as is duly aabth'6dzred by the Board of Directors in Article
11,Section 8 of the By-Laws of the Company,which resolution is: )
Resolved,that the Officer of the Company who works regularly with surety$i3ndser�bq authorized to appoint and empower any
representative of the Company or other person or persons as AIto mey-ii $ct f1p ekecute,on"behaif of the Company any bonds,
undertakings,policies,contracts of indemnity or other writings obligatoq I -t a fe bf alb"and,which the Company might execute through
its officers,and affix the seat of the Company thereto.Any said exectatlorl'of such documents by an Attorney-in-Fact shall be as binding
upon the Company as if they had been duly executed and acknbwied'gad by;the regulary elected or appointed officers of the Company.Any
Attorney-in-Fact,so appointed,may be removed for good ras)septtd h�` u�2`hotit}f so granted maybe revoked as specified in the Power of
Attorney.
Resolved,that the signature of any Officer of ifie�omp>a o etl above and the seal of the Company may be affixed by facsimile on
any power of attorney granted,and the c r of the Company noted above,and the seal of the Company may be
affixed by facsimile to any certificate of an�r sd8b powWand arty such power or certificate bearing such facsimile signature and seal shah be
valid and binding on the Company.Art 'such power, ruled and sealed and certificate so executed and seated shall,with respect to
any bond or undertaking to which'itis attiii coi to be valid and binding on the Company.
IN WITNESS THEREOF, STATE FARM FIRE AND CASUALTY COMPANY has caused this instrument to be signed by its Assistant
Secretary Treasurer,anti5ts Corporate Seal to be affixed this 8 th, day of June,2009.
VX N-
This APP01Ni E ,.SHALL CEASE AND TERMINATE AUTOMATICALLY AS OF DECEMBER 31, 2013, UNLESS SOONER
REVOKED AS Pt2'0VIbED.
,Nf�`eu tyy IN STATE FARM FIRE AND CASUALTY COMPANY
.:� By:
kh`aw�......`_�;�•-x — istaM Se ary Treasurer
STATE OF ILLINOIS
COUNTY OF McLEAN
On this 8th day of June 2009, before me personally came Bradley M. Weaver to me known, who being duly sworn, did depose and say that he is
Assistant Secretary Treasurer of STATE FARM FIRE AND CASUALTY COMPANY,the corporation described in and which executed the above instrument;
that he knows the seal of said corporation;that the seal affixed to said instrument is such Corporate Seal;and that he executed said instrument on behalf of
the corporation by authority of his office under the By-Laws of said corporation.
OFFICIAL
Karen SEAL
Karen Weber Lk IWIA
NOTARY PUBLIC-STATE OF IWNOIS Notary Public
My Corn nisei on E)*w July 24,2014 CERTIFICATE My commission expires July 24,2014
1, the undersigned Officer of STATE FARM FIRE AND CASUALTY COMPANY, do hereby certify that the original Power of Attorney of which the
foregoing is a true and correct copy,is in full force and effect and has not been revoked and the resolutions as set forth are now in force.
Signed and sealed at Bloomington,Illinois.Dated this 112TH day of SEPTEMBER.2413.
„�'`Ftsao ta�ah,
4gv'`..SEAL .4F
Assistant Secretary Tre IV
If you have a question concerning the validity of this Power of Attorney,call(309)766.2090.
FB6.9043.47A
(01-03-12) Printed in U.S.A.
n t r
Agent Na ne �l t (�.{ Agent Code#&State !
Bond/Policy#�' y<�UOI — 1
SEP 12 2013
The enclosed materials were: Underwritten by:KAREN i` Typed by: KW Checked by:
The Fidelity& Surety Bond department appreciates your business. Please read the checked items.
Bond with power of attorney. After your insured has signed as Principal,he/she needs to send both to
the Obligee(entity requiring the bond).
• Resident Agent: if required, you will need to sign.
• Acknowledgment of Principal: if required,your insured will need to have a Notary Public
or County Clerk complete it.
Please verify this bond appears on your system. If it does not,please contact us immediately.
For renewals,a bill is being sent to the insured. If this renewal bond is not needed,please mark'cancel' and
return it to us.
❑ Indemnity Agreement: Please have appropriate person(s)sign where indicated, and return to us within 30 days.
❑ Continuation Certificate: with power of attorney. Your insured needs to send both to the Obligee(entity requiring
the bond). A bill is being sent to the insured. If the bond is no longer needed,please mark`cancel' and return
the original Continuation Certificate to us.
❑ Stipulation: (endorsement)with power of attorney. After your insured has signed as Principal,he/she needs to send
both to the Obligee(entity requiring the bond).
❑ When this indented box is marked, the Obligee(entity requiring the bond) must sign a copy of the
the stipulation and have it returned to us within 30 days.
❑ Bill: Attached for$ ❑Please collect the premium before releasing the bond to your insured.
To follow for$
❑ Fidelity Policy: This is for your insured,No countersignature is required.
❑ Fidelity-Amended Dec.Page/Change Form: This is for your insured.
❑ When this indented box is marked, the insured must accept the amendment by signing a copy and
have it returned to us within 30 days.
❑ Notary Public Errors and Omissions Liabilitv Insurance Policy: This is for your insured.
❑ Other.
State Farm Fire and Casualty Company
Fidelity & Surety Bond Department
One State Farm Plaza—D-1
Bloomington,Illinois 61710-0001
800-251-BOND (2663)
ABS>Business Lines> Fire> Bonds-Fidelity Surety
K:Bond Templates&Filenet: Commercial Unit: Agents Cover Utter 07/1/11 Sue
Oath of Personal Representative official Use only
COMMONWEALTH OF PENNSYLVANIA }
} SS:
COUNTY OF CUMBERLAND }
Petitioner(s)Printed Name Petitioner(s)Printed Address
THOMAS W.TAYLOR 8837 PEDERNALES TRAIL FT. WORTH TX 76118
The Petitioner(s)above-named swear(s)or affirm(s)the stateme is' i e foregoing Palo ton are true and correct to the best of the knowledge and belief
of Petitioner(s)and that,as Personal Representative(s)of the D c e ,the Petitidner will well a d truly administer the estate according to law.
Sworn to or affirmed an subscribed before i Date ` 'ate' t 3
me s day of_ Date
By _ Date
For the RegPS7ir Date
BOND Required: Q YES Q NO To the Register of Wills.
FEES: Please enter my appearance by my signature below:
Letters . . . . . . . . . . ... . . . . . . . . . $ 90.00 Attorney Signa e:
( )Short Certificate(s).....,
( I)Renunciation(s).. . . .. .. , 5.00 I I
( )Codicil(s). . . . . . . . . . . . .
( )Affidavit(s)..... . . . . . .,
Bond.. . . . _. . . . . .. .. _ _ _ Printed Na e: MARCUS A.McKNIGHT, lI
Commission, . . . . . . . . . . . . . . . . . Supreme C art
Other ID Number: 25476
INVENTORY . . . . . . . 15.00
INH TAX RETURN 15.00 Firm Name: IRWIN&MCKNIGHT, P.C.
. . . . . . , . Address: 60 W' ST POMFRET STREET
• • • • • • CARLISLE PA W1 �
'•J ' L7
. . . . . . . Phone: (717)249-2353Ln
Automation Fee. .. . . . . . . . . . 5.00 Fax: (717)249-6354-- t
JCS Fee. . . . . . . .. . . . . . . . . . . . . 23.50 Email: —�
TOTAL. . . . . . . . . . . . . . . . . . . . . $ 153.50
4D E
DECREE OF THE REGISTER —mot o
Estate of DOROTHY J.TAYLOR File No: 01—0,3 - TSB Y
a/kta:
AND NOW, .n YVI f �(� 20�3 in consideration of the foregoing Petition,
satisfactory proof having been presented before me, IT IS DECREED that Letters OF ADMINISTRATION
are hereby granted to THOMAS W.TAYLOR
in the above estate and(if applicable)that
the instrument(s)dated
described in the Petition be admitted to probate and filed of record as the last Will (and Codicil(s))of Decedent.
c
Register of Wills
P )Q
Form RW-02 rev. 1011112011 ,Page 2 of 2
Cumberland County - Register Of Wills
One Courthouse Square
Carlisle, PA 17013
Phone : (717) 240-6345
0
C_- ? rn
n
CD
Date : 7/01/2014
MCKNIGHT MARCUS A III r r
0
60 WEST POMFRET STREET
CARLISLE, PA 17013 c�
oa r- m
-V -i r
}� F-• cn o
RE: Estate of TAYLOR DOROTHY J
File Number: 2003-00838
Dear Sir/Madam:
This notice is to serve as a reminder that the Status Report by
Personal Representative under Rule 6 . 12 is due on the below listed
date .
As per the AMENDMENTS TO SUPREME COURT ORPHANS ' COURT RULES, NO. 103
SUPREME COURT RULES DOCKET NO. 1, for decedents dying on or after
July 1, 1992 , the personal representative or his counsel , within two
(2) years of the decedent ' s death, shall file with the Register of
Wills a Status Report of completed or uncompleted administration.
This filing is due by: 7/17/2014
Please feel free to contact this office with any questions you may
have. If you have already filed your Status Report, please disregard
this notice .
Sincerely,
Lisa M. Grayson,
Clerk of the Orphans ' Court
Pa. U.C. Rule 6.12 STATUS REPORT
REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA
Name of Decedent: DOROTHY J. TAYLOR
Date of Death: 07117/2003 File Number:21-03-0838
Pursuant to Pa. O.C. Rule 6.12, 1 report the following with respect to completion of the administration of
the above-captioned estate:
1. State whether administration of the estate is complete: . . . . . . . . . . . . . . . . . . . . 0 Yes O No
1 If the answer is No, state when the personal representative
reasonably believes that the administration will be complete:
NOVEMBER 2014
3. If the answer to No. l is YES, state the following: o
s rrnn
a. Did the personal representative file a final account with the Court? . . .rn .� 0 &E gff-K
t rn
b. The separate Orphans' Court No. (if any)for the personal r M W -,17
representative's account is: " a Co
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oc
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c. Did the personal representative state an account n cn
informally to the parties in interest? ❑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.
Dale JULY 3,2014
Signature a erron Filing 111 Co
Capacity: []Personal Representative JZCounset
MARCUS A. McKNIGHT, Ili
Nome of Perron Filing this Form
60 WEST POMFRET STREET
Address
CARLISLE, PA 17013
(717)249-2353
Telephone
Form RW-10 rer. 10.13.06
!V'1
1505610140
REV-1500 EX (01.10)
PA Depmbrant of Revenue OFFIOYIL URE ONLY
Bureau oflndMdwiTom Cantpcoft Year Fie Noft
PO ern(280301 INHERITANCE TAX RETURN 2 1 0 3 O B 3 8
Harrisburg.PA 17128-0301 RESIDENT DECEDENT
ENTER DECEDENT INFORMATION BELOW
Social Security Number Data of Death wormy YY Date of Bkth MIDDYYYY
0 7 1 7 2 0 0 3 0 1 2 0 1 9 2 2
DecedeM'e last Name SufAx Deoedent s Fkm Name MI
T A Y L O R D 0 R 0 T H Y J
Of Apptleabte)ErMr Survlvtnp Spousa'a blfomrailon Selow
Spouse's Last Name Sullrx Spouse's First Name Ml
Spoueeh Social Sawrity Number
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
FILL IN APPROPRIATE OVALS 9ELOW
® 1.OrWnal Retum ❑ 2.Supplemental Retum 3.RemabxW Retum(date of death
prior to 12-1342)
❑ 4.Limited Estate ❑ 48.FLWM IMorett Compromise(date of 0 3.Federal Estate Tax Return Requked
death after 12.12.82)
❑ 8 Decedent
(Attach Copy d Teslate ❑ 7.(DOwddslitMy� j LlAng Tnret — 8.TOfai Number of Sete Dapo0 Boxes
9.LXigation Proceeds R60Avd ❑ 10.Spousal Poverty*mk(date 0f death ❑ 11.Election to tax under Sec.9113(/)
between 12-31-91 and 1445) (Attach Soh.O)
CORRESPONDENT•THIS SECTIM MUST BE COMPLETED.ALLCORRE3PONDE CE AND CONFMEWK TAX INFORMATM SHOULD BE DIRECTED TO: 1
Name Daytime Telephone Number
M A R C U S A M c K N 16 H T , I I I 7 1 7 2 4 't= m3 5 -Y mM
A G-.) O
REGISTER OF WLCS %1g y N Sit
rim mrvn
First fine of addrou y` .a +�
I R W I N B M c K N I 6 H T P C T T T
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C7 c) O
Sawnd Ilne of address a'> T' n
r M
6 0 W E S T P 0 M F R E T S T R E E T '-
y � yo
C4 or Post ORke State EP Cade DATE FRED C.1
C A R L I S L E P A 1 7 0 1 3 -- - -»
CorrasponderR'e efnatl eddross:
Urdw PRY4ft Of Wj ry,t dechue 1 have ermnkmd ft rmen,kdu ft a n"sclmdaes end eteMnerxa,and b are seas of my kmawleODa ens eepet.
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SIGNA PERSON F fTUNGRETURN DATE /
ADDRESS
8837 P DERNALES TR. FT. WORTH TX 761
SIGNATURE OF PREPAR TM RFP ENTATNE DATE
ADDRM
60 WEST POMFRET ST EET CARLISLE PA 17013
PLEASE USE ORIGINAL FORM ONLY
Side 1
1505610140 1505610140
J 1505610240
REV-1500 EX
Decedent's Social Security Number
Decedent'sName: DOROTHY J . TAYLOR
RECAPITULATION
1. Real Estate(Schedule A) ... . . . . . . .. .. .. .. . . . . . . . . . . . . . .. .. . . . . . . . . .. 1.
2. Stocks and Bonds(Schedule B) .. . . . . . . .. . . . . . . . . . . . . . . . .. .. .. . . . . . . . 2.
3. Closely Held Corporation, Partnership or Sole-Proprietorship(Schedule C) .. . . . 3.
4. Mortgages and Notes Receivable(Schedule D) 4.
5. Cash, Bank Deposits and Miscellaneous Personal Property(Schedule E).. . .. . . 5.
6. Jointly Owned Property(Schedule F) Separate Billin g Requested . . .. . . . 6. 1 2 2 5 4 5 . 5 0
7. Inter-Vivos Transfers&Miscellaneous Non-Probate Property
(Schedule G) ❑ Separate Billing Requested . . . . . . . 7.
8. Total Gross Assets(total Lines 1 through 7) .. . . .. . . . . . . . . . . . . . . . . . . . . . 8. 1 2 2 5 4 5 . 5 0
9. Funeral Expenses and Administrative Costs(Schedule H) . . . . . .. . . . . . . . . . .. 9. 4 5 5 8 . 5 0
10. Debts of Decedent,Mortgage Liabilities,and Liens(Schedule 1) .. .. . . . . . . . . . 10.
i 1. Total Deductions(total Lines 9 and 10) .. . . . . . . . .. . .. . . . . . . . . . . . . . . . . . 11. 4 5 5 8 • 5 0
12. Net Value of Estate(Line 8 minus Line 11) . . . . . . . . . . . . . . . . . . . .. . . . . . . . 12. 1 1 7 9 8 7 . 0 0
13. Charitable and Governmental Bequests/Sec 9113 Trusts for which
an election to tax has not been made(Schedule J) . . .. . . . . . . .. . . . . . . .. .. 13.
14. Net Value Subject to Tax(Line 12 minus Line 13) . . . . .. . . . . . . .. .. . .. . .. 14. 1 1 7 9 8 7 . 0 0
TAX CALCULATION-SEE INSTRUCTIONS FOR APPLICABLE RATES
15. Amount of Line 14 taxable -
at the spousal tax rate,or
transfers under Sec.9116
(a)(1.2)X.0 _ 0 . 0 0 15. 0 . 0 0
16. Amount of Line 14 taxable
at lineal rate x.045 1 1 7 9 8 7 . 0 0 16. 5 3 0 9 . 4 2
17. Amount of Line 14 taxable
at sibling rate X.12 0 . 0 0 17. 0 . 0 0
18. Amount of Line 14 taxable
at collateral rate X.15 0 . 0 0 18. 0 . 0 0
19. TAX DUE .. . . . . . . . . . . . . . . . . . . . . .. . . . .. . . . . . . . . . . . .. .. . . . . . . . . .. 19. 5 3 0 9 . 4 2
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT ❑
Side 2
L 1505610240 1505610240
REVA 500 EX Page 3 File Number
Decedent's Complete Address: 21 03 0838
DECEDENT'S NAME
DOROTHY J. TAYLOR
STREET ADDRESS
216 STONE HOUSE ROAD
CITY STATE ZIP
CARLISLE PA 17013
Tax Payments and Credits:
I. Tax Due(Page 2,Line 19) (1) 5,309.42
2. Credits/Payments
A.Prior Payments
B.Discount
3. Interest Total Credits(A+B) (2) 0.00
4. If Line 2 is greater than Line 1 +Une 3,enter the difference.This is the OVERPAYMENT. (3)
Fill in oval on Page 2,Line 20 to request a refund. (4) 0.00
5. If Line 1+Line 3 is greater than Lire 2,enter the difference.This is the TAX DUE. (5) 5,309.42
Make check 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: Yes No
a. retain the use or income of the property transferred; ...................................................................... ❑ ❑X
b. retain the right to designate who shall use the property transferred or its income; ............................... ❑ ❑X
c, retain a reversionary interest;or ................................................................................................ ❑ ❑X
d. receive the promise for life of either payments,benefits or care? ....................................................... ❑ Q
2. If death occurred after December 12, 1982,did decedent transfer property within one year of death
without receiving adequate consideration? ....................................................................................... ❑ ❑X
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?.................................................................................................. ❑ ❑X
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES,YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
For dates of death on or after July 1, 1994,and before Jan. 1, 1995,the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is
3 percent[72 P.S.§9116(a)(1.1)(i)].
For dates of death on or after Jan. 1, 1995,the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0 percent
F2 P.S.§9116(a)(1.1)(ii)].The statute does not exempt a transfer to a surviving spouse from tax,and the statutory requirements for disclosure of assets and
filing a tax return are still applicable even if the surviving spouse is the only beneficiary.
For dates of death on or after July 1,2000:
• The tax rate imposed on the net value of transfers from a deceased child 21 years of age or younger at death to or for the use of a natural parent,an
adaptive parent or a stepparent of the child is 0 percent F2 P.S.§9116(a)(1.2)].
• The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5 percent,except as noted in
72 P.S.§9116(1.2)[72 P.S.§9116(a)(1)].
• The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12 percent F2 P.S.§9116(a)(1.3)].A sibling is defined,under
Section 9102,as an individual who has at least one parent in common with the decedent,whether by blood or adoption.
REV-1509 EX+(01-10)
pennsylvania SCHEDULE F
DEPARTMENT
INHERITANCE REVENUE
JOINTLY-OWNED PROPERTY
INHERITANCE TAX AX RETURN
RESIDENT DECEDENT
ESTATE OF: FILE NUMBER:
DOROTHY J. TAYLOR 21 03 0838
If an asset was made jointly owned within one year of the decedent's date of death,it must be reported on Schedule G.
SURVIVING JOINT TENANT(S)NAME(S) ADDRESS RELATIONSHIP TO DECEDENT
A. ESTATE OF ANNA M. HOOVER 60 WEST POMFRET STREET FRIEND
CARLISLE, PA 17013
B.
C.
JOINTLY-OWNED PROPERTY:
LETTER DATE DESCRIPTION OF PROPERTY % DATE OF DEATH
ITEM FOR JOINT I MADE INCLI IDF NAME OF FINANCIAL IN3TITUTK)N AND BANK ACCOUNT IJUMBER OR SIMILAR DATE OF DEATH DECEDENT'S VALUE OF
NUMBER TENANT JOINT IDENTIFYING NUMBER. ATTACH DEED FOR JOINTLY-HELD REAL ESTATE. VALUE OF ASSET INTEREST DECEDENTSINTEREST
1. A. 10/1972 216 STONEHOLISE ROAD, CARLISLE 245,091.00 50. 122,545.50
233,420 TAX ASSESSMENT X 1.05 COMMON LEVEL
RATIO=$245,091.00
TOTAL(Also enter on Line 6,Recapitulation) $ 122 545.50
If more space is needed,use additional sheets of paper of the same size.
REV-1511 EX+(10-09)
pennsylvania SCHEDULE H
DEPARTMENT OF REVENUE FUNERAL EXPENSES AND
RESIDENT DE TAX RETURN ADMINISTRATIVE COSTS
RESIDEM DECEDENT
ESTATE OF FILE NUMBER
DOROTHY J. TAYLOR 21 03 0838
Decedents debts must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
1.
B. ADMINISTRATIVE COSTS:
1. Personal Representative Commissions:
Names)of Personal Representative(s)
Street Address
City State ZIP
Years)Commission Paid:
2, Attorney Fees: IRWIN & MCKNIGHT, P.C. 4,000.00
3. Family Exemption:(If decedents address is not the same as claimants,attach explanation.)
Claimant
Sheet Address
City State ZIP
Relationship of Claimant to Decedent
4. Probate Fees: REGISTER OF WILLS 153.50
6 Accountant Fees:
6. Tax Return Preparer Fees: PATRICIA A. ROSENDALE, CPA 375.00
T REGISTER OF WILLS- FILING FEE 30.00
TOTAL(Also enter on Line 9,Recapitulation) $ 4,558.50
If more space is needed,use additional sheets of paper of the same size.
REV-1513 EX.(01-10)
pennsylvania SCHEDULE J
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN BENEFICIARIES
RESIDENT DECEDENT
ESTATE OF: FILE NUMBER:
DOROTHY J. TAYLOR 21 03 0838
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(S)RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE
I TAXABLE DISTRIBUTIONS [Includeou" ht spousal distributions and transfers under
Sec.91116(a)(1.2).]
1. THOMAS W. TAYLOR Lineal 58,993.50
8837 PEDERNALES TR. 1/2 REMAINDER
FT. WORTH, TX 76118
2. RICHARD W. TAYLOR Lineal 58,993.50
340 E. STONEQUARRY RD. 1/2 REMAINDER
VANDALIA, OH 45377
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 180F REV-1500 COVER SHEET,AS APPROPRIATE.
II. NON-TAXABLE DISTRIBUTIONS:
A.SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAXIS NOT TAKEN:
1.
B.CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS:
1.
TOTAL OF PART❑-ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. $
If more space is needed,use additional sheets of paper of the same size.
REGISTER OF WILLS CERTIFICATE OF
CUMBERLAND COUNTY GRANT OF LETTERS
PENNSYLVANIA ADMINISTRATION
No. 2003- 00838 PA No. 21- 03- 0838
Estate Of: DOROTHY✓ TAYLOR
!First,Middle,Cast)
Late Of: DICKINSON TOWNSHIP
CUMBERLAND COUNTY
Deceased
Social Security No:
WHEREAS, DOROTHY✓ TAYLOR
!First,Middle,Last/
late of DICKINSON TOWNSHIP CUMBERLAND COUNTY
died on the 17th day of July 2003 and,
WHEREAS, the grant of Letters of Administration
is required for the administration of the estate.
THEREFORE, I, GLENDA FARNER STRASBAUGH , Register of Wills in and
for CUMBERLAND County, in the Commonwealth of Pennsylvania, have
this day granted Letters of Administration to:
THOMAS W TAYLOR
who has duly qualified as ADMINISTRATOR (RIX) of the estate
of the above named decedent and has agreed to administer the estate
according to law, all of which fully appears of record in my office at
CUMBERLAND COUNTY COURTHOUSE, CARLISLE, PENNSYLVANIA.
IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed the seal
of my office on the 30th day of September 2013.
q�UgdQ .�i2m tL atob0,0r1h
o ,register of fills' p,' n
�1CMA�D 0 n A.P �,S M
**NOTE** ALL NAMES ABOVE APPEAR (FIRST, MIDDLE, LAST)
2009 .Remarks : 4 TEXT REMARKS 2010
PIN: ' 08-10-0626-021. OWner: FAILOR, ROBERT W JR
DATE TYPE BODY SUBJECT # of Remarks : 4
10/28/2013 OLT OLT SPLIT BY TRACTS LESS DB 201334659
10/28/2013 OLT CREATE PARCEL 08-10-0626-073 FROM THIS
10/28/2013 OLT PARCEL REM AC=7'.. 64 . DB 24D PG 821 AND
10/28/2013 OLT DB 24W PG 272 .
jo
NOTICE OF INHERITANCE TAX pennsytvania
ApgRAISEMENT, ALLOWANCE OR DISALLOWANCE DEPARTMENT OF REVENUE
BUREAU OF 1 4TAX 10- �
INHERITANCE TA?e6tojbff�FFIOE OF DEDUCTIONS AND ASSESSMENT OF REV-1547 EX AFP (11-14)
O6 - TEWI
HARRISBURG PA 17W:EP04OS' --
2019 rjrIC 29 rtM 12 22 DATE 12-29-2014
ESTATE OF TAYLOR . DOROTHY i
CLERK OF DATE OF DEATH 07-17-2003
ORPHANS' COURT FILE NUMBER 21 03-0838
COUNTY CUMBERLAND
MACTK �_ff iMARCIJS r'A A 101
L�L, L_ ' ' ' ' ' ' - ACN
IRWI T PCKNIGHT PC APPEAL DATE: 02-27-2015
60 W POMFRET ST (See reverse side under Objections)
CARLISLE PA 17013-3243 Amount RemittedF—
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
1 COURTHOUSE SQUARE
CARLISLE PA 17013
CUT ALONG THIS LINE RETAIN LOWER PORTION FOR YOUR RECORDS 4—
--------------
-
REV-1547 EX AFP C11-14) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF: TAYLOR DOROTHY JFILE NO. :21 03-0838 ACN: 101 DATE: 12-29-2014
TAX RETURN WAS: OO ACCEPTED AS FILED C CHANGED
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Real Estate (Schedule A) (1) .00 NOTE: To ensure proper
2. Stocks and Bonds (Schedule B) (2) .00 credit to your account,
00 submit the upper portion
S. Closely Held Stock/Partnership Interest (Schedule C) (S) *
of this form with your
4. Mortgages/Notes Receivable (Schedule D) (4) .00 tax payment.
5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) (5) .00
6. Jointly Owned Property (Schedule F) (0 122,545.50
7. Transfers (Schedule G) (7) .00
8. Total Assets (8) 122,545.50
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) C9) 4,558..50
10. Debts/Mortgage Liabilities/Liens (Schedule 1) (10) 00
11. Total Deductions (11) 4,558.50
12. Not Value of Tax Return (12) 117,987.00
13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) (13) .00
14. Net Value of Estate Subject to Tax (14) 117,987.00
NOTE: If an assessment was issued previously, Lines 14, 15, 16, 17, 18 and/or 19 will
reflect figures that include the total of all returns assessed to date.
ASSESSMENT OF TAX:
15. Amount of Line 14 at spousal rate (15) .00 X 00 = .00
16. Amount of Line 14 taxable at lineal rate (16) 117.987.nn x 045 = 5,309.42
17. Amount of Line 14 at sibling rate (17) nn x 12 = .00
18. Amount of Line 14 taxable at collateral rate (18) .00 X 15 = .00
19. Principal Tax Due (19)= 5,309.42
TAX CREDITS:
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID
08-25=2014 '-CD0-19G015,309:42-
BALANCE OF UNPAID INTEREST/PENALTY AS OF 08-26-2014 TOTAL TAX PAYMENT 5,309.42
BALANCE OF TAX DUE .00
INTEREST AND PEN. 2,644.80
TOTAL DUE 2,644.80
IF PAID AFTER DATE INDICATED, SEE REVERSE IF TOTAL DUE IS REFLECTED AS A CREDIT (CR), YOU MAY BE DUE
FOR CALCULATION OF ADDITIONAL INTEREST. A REFUND. SEE REVERSE SIDE FOR INSTRUCTIONS.
COMMONWEALTH OF PENNSYLVANIA REV-1162 EX�11-96)
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT.280601
HARRISBURG,PA 17128-0601
PENNSYLVANIA
RECEIVED FROM: INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
N0. CD 020266
MCKNIGHT MARCUS A III
60 WEST POMFRET STREET
CARLISLE, PA 17013
ACN
ASSESSMENT AMOUNT
CONTROL
NUMBER
-------- fold
101 $2,644.80
ESTATE INFORMATION: SSN:
FILE NUMBER: 2103-0838
DECEDENT NAME: TAYLOR DOROTHY J
DATE OF PAYMENT: 02/23/2015
POSTMARK DATE: 02/23/2015
COUNTY: CUMBERLAND
DATE OF DEATH: 07/17/2003
TOTAL AMOUNT PAID: $2,644.80
REMARKS:
CHECK# 036593
INITIALS: DMB
SEAL RECEIVED BY: LISA M. GRAYSON, ESQ.
REGISTER OF WILLS
REGISTER OF WILLS
NOTICE OF INHERITANCE TAX pennsytvania
BUREAU OF INDIVIDUAL TAXES APPRAISENENT, ALLOWANCE OR DISALLOWANCE DEPARTMENT OF REVENUE
INHERITANCE TAX VISION OF DEDUCTIONS AND ASSESSMENT OF TAX iff, REV-1547 EX AFP (11-14)
PO BOX
280601 A� 12
HARRISBURG 17 8-2.5�ORD-J -I I t vE
RECIST 7 -
- .0 14 DATE 12-29-2014
?0115 FEB 23 pl� 2 f 3 ESTATE OF TAYLOR DOROTHY J
RMN DATE OF DEATH 07-17-2003
FILE NUMBER 21 03-0858
CLEI.-L', OF ... COUNTY CUMBERLAND
MACNIGHT MARFUS,_-_A
1-1 A". ' ACN 101
IRWIN �4&K IT PC , I a.I
APPEAL DATE: 02-27-2015
P
60 W tr-tT' (See reverse side under Objections)
CARLISLE PA 17013-3243 Amount Remitted[
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
1 COURTHOUSE SQUARE
CARLISLE PA 17013
CUT ALONG THIS LINE -11 RETAIN LOWER PORTION FOR YOUR RECORDS 4--
iii:ii_4i--- ---------------
- -
DISALLOWANCE -OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF: TAYLOR DOROTHY JFILE NO. :21 03-0838 ACN: 101 DATE: 12-29-2014
TAX RETURN WAS. (X) ACCEPTED AS FILED C CHANGED
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Real Estate (Schedule A) Cl) .00 NOTE: To ensure proper
2. Stocks and Bonds CSchedule B) C2) .00 credit to your account,
3. Closely Held Stock/Partnership Interest (Schedule C) (3) .00 submit the upper portion
.00, of this form with your
4. Mortgages/Notes Receivable (Schedule D) (4) - tax payment.
S. Cash/Bank Deposits/Misc. Personal Property (Schedule E) (5) .00
6. Jdintly Owned Property (Schedule F) 122,545.50
7. Transfers (Schedule G) (7) .00
8. Total Assets (8) 122,545.50
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) (9) 4,558.50
10. Debts/Mortgage Liabilities/Liens CSchedula 1) (10) .00
11. Total Deductions (11) 4,558.50
12. Net Value of Tax Return C12) 117,987.00
13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) C13) .0 0
14, Net Value of Estate Subject to Tax (14) 117,987.00
NOTE: If an assessment was issued previously, Lines 14, 15, 16, 17, 18 and/or 19 will
reflect figures that include the total of all returns assessed to date.
ASSESSMENT OF TAX:
15. Amount of Line 14 at spousal rate cis) .00 X 00 = .00
16. Amount of Line 14 taxable at lineal rate (16) 1 1 7,9R7-on x 045 = 5,309.42
17. Amount of Line 14 at sibling rate (17) -nn X 12 = .00
18. Amount of Line 14 taxable at collateral rate (18) .00 X 15 = .00
19. Principal Tax Due (19)= 5,509.42
TAX CREDITS:
PAYMENT RECEIPT DISCOUNT AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID
08-25-2014 CDO19601 .0'0 5,309.42
BALANCE OF UNPAID INTEREST/PENALTY AS OF 08-26-2014 TOTAL TAX PAYMENT 5,309.42
BALANCE OF TAX DUE .00
INTEREST AND PEN. 2,644.80
TOTAL DUE 2,644.00
IF PAID AFTER DATE INDICATED, SEE REVERSE IF TOTAL DUE IS REFLECTED AS A CREDIT (CR), YOU MAY BE DUE
FOR CALCULATION OF ADDITIONAL INTEREST. A REFUND. SEE REVERSE SIDE FOR INSTRUCTIONS.
pennsyLvania
DEPARTMENT OF REVENUE
-BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX REV-1607 EX AFP (12-14)
INHERITANCE TAX DIVISION
PO BOX 280601 STATEMENT OF ACCOUNT
HARRjtFUW 1f12$-061 1 NC °
.' �_ .i ,- ��. DATE 03-16-2015
ESTATE OF TAYLOR DOROTHY J
?01� f R19 3 Pi� 1 L12 DATE OF DEATH 07-17-2003
FILE NUMBER 21 03-0838
L GH COUNTY CUMBERLAND
M , , . T ,.I Ij MARCUS A ACN 101
0'f 'kN`9 MCKNIGHT PC
Vib, W POMFRET ST ` Amount Remitted
CU
CARLISLE PA 17013-3243
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
1 COURTHOUSE SQUARE
CARLISLE PA 17013
NOTE: To ensure proper credit to your account, submit the upper portion of this form with your tax payment.
CUT ALONG THIS LINE --)I RETAIN LOWER PORTION FOR YOUR RECORDS E—
- - - -- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
REV-1607 EX AFP C12-14) *** INHERITANCE TAX STATEMENT OF ACCOUNT ***
ESTATE OF:TAYLOR DOROTHY J FILE NO. : 21 03-0838 ACN: 101 DATE: 03-16-2015
THIS STATEMENT PROVIDES CURRENT STATUS OF THE STATED ACN IN THE NAMED ESTATE. BELOW IS A SUMMARY OF THE PRINCIPAL
TAX DUE, APPLICATION OF ALL PAYMENTS, THE CURRENT BALANCE, AND, IF APPLICABLE, A PROJECTED INTEREST FIGURE.
DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 12-22-2014
PRINCIPAL TAX DUE: 5,309.42
PAYMENTS (TAX CREDITS) :
PAYMENT RECEIPT DISCOUNT C+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
08-25-2014 CDO19601 .00 5,309.42
02-23-2015 CD020266 2,644.80- 2,644.80
TOTAL TAX PAYMENT 5,309.42
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
TOTAL DUE
.00
IF PAID AFTER THIS DATE, SEE REVERSE SIDE FOR CALCULATION OF ADDITIONAL INTEREST.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM
FOR INSTRUCTIONS.
Pa. O.C. Rule 6.12 STATUS REPORT
REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA
Name of Decedent: DOROTHY J. TAYLOR
Date of Death: JULY 17, 2003 File Number:21-03-0838
Pursuant to Pa. O.C. Rule 6.12, 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
2. If the answer is No, state when the personal representative
reasonably believes that the administration will be complete:
DECEMBER, 2015
3. If the answer to No. I 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:
c. Did the personal representative state an account
informally to the parties in interest? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ❑ 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 a ched to th' eport.
Date JULY 2, 2015
Sig ure of P son Filing this Form
Ca city: ®Personal Representative Counsel
MARCU IGHT, III
Name of Person Filing this Form
� .� 60 WEST POMFRET STREET
Address
C> M �, c CARLISLE, PA 17013
U_ , ca
U_ U_ n— " r`'
o (717) 249-2353
ca
Q tX: C.0 LLLLJ Telephone
WW ICL
C
C.L1
rJ
w
"ems--=Form --10 rev. 10.16
0
n,
Cumberland County - Register Of Wills
One Courthouse Square
Carlisle, PA 17013
Phone : (717) 240-6345
M
Date : 6/30/2015CD
MCKNIGHT MARCUS A .III y w
rn
60 WEST POMFRET STREET
, ) c--,) Q T)
CARLISLE, PA 17013
� r- rn
GJ
a)
RE : Estate of TAYLOR DOROTHY J
File Number: 2003-00838
Dear Sir/Madam:
This notice is to serve as a reminder that the Status Report by
Personal Representative under Rule 6 . 12 is due on the below listed
date .
As per the AMENDMENTS TO SUPREME COURT ORPHANS ' COURT RULES, NO. 103
SUPREME COURT RULES DOCKET NO. 1, for decedents dying on or after
July 1, 1992 , the personal representative or his counsel, within two
(2) years of the decedent ' s death, shall file with the Register of
Wills a Status Report of completed or uncompleted administration.
This filing is due by: 7/17/2015
Please feel free to contact this office with any questions you may .
have . If you have already filed your Status Report, please disregard
this notice .
Sincerel ,
r Lisa M. Grayson, Esq.
Clerk of the Orphans ' Court
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ESTATE OF : IN THE COURT OF COMMON PLEAS
DOROTHY J. TAYLOR : CUMBERLAND COUNTY, PENNSYLVANIA
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: ORPHANS' COURT DIVI�IQ�N �-r =' �
. NO. 21-03-0838 -� �' `-" � `�'
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PETITION TO RELEASE BOND � _ � ' . ; ;
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TO THE HONORABLE JUDGES OF SAID COURT: c,� ,; .: ��;:�
C1"l .. �7
Marcus A. McKnight, III, your Petitioner, files this Petition to Release BeRd and�'i`n
support thereof avers that:
(1) Your Petitioner, Marcus A. McKnight, III is a competent adult and is the attorney
of record for the Estate of Dorothy J. Taylor.
(2) The Decedent, Dorothy J. Taylor, died on July 17, 2013.
(3) Letters of Administration for the Estate of Dorothy J. Taylor were granted on
September 30, 2013 to Thomas W. Taylor. Grant of Letters is attached hereto as
Exhibit"A."
(4) A Bond and Surety was issued by State Farm Fire and Casualty Company in the
amount of $100,000.00 on September 12, 2013. Bond and Surety is attached
hereto as Exhibit"B."
(5) A Decree that the Administrator of the Estate of Dorothy J. Taylor shall post a
surety bond in the amount of$100,000.00 in the name of the Commonwealth was
filed on September 26, 2013. Decree of the Register of Wills is attached hereto as
Exhibit"C."
(6) Inheritance tax payments in the amount of$7,954.22 were made to the Register of
Wills on August 25, 2014 and February 23, 2015. Receipts are attached hereto as
Exhibit"D."
(7) The Pennsylvania lnheritance Tax Return was filed on August 22, 2014.
(8) Approval from the Pennsylvania Department of Revenue for the Inheritance Tax
Return filed was received on December 31, 2014. Approval is attached hereto as
Exhibit"E."
�
�
(9) The Status Report stating the estate is complete was filed on September 23, 2015.
Status Report is attached hereto as Exhibit"F."
WHEREFORE, your Petitioner respectfully requests that an Order be issued closing the
estate and releasing and discharging State Farm Fire and Casualty Company from the Bond.
��
By
Marcus A. McKnight, III, Esq ' e
Supreme Court LD.No. 25476
IRW1N& McKNIGHT, P.C.
60 West Pomfret Street
Carlisle, PA 17013
(717 -
REGISTER OF WILLS CERTIFICATE OF
CUMBERLAND COUNTY GRANT OF LETTERS
PENNSYLVANIA ....... .. ADMINISTRATION
, �` I i
No. 2003- 00838 PA No. 21- 03- 0838
Estate Of: DOROTHYJ TAYLOR �
(First,Middle,Lastl
La te Of: DICKINSON TOWNSHIP
CUMBERLAND COUNTY
Deceased
Social Securi ty No:
WHEREAS, DOROTHYJ TAYLOR
(FirsG Middle,LasU .
late of DICKINSON TOWNSHIP CUMBERLAND COUNTY
died on the 17th day of July 2003 and,
WHEREAS, the grant of Letters of Administration
is required for the administration of the estate.
THEREFORE, I, GLENDA FARNER STRASBAUGH , Regi s ter of Wi 11 s in and
for CUMBERLAND County, in the Commonwealth of Pennsylvania, have
this day granted Letters of Administration to:
THOMAS W TAYLOR
who has duly qualified as ADMINISTRATOR (RIX) of the estate
of the above named decedent and has agreed to administer the estate
according to law, all of which fully appears of record in my office at
CUMBERLAND COUNTY COURT HOUSE, CARLISLE, PENNSYL VANIA.
IN TESTIMONY I�JHEREOF, I have hereunto set my hand and affixed the seal
of my office on the 30th day of September 2013.
egister of ills " '
(���r� Q� �� �� «�1�5�
Deputy
**NOTE** ALL NAMES ABOVE APPEAR (FIRST, MIDDLE, LAST)
_ _ _ _
___ _
' � : BEFORE THE REGISTER OF WILLS OF
: CUMBERLAND COUNTY,PENNSYLVANIA
ESTATE OF DOROTHY J. TAYLOR, :
DECEASED :
: NO 21-03-0838
DECREE OF TI�REGISTER OF WII,LS
AND NOW,this 30th day of August,2013,upon consideration of the Petition for
Probate and Grant of Letters filed by Thomas W. Taylor, dated and filed on August 29,
2013, for the estate of Dorothy J. Taylor, IT IS HEREBY DECREED that the Petitioner
shall post surety bond in the amount of$100,000.00 in the name of the
Commonwealth. Pursuant to Cumberland County Local Rule 359, any corporation
acting as surety shall have filed in the office of the Prothonotary, a copy of its last
annual statement to the Insurance Commissioner of the Commonwealth of
Pennsylvania.
T S FURTHER DECREED that upon proper filing the Bond of Personal
---
Representative, Letters of Adminstration shall be granted to Thomas W. Taylor.
� Glenda Farner Strasbaugh, Register ills
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COMMONWEALTH OF PENNSYLVANIA REV-1162 EX(11-96)
DEPARTMENT OFREVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT.280601
HARRISBURG,PA 1 71 28-060 7
PENNSYLVANIA
RECEIVED FROM: INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
N0. CD 020266
MCKNIGHT MARCUS A III
60 WEST POMFRET STREET
CARLISLE, PA 17013
ACN
ASSESSMENT AMOUNT
CONTROL
NUMBER
-------- fold
_____'____ ___""'
101 � $2,644.80
ESTATE INFORMATION: sSN: I
FILE NUMBER: 2103-0838 �
�ECE�ENT NannE: TAYLOR DOROTHY J �
DATE OF PAYMENT: 02/23/201 5 I
POSTMARK DATE: 02/23/201 5 I
COUtvTY: CUMBERLAND �
DATE OF DEATH: 07/17/2003 (
�
TOTAL AMOUNT PAID: 52,644.80
REMARKS:
CHECK# 036593
INITIALS: DMB
SEAL RECEIVED BY: LISA M. GRAYSON, ESQ.
REGISTER OF WILLS
TAXPAYER
COMMONWEALTH OF PENNSYLVANIA REV-1162 EX�11-96)
DEPARTMENT OFREVENUE
BUREAU OF��}UDIVIDUAL TAXES
D f��(.280601 �
HARRISBURG,PA 17128-0601 •
PENNSYLVANIA
RECEIVED FROM: INHERITANCE AND ESTATE TAX
9
OFFICIAL RECEIPT
N0. CD 019601
MCKNIGHT MARCUS A III
60 WEST POMFRET STREET
CARLISLE, PA 17013
ACN
ASSESSMENT AMOUNT
CONTROL
NUMBER
-------- }o�d
"""'_" "'_""
101 � $5,309.42
ESTATE INFORMATION: sstv: � I
FILE NUMBER: 2103-0838 �
�ECE�E►vT rvAME: TAYLOR DOROTHY J �
DATE OF PAYMENT: 08/25/2014 I
POSTMARK DATE: 08/25/2014 I
courvTY: CUMBERLAND �
DATE OF DEATH: 07/17/2003 I
�
TOTAL AMOUNT PAID: 55,309.42
REMARKS:
CHECK# 36107
INITIALS: CJ
SEAL RECEIVED BY: LISA M. GRAYSON, ESQ.
REGISTER OF WILLS
TAXPAYER
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�ir������ IX��-��
PA f�btNlnt of Revenue OF19CiAt ilaE ONLY
8u[eau r�f individuai Taxes Cowkyr C�e Yeat F9e NumBe�
����� INHERFTANCE TAX RETURN � 1 Q 3 � 8 3 8
bur�.PA 17428-060i RESI�DENT D�ELIENT
ENYER DEGE+DENT INEtNt�AA710N BF�.OW �
SoCNpI Seeul�y Numbp' Deda of Destl� l�QDYVYY Dabe o}Bkth MNDDtrml
Q 7 1 ? 2 0 0 3 0 1 2 Q I+ 9 2 2
Deoeda�'s L.�at Name Suflix Deaedent's Fint Name Mt
TAYLt3R D4ROTHY J
(it Applkabla�Enbr SurvWinp Spouse's Infor�na�on Bsia�r
SPouse s Lest Nanle Suftix Spou�'�FlrBt N�te M{
Spouee's Sociai Socurity Number
THiS ItEi11RN MUST BE FIL.ED IN DUPUCATE WITH THE
REGISTER OF W1f.LS
FtLL IN APPROPE�ATE OVA6g�LOW ,
� �.a�i�,ei��, p z.s��� � 3.Remainder Retum(+c�e cf deaih
pdortn t2-13=62)
� 4.tint�ed F�be � 4a.Fudma i�erest Gomptomiss(daEe of � S.fede�al Este6B Tax RaWm Raquirad
death�dEer t212-�)
❑ 6.Dscedettt Dled Teslate � 7.Oecad�t MBinpdt�ed a Uving Tn�t _ 8.To�at Ntm�ber of SaTe DepopR Bo�s
EAltach Copy of W�Q {At(ach Gqpy of'Tiust)
� B lit�atior�Pro�ds Received � t Q.5pousal P�vertg Cre�t(daEs of cwath Q t1.Ela�ton to ta�c under Soc.9f 43(Aj
�ween�z�l-91 and�-1-sby {A�ecn s�1,.o�
CORi�ESP�N�1T-11N8�'f10q�JST BE Wl�l.ETER I�.L C�p10E 141�tAll�lTiql.TAX�W1Tq11�dUf.D BE p�CTED T0:
Name Daytime T�ept�as 1�pnnber � � �
M A R C tl S A . M c K N I G H T , I I I 7 1 7 �4�,`�9 2 � 5 �
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City or Post Otiice 3tate ZtP Code �ItTE�ED �
C A R L I S L E P A 1 7 0 1 3 �'
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urwer w p�u�wy,t a.crare � �a�n�t aas r�um,r«�udtne�t�a�►eau�as�d smo�ns,anato u�e beee ormy a�we�s�w ae�er,
it�bue, oontpta6e• ' aFprep�rerad�thNt tl�e persaud te�nbNvc�l��eed an ml i�bnn�n af whidt p[epauer tas a�
SIDNAT E�OR RETURH pq'�
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8837 p ERN LES T FT• WORi'H TX ?6� 8
SIONATURE f�oFtEP E RE6ENTATNE, �
f
auoREss
6� �EST PQMFRE STREET tAR iStE PA 170Z3
PLEJtiSE USE ORltilNAL FORY ONLY
Stde 1 .�;,�,�.,.,,�ao..� ,� : -
"�+�
� 15�561�!]�40 1505610]�4U ' ���
J 150561�240
REV-1500 EX
DecedenYs Social Security Number
DecedenYs Name: D O R O T H Y J • T A Y L O R
RECAPITULATION
1. Real Estate(Schedule A) .. . . . . .. . . .. . . . ... . . ... . .. .. . .. .. . .. . . ... .. �• •
2. Stocks and Bonds(Schedule B) .. . . . . . . . . . ... .. . .. . .. .. . .. .... .. . .. . . Z• •
3. Closely Heid Corporation,Pa�tnership or Sole-Proprietorship!Sche�iule C) .. . . . 3. •
4. Mortgages and Notes Receivable(Schedule D) . . .. . .. . ... .. ... .. . . ... ... 4. •
5. Cash, Bank Deposits and Miscellaneous Personal Property(Schedule E).. .. .. . 5. •
6. Jointl Owned Pro ert Schedule F 1 2 2 5 4 5 . 5 0
y p y( ) ❑ Separate Billing Requested .. .... . 6.
7. Inter-Vivos Transfers&Miscellaneous Non-Probate Property
(Schedule G) � Separate Billing Requested .. .. .. . 7. .
8. Total Gross Assets(total Lines 1 through 7) .. . . . .. . . ... . ... .. .. . . ... . . 8. 1 2 2 5 4 5 , 5 0
9. Funeral Expenses and Administrative Costs(Schedule H) ... .. .. .... .... ... 9• 4 5 S 8 . 5 0
10. Debts of Decedent,Mortgage Liabilities,and Liens(Schedule 1) .. .. .... ... . . 10. •
i�. Total Geductior�s(total Lines 5 and i�) . . . ... . . .. . . .. .. . . ... ... ... . ... 11. �I � 5 8 . $ �
12. Net Value of Estate(Line 8 minus Line 11) .. .. .. . .. . .. ... .. .. . . ... . .. . 12• 1 1 7 9 8 7 . 0 0
13. Charitable and Governmental BequestslSec 9113 Trusts for which
an election to tax has not been made(Schedule J) .. . .. .. .. .. .. ... . .... . 13• •
14. Net Value Subject to Tax(Line 12 minus Line 13) ... . ... .. . .. . .. .... .. . 14. 1 1 7 9 8 7 . 0 0
TAX CALCULATION-SEE INSTRUCTIONS FOR APPLICABLE RATES
15. Amount of Line 14 taxable
at the spousal tax rate,or
transfers under Sec.9116
(a)(1.2)X.0 _ 0 . 0 0 15. 0 . 0 Q
16. Amount of Line 14 taxable
at�inea�rate X.045 1 1 7 9 8 7 . 0 0 �s. 5 3 0 9 . 4 2
17. Amount of Line 14 taxable
at sibling rate X.12 0 . 0 0 17. 0 . 0 0
18. Amount of Line 14 taxable
at collateral rate X.15 � • � � 1 g, � • � �
19. TAX DUE . . . . . . . . . .. . . . . . . . . .. . .... . .. . .. .. . .. .. .. .. . . .. . .. . . . . 19. 5 3 0 9 • 4 2
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT �
Side 2
L 1505610240 1505610240 J
REV-1500 EX Page 3 File Number
Decedent's Complete Address: 2� 03 os3s
DECEDENTS NAME
DOF�OTHY J. TAYLOR
STREET ADDRESS
216 STONE HOUSE ROAD
CITY STATE ZIP
CARLISLE PA 17013
Tax Payments and Credits:
1� Tax Due(Page 2,Line 19) (1) 5,309.42
2. Credits/Payments
A.Prior Payments
B.Discount
Total Credits(A+B) (2) 0.00
3. Interest
4. If Line 2 is greater than Line 1+Line 3,enter the difference.This is the OVERPAYMENT. (3>
Fill in oval on Page 2,Line 20 to request a refund. (4) 0.00
5. !f Line 1+!ine 3 is greater than Line 2,enter the diffe!ence.T�is is:he T�X DJE. (5) 5,30�.42
Make check 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: Yes No
a. retain the use or income of the property transferred: ...................................................................... ❑ X�
b. retain the right to designate who shall use the property transferred or its income; ............................... ❑ �X
c. retain a reversionary interest;or ................................................................................................ ❑ �
d. receive the promise for life of either payments,benefits or care? ....................................................... ❑ ❑X
2. If death occurred after December 12,1982,did decedent transfer property within one year of death
without receiving adequate consideration? ....................................................................................... ❑ X❑
3. Did decedent own an"in trust for"or payable-upon-death bank account or security at his or her death? ......... ❑ XD
4. Did decedent own an individual retirement account,annuity or other non-probate property,which
contains a beneficiary designation?.................................................................................................. ❑ 0
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES,YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
For dates of death on or after July 1, 1994,and before Jan. 1, 1995,the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is
3 percent p2 P.S.§9116(a)(1.1)(i)].
For dates of death on or after Jan. 1, 1995,the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0 percent
[72 P.S.§9116(a)(1.1)(ii)].The statute does not exempt a transfer to a surviving spouse from tax,and the statutory requirements for disclosure of assets and
filing a tax return are still appiicable even if t�ie s�raiving spouse;s Lhe o�ly�eneficiary.
For dates of death on or after July 1,2000:
• The tax rate imposed on the net value of transfers from a deceased child 21 years of age or younger at death to or for the use of a natural parent,an
adoptive parent or a stepparent of the child is 0 percent[72 P.S.§9116(a)(1.2)].
• The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5 percent,except as noted in
72 P.S.§9116(1.2)[72 P.S.§9116(a)(1)].
• The tax rate imposed on the net value of transfers to or for the use of the decedenYs siblings is 12 percent[72 P,S.§9116(a)(1.3)].A sibling is defined,under
Section 9102,as an individual who has at least one parent in common with the decedent,whether by blood or adoption.
REV-1509 EX+(01-10)
pennsylvania SCHEDULE F
DEPARTMENT OF REVENUE �OINTLY-OWNED PROPERTY
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF: FILE NUMBER:
DOROTHY J. TAYLOR 21 03 0838
If an asset was made jointly owned within one year of the decedenYs date of death,it must be reported on Schedule G.
SURVIVING JOINT TENANT(S)NAME(S) ADDRESS RELATIONSHIP TO DECEDENT
A. ESTATE OF ANNA M. HOOVER 60 WEST POMFRET STREET FRIEND
CARLISLE, PA 17013
s.
c.
JOINTLY-OWNED PROPERTY:
LETTER DATE DESCRIPTION OF PROPERTY %OF DATE OF DEATH
ITEf� �OR JOINT MnDF � I;JCLUDE PiAt�tE GF FlNAivCIAL IivSTITUTiON AN�J BANK ACGGUNT NUMBER OF.SIMILAn �ATE OF DE4TH DECEDEMT'E VALUE OF
NUMBER TENANT JOINT IDENTIFYING NUMBER.ATTACH DEED FOR JOINTLY-HELD REAL ESTATE. VALUE OF ASSET INTEREST DECEDENTS INTEREST
1. A. 10/1972 216 STONEHOUSE ROAD, CARLISLE 245,091.00 50. 122,545.50
233,420 TAX ASSESSMENT X 1.05 COMMON LEVEL
RATIO=$245,091.00
TOTAL(Also enter on Line 6,Recapitulation) $ 122 545.50
If more space is needed,use additional sheets of paper of ihe same size.
REV-1511 EX+(10-09)
�ennsylvania SCHEDULE H
DEPARTMENT OF REVENUE FUNERAL EXPENSES AND
INHERITANCE TAX RETURN ADMINISTRATIVE COSTS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
DOROTHY J. TAYLOR 21 03 0838
DecedenYs debts must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
1.
B. AD�4INISTRAT!VE GOSTS:
1. Personal Representative Commissions:
Name(s)of Personal Representative(s)
Sheet Address
City State ZIP
Year(s)Commission Paid:
p, Attomey Fees: IRWIN &McKNIGHT, P.C. 4,000.00
3. Family Exemption:(If decedenYs address is not the same as claimanYs,attach explanation.)
Claimant
Street Address
City State ZIP
Relationship of Claimant to Decedent
4� ProbateFees: REGISTER OF WILLS 153.50
5 Accountant Fees:
6. Tax Retum Preparer Fees: PATRICIA A. ROSENDALE, CPA 375.00
7. REGISTER OF WILLS-FILING FEE 30.00
TOTAL(Also enter on Line 9,Recapitulation) $ 4 558.50
If more space is needed,use additional sheets of paper of the same size.
• REGISTER OF WILLS CERTIFICATE OF
CUMBERLAND COUNTY GRANT OF LETTERS
PENNSYLVANIA ADMINISTRATION
r
No. 2003- 00838 PA No. 21- 03- 0838
Estate Of: DOROTHYJ TAYLOR
fFiisf,Midd/e,Last1
La te Of: D/CKINSON TOWNSH/P
CUMBERLAND COUNTY
Deceased
Soci al Securi ty No:
WHEREAS, DOROTHYJ TAYLOR
(First Midd/e,LasU
late of DICKINSON TOtnTNSHIP CUMBERLAND COUNTY
died on the 17th day of Ju1y 2003 and,
WHEREAS; the grant of Letters of Administration
is required for the administration of the estate.
THEREFORE, I, GLENDA FARNER STRASBAUGH , Register of Wi11s in and
for CUMBERLAND County, in the Commonwealth of Pennsylvania, have
this day granted Letters of Administration to:
THOMAS W TAYLOR
who has duly qualified as ADMINISTRATOR (RIX) of the estate
of the above named decedent and has agreed to administer the estate
according to law, all of which fully appears of record in my office at
CUMBERLAND COUN"TY COURT HUUSE, CAfiLISLE, PE/VNSYL VAN/A.
IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed the seal
of my offi ce on the 30th da y of September 2013.
. egis:er of ills . �
�1 fl�Q d, �V' �{.1��.(.l��i`1cS�'�l
Deputy
**NOTE** ALL NAMES ABOVE APPEAR (FIRST, MIDDLE, LAST)
2009 Remarks: 4 TEXT REMARKS 2010
PIN: 08-10-0626-021. Owner: FAILOR, ROBERT W JR
DATE TYPE BODY SUBJECT # of Remarks: 4
10/28/2013 OLT OLT SPLIT BY TRACTS LESS DB 201334659
10/28/2013 OLT CREATE PARCEL '08-10-0626-073 FROM THIS
10/28/2013 OLT PARCEL REM AC=7'. 64 . DB 24D PG 821 P�TD
10/28/2013 OLT DB 24W PG 272 .
�33, �z� X
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NOTICE OF INHERITANCE TAX � pennsylvania
BUREAU oF t��--�VIDUAL raxEs APPRAISEMENT, ALLOWANCE OR DISALLOWANCE
INHERITANCE TAX GTVISION OF DEDUCTIONS AND ASSESSMENT OF TAX � DEPARTMENT OP REVENUE
PO BOX 260601 - REV-1547 IX AFP (11-14)
HARRISBURGfPA 17128-0601
,.. _
DATE 12-29-2014
��-�,° ESTATE OF TAYLOR DOROTHY J
_ DATE OF DEATH 07-17-2003
'` ' "'� FILE NUMBER 21 03-0838
,�
MACNIGHT III MARCUS q ' COUNTY CUMBERLAND
IRWIN 8� MCKNIGHT PC ACN 101
APPEAL DATE: 02-27-2015
6 0 W P 0 M F R E T S T (See reverse side under Objections)
CARLISLE PA 17013-3243 Amount Remitted
MAKE CHECK PAYABLE AND REMIT PAYMENT T0:
REGISTER OF WILLS
1 COURTHOUSE SQUARE
CARLISLE PA 17013
CUT ALONG THIS LINE ____ ---► RETAIN LOWER PORTION FOR YOUR RECORDS F--
-------------------- -----------------------
REV-1547 EX AFP (11-14� NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR
------------
BISA�LOWAhCE OF DEDilCTIONS AND ASSESSMENT OF TAX
ESTATE OF: TAYLOR DOROTHY JFILE N0. :21 03-0838 ACN: 101 DATE: 12-29-2014
TAX RETURN WAS: C X) ACCEPTED AS FILED C ) CHANGED
APPRAISED VALUE OF RETURN BASED ON: ORI6INAL RETURN
1. Real Estate (Schedule A) �1) .0 0
NOTE: To ensure proper
2. Stocks and Bonds CSchedule B) C2� .00 credit to your account,
3. Closely Held Stock/Partnership Interest (Schedule C) �3� .00 submit the upper portion
4. Mortgages/Notes Receivable (Schedule D) .�� of this form with your
C4� tax payment.
5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) (5) •00
6. Jo'intly Owned Property (Schedule F) �6� 122,545.50
7. Transfers CSchedule G) ��� .0 0
8. Total Assets
cs� _ 122, 45 50
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adm. Costs/Misc. Expenses CSchedule H) �q�_ 4.558 50
10. Debts/Mortgage Liabilities/Liens CSchedule I) (10) .00
11. Total Deductions C11) 4,558.50
12. Net Value of Tax Return 117,987.00
C12)
13. Charitable/6overnmental Bequests; Non-elected 9113 Trusts (Schedule J) .00
14. Net Value of Estate Subject to Tax C13)
c14� - 117,987.00
NOTE: If an assessment was issued previously, Lines 14, 15, 16, 17, 18 and/or 19 will
reflect figures that include the total of all returns assessed to date.
ASSESSMENT OF TAX:
15. Amount of Line 14 at spousal rate C15) .00 X 00 - .OU
16. Amount of Line 14 taxable at lineal rate C16) 717-9R7 f10 X 045 = 5,309.4 2
17. Amount of Line 14 at sibling rate C17) -�� X 12 = .00
18. Amount of Line 14 taxable at collateral rate (18) .00 X 15 = .00
19. Principal rax nue �19�= 5,309.42
TAX CREDITS:
PAYMENT RECEIPT DISCOUNT (+)
DATE NUMBER INTEREST/PEN PAID (-) AMOUNT PAID
08-25-2014 CD019601 .00 5,309.42 -
BALANCE OF UNPAID INTEREST/PENALTY AS OF 08-26-2014 TOTAL TAX PAYMENT 5,309.42
BALANCE OF TAX DUE .00
INTEREST AND PEN. 2,644.80
TOTAL DUE 2,644.80
* IF PAID AFTER DATE INDICATED, SEE REVERSE IF TOTAL DUE IS REFLECTED AS A CREDIT CCR), YOU MAY BE DUE
FOR CALCULATION OF ADDITIONAL INTEREST. A REFUND. SEE REVERSE SIDE FOR INSTRUCTIONS.
Pa. O.C. Rule 6.12 STATUS REPORT
REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA
Name of Decedent: DOROTHY J. TAYLOR
Date of Death: JULY 17, 2013 File Number:21-03-838
Pursuant to Pa. O.C. Rule 6.12, 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 [I No
2. If the answer is No, state when the personal representative
reasonably believes that the administration will be complete:
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 ONo
b. The separate Orphans' Court No. (if any)for the personal
representative's account is:
c. Did the personal representative state an account
informally to the parties in interest? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ®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.
Dare SEPTEMBER 23,2015 c2et. .�
Signature of Person F' ' t is Form
Capacity: ersonal Representati e O Counsel
CV")
o MARCUS A. McKNIGHT, III
U.] ,_q (+) O Name of Person Filing this Form
t: E C) �
60 WEST POMFRET STREET
tj_. u_ C_ Address
C7
C.) z C ) U-, . CARLISLE, PA 17013
t:9 c`i __jp en `'' Cn (717) 249-2353
CU L Cf` Telephone
W4 U,
C�'` o
C_1
Form RW-!0 rev. /0.!3.06