HomeMy WebLinkAbout03-0801PETITION FOR PROBATE and GRANT OF LETTERS
estate of ~J~J~r ~, ./~OS ~o. ~l/-OJ-(~Oi
also known as To:
Social Security No. ,~t9 R - 16 - ,~}q g31ceased'
Register of Wills for the
County of C~nberland
Commonwealth of Pennsylvania
The petition of the undersigned respectfully represents that:
Your petitioner(s), who is/are 18 years of age or older an the execut 1~(
in the last will of the above decedent, dated
and codicil(s) dated
in the
named
19__
(state relevant circumstances, e.g. renunciation, death of executor, etc.)
Decendent was domiciled at death in Ctdcra be r t~'/,O ~ Cou. nty, Pennsylvania, with
h . ~-5 last family or_principal residence at
(list street, number and muncipality)
Decendent, then '7 ff years of age, died q/~,~ ~'/O3 , 19. ,
at h
Except as follows, decedent did not marry, was not divorced and did not have a child born or adopted
after execution of the will offered for probate; was not the victim of a killing and was never adjudicated
incompetent:
Decendent at death owned property with estimated values as follows:
(If domiciled in Pa.) All personal property
(If not domiciled in Pa.) Personal property in Pennsylvania
(If not domiciled in Pa.) Personal property in County
Value of real estate in Pennsylvania
situated as follows:
WHEREFORE, petitioner(s) respectfully request(s) the probate of the last will and codicil(s)
presented herewith and the grant of letters Test~n~ry
(testamentary; administration c.t.a.; administration d.b.n.c.t.a.)
theron.
OATH OF PERSONAL REPRESENTATIVE
COMMONWEALTH OF PENNSYLVANIA 3.
COUNTY OF C~nberland f SS
The petitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing petition are
true and correct to the best of the knowledge and belief of petitioner(s) and that as personal represen-
tative(s) of the above decedent petitioner(s) will well and truly administer the estate according to law.
/7-/6 7- 9
before me this 3~d day of
~ Octobe~ . --]--. ,~ l~ 2003
~nna M. Otto, ls~ ~p~ty w ~egister
NO. 21-2003-801
Estate Of
WALTER R.MANS
,Deceased
DECREE OF PROBATE AND GRANT OF LETTERS
AND NOW October 6Eh, ~ 2_~_~ in consideration of the petition on
the reverse side hereof, satisfactory proof having been presented before me,
IT IS DECREED that the instrument(s) dated Au~lust 14Lh, 2003
described therein be admitted to probate and filed of record as the last will of
Walter R. Mans ;
and Letters
are hereby granted to
Test anentary_
Marqaret R. Mans
FEES
Probate, Letters, Etc .......... $. 60.00
Short Certificates(6(~ .......... $. 180.00
~g~liStRx..~Pa§es · ~ 2.)-- $ 6= 00
JCP $. 10.00
TOTAL __ $.256.00
Filed ................
MAILED LETTERS TO EXECUTR/X.
ATTORNEY (Sup. Ct. I.D. No.)
ADDRESS
PHONE
his is to certify that the information here given is correctly copied from an original certificate of death duly filed with me as
Local Re, gistrar. The original certificate will be forwarded to the State Vital Records Office for permanent ~ling.
WARNING: It is illegal to duplicate this copy by photostat or photograph.
' r Local'R~gistrar ....
P 9496802 z , oo3
No. ~ g Date :
BLACK iNK
COMMONWEALTH OF PENNSYLVANIA · DEPARTMENT OF HEALTH · VITAL RECORDS
CERTIFICATE OF DEATH
~'~' ~) ~ '
21-2003-801
LAST WILL AND TESTAMENT
OF
WALTER R. MANS
I, WALTER R. MANS, of the Township of Hampden, Cumberland County, Pennsylvania,
declare this to be my Last Will and revoke any will or codicil previously made by me.
ITEM 1: Upon my demise, I direct my Executrix contact Neill Funeral Home, Camp Hill,
Pennsylvania to arrange my funeral services. I further direct that my body be buried Peace Church
Cemetery, Camp Hill, Pennsylvania.
I direct that all my just debts and funeral expenses be paid as soon as practical
ITEM 2:
after my death.
ITEM 3:
I direct that all taxes and interest and penalties thereon that may be assessed in
consequence of my death, of whatever nature and by whatever jurisdiction imposed, shall be paid from
my residuary estate as a part of the expense of the administration of my Estate.
I, give, devise and bequeath my FPA Fund to my daughter, SALLY ANN
ITEM 4:
MANS.
ITEM 5:
I give, devise and bequeath all the rest, residue and remainder of my estate of
every nature and wheresoever situate, together with insurance thereon, to my wife, MARGARET R.
MANS providing she survives me by thirty (30) days.
ITEM 6: Should my wife, MARGARET R. MANS, predecease me or die on or before the
thirty-first (31 st) day following my death, I give, devise and bequeath all the rest, residue and remainder
of my estate of every nature and wheresoever situate, together with insurance thereon in equal shares, to
my children, namely, BONNIE LEE MURPHY of 1190 Riverside Road, Sugar Hill, Georgia and SALLY
ANN MANS 79 West Main Street, Shiremanstown, Pennsylvania.
Page 1 of 3
ITEM 7: Until distributed, no gift or beneficial interest shall be subject to anticipation or
voluntary or involuntary alienation.
ITEM 8: I appoint my wife, MARGARET R. MANS, Executrix of this my Last Will.
Should my wife, MARGARET R. MANS predecease me, fail to qualify or cease to act for any reason as
my Executrix, I appoint my daughter, SALLY ANN MANS, Executrix of my Last Will
ITEM 9: I direct that my personal representative, or her successor shall not be required to
give bond for the faithful performance of their duties in any jurisdiction.
IN WITNESS WHEREOF, I have hereunto set my hand and seal to this, my Last Will and
Testament, this j~~of j~~~, 2003.
WALTER R. MANS
Signed, sealed, published and declared by the above-named Testator as and for his Last Will and
Testament in our presence, who, at his request, in his presence and in the presence of each other, have
hereunto subscribed our names as attesting witnesses.
residing at
Page 2 of 3
COMMONWEALTH OF PENNSYLVANIA )
) SSi
COUNTY OF CUMBERLAND )
We, WALTER R. MANS, , and
~i~/I~L ~ /~o~¢c/~ [(~ , the Testator and the witnesses respectively, whose names are
signed to the attached or foregoing instrument, being first duly sworn, do hereby declare to the
undersigned authority that the Testator signed and executed the instrument as his Last Will and that he
had signed willingly, and that he executed it as his free and voluntary act for the purpose therein
expressed, and that each of the witnesses, in the presence and hearing of the Testator signed the will as
witness and that to the best of his or her knowledge, the Testator was at the time eighteen (18) years or
older, of sound mind and under no constraint or undue influence.
WALTER R. MANS
Witness
Witness .....
Subscribed, sworn and acknowledged before me ~ by
WALTER R. MANS, the Testator, and subscribed and sworn to before me by
C,-I-o~ttat, l, [tontlI~utt..t.,K and ~!c;t4~qt~lb3;. rSot/lt~-l/.t~_h~-the witnesses, this
t ~ '~ay of ~ Jl~_)~ ,2003.
Notar~ubli~ - /r /(SEAL)
Page 3 of 3
EV-1560 EX (600)
~ COMMONWEALTH OF
~ PENNSYLVANIA
,~,~~~m. DEPARTMENT OF REVENUE
~]1~/~,~'~'~ DEPT. 280601
· ~,~.~ HARRISBURG, PA 17128-0601
REV 1'500
INHERITANCE TAX RETURN
I ~- ~ - 0_~_
RESIDENT DECEDENT I c-~-~E
I-.
Z
U.I
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LU
n,'
DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
DATE OF DEATH (MM-DD-YF_.AR) DATE OF BIRTH (MM-DD-YEAR)
SOCIAL SECURITY NUMBER
.z~x - Id, - .2,/o7
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
IF APPLICABLE)SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURll'~ NUMBER
~-~ 1. Odginal Return
r---~ 4. Limited Estate
[]6. Decedent Died Testate (Attach copy el~ WiU)
r--] 9. Litigation Proceeds Received
NAME
~'-~ 2. Supplemental Return ~-~ 3. Remainder Return (date of death prior to 12-13-82)
[] 4a. Future interest Compromise (date oldeath after 12-12-82} [] 5. Federal Estate Tax Return Required
[~] 7. Decedent Maintained a Living Trust (^t~ch COpy of Trust) ~ 8. Total Number of Safe Deposit Boxes
F'-[ 10. spousal Poverty Credit (date of death between 12-31-91 and 1-1-95) [] 11. Election to tax under Sec. 9113(A) (Attach Sch O)
COMPLETE MAILING ADDRESS
FIRM NAME (,fApp~icabla) J~ 1"~,,5 ~ISK~A~O ~ C~O~t'
TELEPHONE NUMBER
1. Real Estate (Schedule A) (1)
2. Stocks and Bonds (Schedule B) (2)
3. Closely Held Corporation, Partnemhip or Sole-Proprietorship (3)
4. Mortgages & Notes Receivable (Schedule D) (4)
5. Cash, Bank Deposits & Miscellaneous Personal Property (5)
(Schedule E)
6. Jointly Owned Property (Schedule F) (6)
~] Separata Billing Requested
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7)
(Schedule G or L)
Total Gross Assets (total Lines 1-7)
Funeral Expenses & Administrative Costs (Schedule H) (9)
Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10)
Total Deductions (total Lines 9 & 10)
Net Value of Estate (Line 8 minus Line 11)
9.
13.
14.
~1
JEo ~q c,
OFFICIAL USE ONLY
Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been
made (Schedule J)
Net Valu.e Subject to Tax (Line 12 minus Line 13)
(8) ~"/· 2,g 3
(11) /:3,
(12) '7 t]~, ~'O
(13) - 0
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
15. Amount of Line 14 taxable at the spousal tax
rate, or transfers under Sec. 9116 (a)(1.2)
16. Amount of Line 14 taxable at lineal rate
17. Amount of Line 14 taxable at sibling rate
18. Amount of Line 14 taxable at collateral rate
19. Tax Due
3qtq~l¥ x..O oo (15)
/'~1?OG 3 x .0 ~' (16)
- O- x .12 (17)
- O- x .15 (18)
09)
20. []
Decedent's Complete Address:
STREETADDRESS ./7/~/ 3 /~/f~l ~Z),E,~.~
~4 VE .
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
(1)
Total Credits (A + B + C ) (2)
3. Interest/Penalty if applicable
D. Interest
E. Penalty
Total Interest/Penalty ( D + E ) (3)
4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the'OVERPAYMENT.
Check box on Page 1 Line 20 to request a refund (4)
5.. If Une 1 + Une 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) / ~ ;2, ~ '7
A. Enter the interest on the tax due. (5A)
B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (SB) I ~ ~. ~'~'
Make Check Payable to: REGISTER OF WILLS, AGENT
PLEASE ANSWER THE FOLLOWING QUESTIONS .BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
IF THE ANSWER
Did decedent make a transfer and: Yes No
a. retain the use or income of the property transferred; .......................................................................................... [] []
b. retain the right to designate who shall use the property transferred or its income; ............................................ [] []
c. retain a reversionary interest; or .......................................................................................................................... [] []
d. receive the promise for life of either payments, benefits or care? ...................................................................... [] []
If death occurred after December 12, 1982, did decedent transfer property within one year of death
without receiving adequate consideration? ............................................................... : .............................................. [] []
Did decedent own an "in trust for'' or payable upon death bank account or security at his or her death? .............. [] []
Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
conta ns a benefic ary des gnat on? ~..T...~.~.&r``~.~.~.~.P.R~A..~.[.~.[.E~.~'~w...~.~/i~.b.~L?~F/~ ..... []
TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT
AS PART OF THE RETURN.
Under penalties of perjury, I declare that I have exam ned th s return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct and complete.
Declaration of preparer other than the personal representative is based On all information of which preparer has any knowledge.
SIGNATURE OF PERSON RESPOI~IBLE. FOR FILING RETURN
ADDRE~SS //' _', " ;
ADDRES,~,.~"
For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3%
[72 P.S. {9116 (a) (1.1) (i)].
For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0% [72 P.S. {9116 (a) (1.1) (ii)
The 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
the {urviving 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 twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive paten
or a stepparent of the child is 0% [72 P.S. §9116(a)(1.2)].
The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5%, except as noted in 72 P.S. {9~116(1.2) [72 P.S. {911§(a)(1)].
~he tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% [72 P.S. {9116(a)(1.3)]. A Sibling is defined, Under Section 9102, a~ a,
individual who. has at'least one parent in common with the decedent, whether by blood or adoption.
REV-1503 E~ + (1-97) ~
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
All property joinUy-ovmed with right of survivorship must be disclosed on Schedule F.
FILE NUMBER
21-O~-oKo/
SCHEDULE B
STOCKS & BONDS
ITEM
NUMBER
JO,
II,
20.
2.~,
2?,
30.
32.
:~?.
OF
Iio
.lo0 ~ c~ ~ q & ~ t oG
~ ~1.1~ Io3
~2~qO
233~J
~'! 0 qy~ o~
~oo ~l ~j~ tp~
Ioo ~o9 Il I o~
I~¢0 ~qeq~3
39 ~9o~103
I I o~ o~ go9
~o z~ I I o
~9o~ I ~ o
DESCRIPTION
~OLIb~TEO EbISo~C, E~
DE~PHI Co~P. bPH ~.~
~e~[~ Foeo5 co~p,
PPL C~p
~TA~oo~ ~o~ R~o~ HoT ~.
VIAb Co~p
SA eRE HocD~s CO~ ~ ZI.9~
THE FI~OV~ G~oup FNV~ .
TOTAL (Also enter on tine 2, Recapitulatior
(if more space is needed, insert additional sheets of the same size)
VALUE AT DATE
OF DEATH
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
~SIDENT DECEDENT
SCHEDULE E
CASH, BANK. DEPOSITS, & MISC.
PERSONAL pROPERTY
FILE NUMBER
21-.~- 0~'ot
Include the proceecl~ of It~aUon and the date the proceeds were received by the estate. All property jointly-owned with the right of Survlvomhip mu~t be dizen ~'hedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1.
TOTAL (Also enter on line 5, Eecapitulation) $
(if more space is needed, insat additional sheets of the same size)
REV-1,5~9 EX + (t-971
COMMONWEALTH OF: PENNSYLVANIA
iNHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE
SCHEDULE F
JOINTLY-OWNED PROPERTY
FILE NUMBER
If an asset was made joint within one year of the decedent's date of death, it must be reported on Schedule G.
SURVIVING JOINT TENANT(S) NAME ADDRESS RELATIONSHIP TO DECEDENT
A. ~OM/UlF... L, Iv~ulz~P,'~ #90 ,~IVE,~ f~,~p. [~1~., ,.~CI&AI~Z. ).lll. l.~ ~'~ ~0.~-. 2t00 ~)~G~4fl~lZ
JOiNTLY-OWNED PROPERTY:
LETTER DATE DESCRIPTION OF PROPERTY % OF DATE OF DEATH
iTEM FOR JOINT MADE Include name ot financial institution and bank account number or similar identifying number. Attach DATE OF DEATH DECD'S VALUE OF
NUMBER TENANT JOINT deed for jointly-held real estate. VALUE OF ASSET INTEREST DECEDENT'S INTERES1
1. A. ~-~.~! [,U~,,,~'r 'i3A,~V.. $~-~0. CC~ ,~e~-..'r, tJo. rH~O01"l~¥9 ,~'0oo0 $0~0
:Z. ~. ~.-:~.0~ Co ,.-, ~ ,.., ,-r7 1~^~. 3o~0,¢~ 4c,-~'.~/o. 4~'0,s3~3o /ooooo J,"O~)o
TOTAL (Also enter on line 6, Recapitulation) $ ~ ~O O o
(If more space is needed, insert additional sheets of the same size)
SCHEDULE G
INT~R-VI¥O$ TRaNSFeRS &
MISC. NON-PROBATE PROPERTY
FILE NUMBER
Thb achadule rmat ~ con'~pk~ted ,,nd file~ fth~ aru~ar to an:,' of queatic~ 1 lvough 4 on ~ reverse side ~ ~a REV-1500 COVER ,.,~HFST Is yeS.
DEgCRIPTION 01: PROPERTY ...... % OF "
NUMAR .......... VALUE OF AOG~ I~ERE~ IF ~'~*' .~ .....
TOT~ ¢iso mr on line 7, ~lul~) $ J~O
(If':-no~e sl;~ec, e is needed, Iraert ac~ltlon$ she,~s of the same aim)
P'~'1511 EX + (1'cJ7) ~
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
FILE NUMBER
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A,
1.
5.
6.
7.
FUNERAL EXPENSES:
ADMINISTRATIVE COSTS:
Pemonal Representative's Commissions
Name of Personal Representative (s)
Social Security Number(s) / EIN Number of Personal Representative(s)
Street Address
City State Zip
Year(s) Commission Paid:
Attorney Fees
Family Exemption: (if decedent's address is not the same as claimant's, attach explanation)
Claimant
StreetAddress ~'/~ ~R~£,,d ~V~E,
City ~,~/"1 I~ ~ ) ~L.- State J~l' Zip
Relationship of Claimant to Decedent ~'1~ ~' ~'/~' E
Probate Fees
Accountant's Fees
Tax Retum Preparer's Fees
TOTAL (Also enter on line 9, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT D~ECEDENT
ESTATE OF
SCHEDULE!
DEBTS OF DECEDENT,
MORTGAGE LIABILITIESI&LIENS
FILE NUMBER
Include unreimbursed medical expenses.
ITEM
NUMBER DESCRIPTION
AMOUNT
TOTAL (Also enter on line 10, Recapitulation) $ -.-,~'~, ~
(If more space is needed, insert additional sheets of the same size)
REV-1513 EX+ (9-00~
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
SCHEDULE J
BENEFICIARIES
FILE NUMBER
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE
!
1.
1.
TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under
Sec. 9116 (a) (1.2)]
-
TOTAL OF PART II- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET
(If more space is needed, insert additional sheets of the same size)
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET
NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
$
LETTERS OF TESTAMt~WTARY
ESTATE OF
WALTER R. MANS
LATE OF .-
HAMPD~N :TC~HiP
CUMBERLAND COUNTY
PENNSYLVANIA
DECEASED
ESTATE ISSUED'ON: 10/06/03
ESTATE NO: 21-2003-801
REGISTER OF WILLS &
CLERK OF THE ORPHANS' COURT
Cumberland County Courthouse
Carlisle. Pennsvlwni~ I
WHEREAS, on'the 6th
dated August 14th 2003
Register of Wills of CUMBERLAND County, Pennsylvania
Certificate of Grant of Letters
No. 2003-00801 PA No. 21-03-0801
ESTATE OF MANS WALTER R
Late of HAMPDEN TOWNSHIP
Deceased
Social Security No. 202-16-2407
day of October
2003 an instrument
was admitted to probate as the last will of MANS WALTER R
late of ~PDEN TOWNSHIP , CUMBERLAND County, who died on the
28th day of SeDtember 2003 and,
WHEREAS, a true Copy of the will as probated is annexed hereto.
THEREFORE, I, DONNA M. OTTO , Register of Wills in and for
the County of CUMBERLAND in the Commonwealth of Pennsylvania, hereby certify
that I have this day granted Letters TESTAMENTARY
to MANS MARGARET R
who has duly qualified as Executor (rix)
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, PENNSYLVANIA.
IN TESTIMONY WHEREOF, I have'.~hereunto set my hand and affixed the seal
of my Office the 6th day of October 2003.
**NOTE** ALL NAMES ABOVE APPEAR (LAST, FIRST~ MIDDLE)
LAST W'ILL AND TESTAMENT
OF
WALTER R. MANS
~ WALTER R.'MANS, of the Township of Hampdeh, Cumberland County, pennsylvania,
declare this to be my Last Will and revoke any will or codicil previously made by me.
ITEM 1: Upon my demise, I direct my Executrix contact Neill Funeral Home, Camp Hill,
Pennsylvania to arrange my funeral services. I further direct that my body be bur/ed Peace Chumh
Cemetery, Camp Hill, Pennsylvania.
ITEM 2:
after my death.
I direct that all my just debts and funeral expenses be paid as soon as practical
I direct that all taxes' and. interest and penalties thereon that may be assessed in
consequence of my death, of whatever nature and by whatever jurisdiction imposed, shall be paid from
ray residuary estate as a part of the expense of the administration of my Estate.
I, give, devise and bequeath my FPA Fund to my daughter, SALLY ANN
ITEM 5:
I give, devise and beqUeath all the rest, residue and remainder of my estate of
every naVare and wheresoever situate, 'together with insurance thereon, to my wife, MARGARET R.
MANS providing she survives me by thi .rty (30) days.
ITEM 6:
Should my wife, MARGARET R. MANS, predecease me or die on or before the
thirty-first (31 st) day following my death, I give, devise and bequeath all the rest, residue and remainder
of my estate of every nature and wheresoever situate, together with insurance thereon in equal shares, to
my children, namely, BONNIE LEE MURPHY of 1190 Riverside Road, Sugar Hill, Georgia and SALLY
ANN MANS 79 West Main Street, Shiremanstown, Pennsylvania.
,Page 1 of 3
ITEM 7: Until distributed, no girt or beneficial interest shall be subject to anticipation
voluntary or involuntary alienation.
ITEM 8: I appoint my wife, MARGARET R. MANS, Executrix of this my Last W:'
Should my wife, MARGARET R. MANS predecease me, fail to qualify or cease to act for any reason
my EXecutrix, I appoint my daughter, SALLY ANN MANS, Executrix of my Last Will
ITEM 9: I direct that my personal representative, or her successor shall not be required
give bond for the faithful performance of their duties in any jurisdiction.
IN WITNESS WHEREOF, I have hereunto set my hand and seal to this, my Last Will a:
WALTER R. MANS
Signed; sealed, published and declared by the above-named Testator as and for his Last Will a:
Testament in our presence, who, at his request, in his presence and in the presence of each other, ha
hereunto subscribed our names as attesting witnesses.
residing at
Page 2 of 3
' ~ CoMM~ )N'~,'F~AL ~ 'OF PF-.N,~sY L%' AN'L~,
cou~' ov
,, . We, WALTER .
old, r, of sound mind and'Under no constraint ot undue influence.
expres~d,, and{ha~, ea61a.: of'~e witnesses, in the presence.and hearing of the Testator signett the will
witness and:that to thc bestof his or her knowledge, the Testator was at the time eighteen (18) years
R. M, S, tlc
~c Tes~tor and the ~messes re~ec~vely, whO~
,. ,, , , ,
~o':'the a~ehe~ or '~fOregoing ins~t~ being first 'd~y sw~,. do h~ d~l~,
, ~at. ~e Testator sided'and executed ~e ins~t as ~s La~ Will
and ~t he exeCUted it as his ~ee md volunt~ act-for ~e ~
WALTER R. MA_NS
Witness
Witness
, in the year
.Made the ~.~ 0 ~ day of June
Afir~eteen hundred and seventy (1970)
~~£~ RUSSSLL C. ~RT~N, SR. and' 'A~HIE E.. ~RT~N, his wife,
~erland county, Pennsylvania,
.
: ~ :i (~ere~naf~er ~alled the Gr~tntor s ), of th.e one par~, an.d
i ~ ':
. ~ ; W~TER R. ~NS and ~R~T R. ~Ns, his wife, of
~rrisburg, Dauphin ~unty, pe~sylvania,
(hereinafter called the Orar~gee s), of ~he ogker part:
Nineteen Thousand, Five Hundred (~19,500.00) Dollars ....... 2--lawful ....
m.o~ley of the U~ited States of ,~i~erica., u~&t:o t~m well an.d truly paid by the
said Gra~&teez at a~d before ~he seali~ and delivery of tkese prese~ts, ghe receipt
· have ~ranted, bar,air, ed, sold, alien, ed,
whereof is kereb~ acb~owledged,
e~.[eoffed, regeased, conve~ed a~d eo~r~ed, a~,d b~ gh. ese prese~ts do
ba.r~ai~*, seH,'alier;, enfeoff , release, convey a~ co~$rm ~ngo gke saLd
~heir heirs and Assigns ...............
a~ 'r~'r ChaTAIN piece o~ parcel of lane, '~'ituate in ~pden Townshi[
(Off Uhe Clearview Farm), ~rland ~unty, pennsylvania,
particularly Bounded and aescri~a as foll~s, ~o wit,
~¢I~ING at a ~int on the NortMrn sine of ~mpden Avenu~ w~ch
point is ag the division lines of Lots nu~rea 185 and 186 on ~he
hereinafter mentioned plan of lots: thence North 7 degrees 32 minu~es
East along said division line a distance of on~ hundred eight and
nineey-one (108.91) hundredth feet to a point at the division line~/
of Logs nutted 203 and 186; =hence Sough 83 deqreea 09 minu~esr~ast
along asia division line and ~yond a dista~e of. akX$Xy~0
a curve on Hampden Avenue-thence Westwardly in an ar~ 'to ~ right
wi=h a radius of =hree hundred fir=y-seven and fifty-oigh= hun~ed~h
(3~7.58) fee= =he arc disgance sixteen (16) feet to a poin=l =hence
conUinuing along ~mgd~n Avenue North 83 degrees 34 minu=es
for~y-oighu (48) fee= to a point, ~he. place .of ~GI~ING.
IT ~ING lo= n~red 186 on ~neral ~lan of:'S~ctio~>2 ~'a~d 3 of
Clearview Farms, recorded in and for the ~unty of ~rland in
PI~ ~ok 9, Page 6.
H~VING THEREON E~CTED a single brick ranch ty~e dwelling, said
:-.r.~',? .:,e~ be. ing known a~'v~ n~re(~ as 4613 ~den"~v~nue, ~P Hil. i~
r.,:~ ~ n.s:~:' l rania ..
Name of Decedent:
Date of Death:
wrffi No.
To the Register:
CERTIFICATION OF NOTICE UNDER RULE 5.6(a)
got
Admin. No.
I certify that notice of (beneficial interest) estate administratioll required by Rule 5.6(al 9f the Orphans' Court Rules was
served on or mailed to the following beneficiaries of the above-captioned estate on /~tr~, ~/~ _~z~_~ :
Notice has now been given to all persons entitled thereto under Rule 5.6(a) except
Signature
Name
Address
Telephone (7/7) ~/39 - tV~ o
Capacity: I// Personal Representative
Counsel for personal represen.tative
IMPORTANT NOTICE
NOTICE OF ESTATE ADMINISTRATION
THIS NOTICE DOES NOT MEAN THAT YOU WILL RECEIVE
ANY MONEY OR PROPERTY FROM THIS ESTATE OR OTHERWISE.
Whether you will receive any money or property will be deter-
mined wholly or partly by the decedent's will. If the decedent
died without a will, whether you will receive any money or prop-
erty will be determined by the intestacy laws of Pennsyl¥.ania.
BEFORE THE REGISTER OF Wll J S, COUNTY OF CUMBERLAND, CARLISLE, PA
In re Estate of ~A ~"r ~.r~ /'~,
Estate No. ~-I- 9.0 o3 - go I
(Name and Address)
, deceased,
Please take notice of the death of decedent and the grant of letters to the personal representative(s) named below.
The Decedent ~^c..T~,e. ~, t~'.~ ,diedonthe
dayof ~P1'~O[~ ., ~oo~ ,at d~l~/4~-,-,e~4tt.,~o~ County,
Penn.~ylvania.
The Decedent died testate (with a Will); or
The Decedent died intestate (without a Will).
Tho personal representative of the Decedent is
(name, address and telephone number).
If the Decedent died testate, the will has been filed with the Office of the Register of Wills of Cumberland County, 1
Courthouse Square, Carlisle, Pa. 17013. Phone No. 717-240-6345
If the Decedent died intestate, a Petition for the Grant of Letters of Administration was fried with the Office of the
Register of Wills of Cumberland County, 1 Courthouse Square, Carlisle, Pa. 17013. Phone No. 717-240-6345
A copy of the Will or Petition may be obtained by contacting the Register of Wills and paying the charges for duplication.
Name (print) ~t~ *,%~1[ f g. /l~a~ ~
Address /Tt{. ] ~ HA ~/~ oF. ~J A ~'~.
Telephone (717) 73 9 - 1¥3 0
Capacity: Personal Representative
Counsel for personal representative
IMPORTANT NOTICE.
NOTICE OF ESTATE ADMINISTRATION
THI.q NOTICE DOES NOT MEAN THAT YOU WILL RECEIVE .
ANY MONEY OR PROPERTY FROM THIS ESTATE OR OTHERWISE.
Whether you will receive any money or property will be deter-
mined wholly or partly by the decedent's will, If the decedent
died without a will, whether you will receive any money or prop-
erty will be determined by the intestaey laws of Pennsylvania.
BEtK)RE THE REGISTER OF WILLS, COUNTY OF CUMBERLAND, CARLISLE, PA
In re Estate of ' ~//AL~r~(~ I~, /k~,',~S
Estate No. ~1 -Z~3 ~ ~/
(N~ ~d Ad.ess)
TO:
, deceased,
Pl~ take notice of the death of decedent and the grant of letters to the personal representative(s) named below.
The Decedent ~L//~ ~-y ~-~ ~./vi ^ ra S , died on reel ~ ~ T/4
Pennsylvania.
The Decedent died testate (with a Wil~); or
The Decedent died intestate (without a Will).
The personal representative of the Decedent is
(name, a~ss and telephone number).
If the Decedent died testate, the will has been flied with the Office of the Register of Wills of Cumberland County, 1
Courthouse Square, Carlisle, Pa. 17013. Phone No. 717-240-6345
If the Decedent died intestate, a Petition for the Grant of Letters of Ach'ninistration was filed with the Office of the
Register of ~rflls of Cumberland County, 1 Courthouse Square, Carlisle, Pa. 17013. Phone No. 717-240-6345
A copy of the Will or Petition may be obtained by contacting the Register of Wills and paying the charges for duplication.
Name (print)''~ ~A~ ~, ~B
Capacity: Personal Representative
Counsel for personal representative
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
NO.
REV-1162 EX(11-96)
CD 003323
MANS MARGARET R
4613 HAMPDEN AVENUE
CAMP HILL, PA 17011-4034
........ fold
ESTATE INFORMATION: SSN: 202-16-2407
FILE NUMBER: 2103-0801
DECEDENT NAME: MANS WALTER R
DATE OF PAYMENT: 12/10/2003
POSTMARK DATE: 00/00/0000
COUNTY: CUMBERLAND
DATE OF DEATH: 09/28/2003
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 $18,257.00
REMARKS:
MARGARET R MANS
TOTAL AMOUNT PAID:
$18,257.00
SEAL
CHECK# 1047
INITIALS: JA
RECEIVED BY:
DONNA M. OTTO
DEPUTY REGISTER OF WILLS
REGISTER OF WILLS
STATUS REPORT UNDER RULE 6.12
Name ofDecedent: I/~4LTf::~ g, /I~A,,'J ~,
Date of Death: EO'T£i~ r~ ~ ,~ ~ed/ ,q. 007
Will No.: ,2- I - ;2 o o ~ .- ~'O I
Admin. No.:
Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the
following with respect to completion of the administration of the above-captioned estate:
1. State whether administration of the estate is complete:
'res [] No
2. If the answer is No, state when the personal representative reasonably believes
that the administration will be complete:
3. If the answer to No. 1 is Yes, state the following:
ao
Did the personal representative file a final account with the Court?
Yes _ No []
b. The separate Orphans' Court No. (if any) for the Personal representative's
account is:
c. Did the personal representative state an account informally to the parties
in interest? Yes [~ No [-']
Co
Date:~~
Copies of receipts, releases, joinders and approval of formal or
informal accounts may be filed with the Clerk of the Orphans' Court
and may be attached to this report.
Nalne
Av .
Address
Telephone No.
Capacity: [~ Personal Representative
['"] Counsel for personal representative
BUREAU OF INDTVlDUAL TAXES
INHER/TANCE TAX DTV/$I()N
DEPT. 280601
HARRTSDURG, PA 17128-0601
COHHONWEALTH OF PENNSYLVANZA
DEPARTNENT OF REVENUE
NOTZCE OF ZNHERZTANCE TAX
APPRAISENENT, ALLO#ANCE OR DZSALLOWANCE
OF DEDUCT/OHS AND ASSESSNENT OF TAX
JOHN N BISBANO JR
STE 252
4811JONESTOWN RD
HBG
PA 17109
DATE 02-02-2004
ESTATE OF HANS
DATE OF DEATH 09-28-2005
FZLE NUHBER 21 0:5-0801
COUNTY CUHBERLAND
ACN 101
I Amoun~ Reml 'l:~ed
REV-154? EX AFP COl-OS)
WALTER R
HAKE CHECK PAYABLE AND RENZT PAYHENT TO:
REGTSTER OF WTLLS
CUHBERLAND CO COURT HOUSE
CARLTSLE, PA 1701:5
CUT ALONG TH]:S L]:NE ~ RETAZN LOWER PORTZON FOR YOUR RECORDS ~
REV-1547 EX AFP (01-03) NOTZCE OF ZNHERZTANCE TAX APPRAZSEHENT, ALLOWANCE OR
DZSALLOWANCE OF DEDUCTZONS AND ASSESSHENT OF TAX
ESTATE OF HANS WALTER R FZLE NO. 21 05-0801 ACN 101 DATE 02-02-2004
TAX RETURN WAS: (X) ACCEPTED AS FILED ( ) CHANGED
RESERVAT]:ON CONCERNZNG FUTURE ]:NTEREST - SEE REVERSE
APPRAZSED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Real Estate (Schedule A)
2. Stocks and Bonds (Schedule B) (2)
$. Closely Held Stock/Partnership Znterest (Schedule C) ($)
4. Hortgages/Notes Receivable (Schedule D) (~).
5. Cash/Bank DeposA*s/Nisc. Personal Property (Schedule E) ($)
6. Jointly Owned Property (Schedule F) (6)
7. Transfers (Schedule G) (7)
8. Total Asse~s
APPROVED DEDUCTZONS AND EXEHPTZONS:
9. Funeral Expanses/Adm. Costs/Hlsco Expenses (Schedule H) (9)
10. Debts/Mortgage Liabilities~Liens (Schedule Z) (10}
11. Total Daduc*ions
12. Na~ Value of Tax Ra~urn
581,450.00
.00
5z747.00
75z000.00
150~076.00
(8)
12,882. O0
.00 NOTE: To Lnsure proper
cradLt to your accoun*,
subm/~ ~he upper pore/on
.00 of ~h/s fora w/th your
~ax payment.
15.
14.
NOTE:
812,25:5. O0
ZF PAZD AFTER DATE ZNDZCATED, SEE REVERSE
FOR CALCULATZON OF ADDZTZONAL ZNTEREST.
ASSESSNENT OF TAX:
15. Amount: of L/ne 14 at Spousal rate
16. Amoun* of LLne 14 taxable at L/naal/Class A rate
17. Amount of L/ne 1~ at S/bl/ng rate
18. Amount of L/ne 14 taxable at Collateral/Class B rate
19. Pr/nc/pal Tax Due
TAX CREDZTS:
PAYH~NT KECETpT DISCOUNT (+)
DATE NUNBER :]:NTEREST/PEN PA:]:D (-)
12-10-200:5 CD003:523 960.89
(15) :571,744.00 X O0 = .00
(16). 427,063.00 x 045: 19,218.00
(17). .00 X 12 = .00
(18) .00 X 15 = .00
(19)= 19,218.00
AHOUNT PAZD
18,257. O0
reflect figures that include the total of ALL returns assessed to date.
TOTAL TAX CREDZT I 19,217.89
BALANCE OF TAX DUEl .11
ZNTEREST AND PEN. .00
TOTAL DUE .11
( ZF TOTAL DUE ZS LESS THAN $1, NO PAYHENT ZS RE~IJZRED.
ZF TOTAL DUE ZS REFLECTED AS A 'CREDZT' (CR), YOU NAY BE
A REFUND. SEE REVERSE SZDE OF THZS FORN FOR ZNSTRUCTZONS.)'~
Char/tabla/Governmmntal Bequests; Non-elected 911:5 Trusts (Schedule J) (1:5) . O0
Ne~: Value of Es~:ata Subject to Tax (14] 798,807. O0
:;f an assessment ~as $ssued previouszy, l~nes 14, 15 and/or 16, 17, 18 and 19
564.00
(11) 13.~6.fl0
(12) 798,807.00
RESERVATION:
PURPOSE OF
NOTICE:
PAYMENT:
REFUND (CR):
OBJECTIONS:
ADMIN-
ISTRATIVE
CORRECTIONS:
DISCOUNT:
PENALTY:
INTEREST:
Estates of decedents dying on or before December 1Z, 198Z -- if any future interest in the estate is transferred
in possession or enjoyment to Class B (collateral) beneficiaries of the decedent after the expiration of any estate for
life or for years, the Commonwealth hereby expressly reserves the right to appraise and assess transfer Inheritance Taxes
at the lamful Class B (collateral) rate on any such future interest.
To fulfill the requirements of Section 21qO of the Inheritance and Estate Tax Act, Act Z3 of ZOO0. (72 P.S.
Section 91q0).
Detach the top portion of this Notice and submit with your payment to the Register of NiZls printed on the reverse side.
--Make check or money order payable to: REGISTER OF NZLLS, AGENT
A refund of a tax credit, which mas not requested on the Tax Return, may be requested by completing an "Application
for Refund of Pennsylvania Inheritance and Estate Tax" (REV-131S). Applications are available at the Office
of the Register of Hills, any of the 23 Revenue District Offices, or by calling the special 24-hour
ansaering service for fores ordering: 1-BOO-36Z-ZOSO; services for taxpayers with special hearing and / or
speaking needs: 1-800-qqT-3OZO (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 sheen on this Notice must object within sixty (60) days of receipt of
this Notice by:
--aritten protest to the PA Department of Revenue, Board of Appeals, Dept. ZeIOZI, Harrisburg, PA 171lB-lOg1, OR
--mlmction to have the matter determined at 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 Depar~ent of Revenue,
Bureau of Individual Taxes, ATTN: Post Assessment Reviee Unit, Dept. 280601, Harrisburg, PA 171Z8-0601
Phone (717) 787-6505. See page 5 of the booklet "Instructions for Inheritance Tax Return for a Resident
Decedent" (REV-1501) for an explanation of administratively correctable errors.
If any tax due is paid within three (3) calender months after the decedent's death, a five percent (BI) discount of
the tax paid is allowed.
The lex 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 ehich became delinquent before January l, 198Z bear interest at the rate of
six (6Z) percent per annum caIculated at a daily rate of .00016q. All taxes which became delinquent on and after
January 1, 198Z mill bear interest at a rate ~hich will vary from calendar year to calendar year with that rate
announced by the PA Department of Revenue. The applicable interest rates for 198Z through ZOOS are:
Interest Daily Interest Daily Interest Daily
Year Rate Factor Year Rate Factor Year Rate Factor
1982 20Z .OOOSqa 1987 9Z .O00Z~7 1999 7Z .00019Z
1983 162 .O00q3B 19B8-1991 112 .000301 2000 8Z .000Z19
198fi X1Z ,000301 1992 92 .0002~7 2001 92 .0002q7
1985 132 .000356 1993-199q 72 .O0019Z 200Z 62 .OOO16q
1986 102 .O00Z7fi 1995-1998 9Z .OOOZ~7 2003 5Z .000137
--Interest is calculated as follows:
INTEREST = BALANCE OF TAX UNPAID
X NUHBER OF DAYS DELINQUENT X DALLY INTEREST FACTOR
--Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fifteen (15) days
beyond the date of the assessment. If payment is made after the interest computation date shown on the
Notice, additional interest must be calculated.
BUREAU OF TNDTVZDUAL TAXES
]NHERTTANCE TAX DTVZSTON
P.O. Box 280601
HARRZSRURG., PA 171Z8-0601
JOHN N BISBANO JR
STE 252
q811 JONESTOWN RD
HBG
PA 17109
COHNONWEALTH OF PENNSYLVANIA
DEPARTHENT OF REVENUE
NOTICE OF DETERHZNATZON AND
ASSESSHENT OF PENNSYLVANIA
ESTATE TAX BASED ON FEDERAL
CLOSING LETTER
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
11-08-200q
NANS
09-28-2005
21 05-0801
CUMBERLAND
2O2
Amoun~ Remind:ed
WALTER R
HAKE CHECK PAYABLE AND REHZT PAYHENT TO:
REGISTER OF WILLS
CUHBERLAND CO COURT HOUSE
CARLISLE, PA 17015
NOTE: To insure proper credit: ~;o your account, submi~ ~hm upper por~;ion of ~his form wi~:h your ~ax payment.
CUT ALONG THZS LZNE
nu/,~;= up ~ETERNZNATZON ~'~'~'H'~T ...........................
OF PENNSYLVANTA ESTATE TAX BASED ON FEDERAL CLOSZNG LETTER ..
ESTATE OF MANS HALTER R FILE N0.21 05-0801 ACN 202 DATE 11-08-200~
ESTATE TAX DETERHZNATZON
Credit For State Death Taxes as Verified
Pennsylvania Inheritance Tax Assessed
(Excluding Discount and/or Interest)
Inheritance Tax Assessed by Other States
or Territories of the Un/ted States
(Excluding D~scount and/or Interest)
Total Inheritance Tax Assessed
Pennsylvania Estate Tax Due
18,257.11
Amount of Pennsylvania Estate Tax Previously Assessed
Based on Federal Estate Tax Return
.00
TAX CREDITS:
Additional Pennsylvan/a Estate Tax Due
PAYHENT
DATE
~RECEIPT
~NUMBER
~ZF PAID AFTER THIS DATE, SEE REVERSE SIDE
FOR CALCULATION OF ADDZTZONAL ZNTEREST.
DISCOUNT (+)
ZNTEREST/PEN PAID (-)
AMOUNT PAID
TOTAL TAX CREDIT ~
BALANCE OF TAX DUE/
INTEREST AND PEN. /
TOTAL DUE /
(IF TOTAL DUE ZS LESS THAN $1, NO PAYHENT TS REI~UZRED
ZF TOTAL DUE ZS REFLECTED AS A "CREDIT" (CR), YOU HAY BE
DUE A REFUND. SEE REVERSE SIDE OF THIS FORH FOR ZNSTRUCTZONS. )
.00
18~257.11
.00
.00
.00
· °°l
.00
.00
.00
PURPOSE OF
NOTICE:
To fulfill the requirements of Section 2160 of the Inheritance and Estate Tax Act, Act 25 of ZOO0. (72 P.S.
Section 9160).
PAYMENT: Detach the top portion of this Notice and submit with your payment to the Register of Nills printed on the
reverse side.
-- Make check or money order paYable to: REGISTER OF NXLLS, AGENT.
REFUND (CR): A refund of a tax credit may be requested by completing an -Application For Refund of Pennsylvania Inheritance and
and Estate Tax" (REV-1515). Applications are available online at Hwu-ravenua-stata'pa'us' any Register of Nills or
Revenue District Office, or from the Department's ZB-hour answering service For forms orders: 1-800-562-ZOS0; services
for taxpayers eith special hearing and/or speaking needs: 1-B00-667-5020 (TT only).
Any party in interest not satisfied with the appraisment, allowance or disallowance oF deductions or assessment of tax
(including discount or interest) as sheen on this Notice may object within 60 days oF the date of receipt of this notice
by filing one of the following:
A) Protest to the PA Department of Revenue, Board of Appeals. You may object by filing a protest online at
www.boardofappaals.stato.pa-us on or before the expiration of the sixty-day appeal period. In order for
an electronic protest to be valid, you must receive a confirmation number and processed date from the
Board of Appeals wabsita. You may also send a written protest to PA Department of Revenue, Board of Appeals
P.O. Box ZBIOZ1, Harrisburg, PA 171Z8-1021. petitions may not be faxed.
B) Election to have the aatter determined at the audit of the account of the personal representative.
C) Appeal to the Orphans' Court.
ADMIN-
ISTRATIVE
CORRECTIONS: 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, P.O. Box ZB0601, Harrisburg, PA 1712B-0601,
Phone (717) 787-6505. Sea page 5 of the booklet "Instructions for Inheritance Tax Return for a Resident
Decadent" (REV-la01) for an explanation of administratively correctable errors.
PENALTY: The 1SX tax amnesty non-participation penalty is computed on the total of the tax and interest assessed, and nat
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 time period as you would appeal the tax and interest
that has bean assessed as indicated on this notice.
INTEREST: Additional Pennsylvania Estate Tax assessed as a result of a change on the Federal Estate Tax closing
letter becomes delinquent at the expiration of one (1) month from the date the final notice of the increase
in Federal Estate Tax is received.
Taxes which became delinquent before January 1, 19BZ bear interest at the rate of six (62) percent per annum
calculated a daily rate of .000166 All taxes which became delinquent on or after January 1, 1982 will bear
interest ataatrate which will vary from calendar year to calendar year with that rate announced by the PA
Department of Revenue. The applicable interest rates for 1982 through ZOO6 are:
OBJECTIONS:
Interest Daily
Interest Daily Interest gaily
Year Rate Factor Year Rate Factor_
Yeast Rate Factor __
1982 ZOZ .000568 1988-1991 llZ .000501 ZOO1 92 .000267
1985 162 .000658 1992 92 .000267 2002 62 .000166
1986 112 .000501 1995-199~ 72 .000192 2005 52 .000157
1985 152 .000556 1995-1998 92 .000267 ZOOq 62 .000110
1986 102 .000276 1999 72 ,000192
1987 92 .000267
--Interest is calculated as folloas:
INTEREST = BALANCE OF TAX UNPAID X NUNBER OF DAYS DELINQUENT X DAILY 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 bm calculated.
BUREAU OF ZNDTVTDUAL TAXES
TNHERZTANCE TAX DZVZS/ON
DEPT. ZD0601
HARRZSBURG, PA 17128-0601
COMMONWEALTH OF PENNSYLVANZA
DEPARTHENT OF REVENUE
NOTZCE OF DETERHZNATZON AND
ASSESSHENT OF PENNSYLVANZA
ESTATE TAX BASED ON FEDERAL
ESTATE TAX RETURN
JOHN N BTSBANO JR 'uu.
STE 25Z
4811 JONESTONN RD ,'
HBG
PA
DATE 11-01-2004
ESTATE OF HANS
DATE OF DEATH 09-28-2005
FZLE NUNBER 21 05-0801
:i~-COUNTY CUMBERLAND
OACN 201
Amount: Rem i 'l:'l:ed
WALTER R
HAKE CHECK PAYABLE AND REHZT PAYHENT TO:
REGTSTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLTSLE, PA 1701:3
NOTE: To /nsure proper cred/~ ~o :your account, submL~c ~he upper por~/on of ~his form wi~h your ~ax payment.
CUT ALONG THZS LZNE ~ RETAZN LOWER PORTTON FOR YOUR F:ZLES ~
~-v-:; ~- -E ~- -~P P- -(-5 ~---o-~ ~ ..... ~-~ - ~b¥~ ~- -6 P- -~E ¥~-~ ~k-~f ~-~ - ~-~ -~-~E~-~E ~- ............................
OF PENNSYLVANTA ESTATE TAX BASED ON FEDERAL ESTATE TAX RETURN ~#
ESTATE OF MANS WALTER R FZLE NO.Z1 05-0801 ACN 201 DATE 11-01-2004
ESTATE TAX DETERH]:NATTON
1. Credi~ For S~a~e Death Taxes as Verified
Z. Pennsylvania Inheritance Tax Assessed
(Excluding Discoun~ and/or Interest)
$. Inheritance Tax Assessed by O~her S~a~es
or Territories o~ ~he United S~a~es
(Excluding Discoun~ and/or 1n~eres~)
4. To~al Inheritance Tax Assessed
5. Pennsylvania Es~a~e Tax Due
TAX CREDZTS:
18z257.11
.0O
.0O
18z257.11
.O0
PAYHENT RECEIPT DZSCOUNT (+)
DATE NUMBER ZNTEREST/PEN PAZD (-) AHOUNT PAZD
~IF PAZD AFTER THIS DATE, SEE REVERSE SZDE
FOR CALCULATION OF ADDZTZONAL ZNTEREST.
TOTAL TAX CREDZT I .00
BALANCE OF TAX DUEl .00
ZNTEREST AND PEN. .00
TOTAL DUE . O0
(ZF TOTAL DUE ZS LESS THAN $1, NO PAYHENT ZS RE~UZRED
ZF TOTAL DUE ZS REFLECTED AS A 'CREDZT' (CR), YOU NAY BE
DUE A REFUND. SEE REVERSE STDE OF THTS FORH FOR ZNSTRUCTZONS.)
PURPOSE OF
NOTICE:
PAYNENT:
REFUND (CR):
OBJECTIONS:
ADNIN-
ZSTRATZVE
CORRECTIONS:
PENALTY:
INTEREST:
To fulfill the requirements of Section 2140 (b) of the Inheritance and Estate Tax Act, Act 23 of ZOO0.
(72 P.S. Section 9140}.
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 ~ZLLS, AGENT.
A refund of a tax credit may be requested by completing an "Application for Refund of Pennsylvania
Inheritance and Estate Tax" (REV-1315). Applications are available at the Office of tho Register of Hills,
any of the 25 Revenue District Offices or from the Department's Z4-hour answering service for forms ordering:
1-800-562-Z050; services for taxpayers with special hearing and / or speaking needs: 1-800-447-5020 (TT only).
Any party in interest not satisfied with the assessment of tax as shown on this notice may object eithin
sixty (60) days of receipt of this Notice by:
--arittan protest to tho PA Department of Revenue, Board of Appeals, Dept. 281021, Harrisburg, PA 17128-1021,
--electing to have the matter determined at audit of the personal representative, OR
--appeal to the Orphans' Court.
OR
Factual errors discovered on this assessment should be addressed in ariting to: PA Department of Revenue,
Bureau of Individual Taxes, ATTN: Post Assessment Review Unit, Dept. 2B060l, Harrisburg, PA 17128-0601,
Phone (717) 787-6505. See page 5 of the booklet "Instructions for Inheritance Tax Return far a Resident
Decedent" (REV-1501) for an explanation of administratively correctable errors.
The 152 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 time period as you would appeal the tax and interest
that has been assessed as indicated on this notice.
Far dates of death on or after 10-5-91, Pennsylvania Estate Tax based on the Federal Estate Tax
return becomes delinquent at the expiration of nine (09) months from the date of death.
For dates of death prior to 10-5-91, Pennsylvania Estate Tax based on the Federal Estate Tax return
becomes delinquent at the expiration of eighteen (18) months from the date of death.
Taxes mhich became delinquent before January 1, 1982 bear interest at the rate of six (62) percent per annum
calculated at a daily rate of .000164. All taxes ahich became delinquent on or after January l, 1982 mill bear
interest at a rate which mill vary from calendar year to calendar year eith that rate announced by the PA
Department of Revenue. The applicable interest rates for 1982 through Z004 are:
Interest Daily Interest Daily
Yea~ Rate Factor Year Rate Factor
1982 ZOZ .000548 1988-1991 llZ .000501
1983 XTZ .000458 1992 92 .000247
1984 llZ .000501 1995-1994 72 .000192
1985 X3Z .000356 1995-1998 97. .000247
1986 102 .000274 1999 7X .000192
1986 107. .000274 ZOO0 8Z .000219
--Interest is calculated as follows:
INTEREST = BALANCE OF TAX UNPAID
Interest Daily
Year Rate Factor
ZOO1 9Z .000247
ZOOZ 6Z .000164
2003 52 .000157
Z004 4Z .000110
--Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fifteen (15} days
beyond the data of the assessment. If payment is mmda after the interest computation data shown on the
Notice, additional interest must be calculated.
X NUHBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR
ESTATE
OF
WALTER R. MANS
DATE OFDEATH
SEPTEMBER 28, 2003
COMMONWEALTH OF
PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 280601
~NARRISBURG, PA 17128-0601
REV-1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
'l~P'l~ ~UMBER
~ /-Od 4)
DECEDENT'S NAME (L~ST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER
I--
DJ
t'~ CATE OF DEATH (MM-DB-YEAR) CATE OF BIRTH (MM-OD-YEAR) THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
DJ ~ - :2, ~"- O 3 O? - O5'-/92-~ REGISTER OF WILLS
DJ
[]1 Original Return
[]4. Limited Estate
[]6. Decedent Died Testate (^~a~
[~9 Lkigedon Proceeds Received
(iF APPLICABLE) SURViViNG SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
K.
[]2 Supplemental Return
[~4a. Future Intarest Compromise (~am of death alter 12-12-82)
[~7. Decedent Maintained a Living Trust (^~ac~ copy of T~ust)
FiRM NAME
SOCIAL SECURITY NUMBER
TELEPHONE NUMBER
719
1. Real Estate (Schedule A) (1)
2, Stocks and Bonds (Schedule S) (2)
3. Closely Held Corporation, Partnership or Sole-Proprietorship (3)
4. Mortgages & Notes Receivable (Schedule D) (4)
5, Cash, Bank Deposits & Miscellaneous Persona~ Property (5)
(Schedule E)
6. Jointly Owned Property (Schedule F) (6)
[~ Separate Billing Requested
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7)
(Sched~&e G or L)
8. Total Gross Assets (total Lines 1-7)
9. Funeral Expenses & Administrative Costs iSchedule H) (9)
10 Debts o1 Decedent, Mortgage Liabilities, & Liens (Schedule I) (10)
11 Total Deductions (total Lines 9 & 10)
12. Net Value of Estate (Line 8 minus Line 11)
13. Charitable and Governmental Bequests~Sec 9113 T~usts for which an election to tax bas not been
made (Schedule J)
14. Net Value Subject to Tax (Line 12 minus Line 13)
[~5. Federal Estate Tax Return Required
8. To~al Number of Safe Deposit Boxes
E~11. Election to tax under Sec. 9113(A) (^~ach
COMPLETE MAILING ADDRESS
OFFICIAL USE ONLY
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
(13)
(11)
(12)
15. Amount of Line 14 taxable at the spousal tax
rate, or ~ansfers under Sec. 9116 (a)(1.2)
16. Amount of Line 14 taxable at lineal rate
17. Amount of Line 14 taxable at sibting rate
1 g. Amount of Line 14 taxable at collataral rate
19. Tax Due
77'7'g'/ x.oe_P_~ (15) - a-
x.0M~_ (16)
x .12 {17)
x .15 (18)
(19)
(6) fr:z /
Decedent's Complete Address:
[STR~EETADDRESS
~ITY
I STATE
I ZIP
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Paymenta
A. Spousal Poverty Credit
B Prior Payments
C. Discount
(1)
Total Credita (A + B + C ) (2)
3. Interest/Penalty if applicable
D. Interest
E, Penalty
Total Interest/Penalty ( D + E ) (3)
4. if Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT,
Check box on Page 1 Line 20 to request a refund (4)
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5)
A. Enter the interest on the tax due. (5A)
B. Enter the to[al of Line 5 ", 5A. This is the BALANCE DUE. (5B)
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; .......................................................................................... [] []
b. retain the right to designate who shall use the property transferred or its income; .......................... : ................. [] []
c. retain a reversionary interest; or .......................................................................................................................... [] []
d. receive the promise for life of either payments, benefits or care? ...................................................................... [] []
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death
without receiving adequate consideration? ............................................................................................................. [] []
3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? .............. [] []
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary designation? ."~-~.~,~'J;t~.lb..L,%...~.P.e.~.~:..,~...'~..~..[C..L~.~..~...~ [] []
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
Under pena~Pes o( perjury, I declare that I have examined this return, including accompanying schedules and sta[ements, and t~ the best of my knowledge and belief, ii is true, correct and complete.
Declarabon o[ preparer other than the personal representative is based on all information of which preparer has any knowledge.
SIGNATURE OF PERSON RESPONSIBLE EOR FJLING RETURN
ADDRESS .'~ 'e'~ .'~- /'~ '~--/ "'
SIGNATURE OF P'R~'I:~R~-"~LL-~THA~'~"EP~ESENTATIVE
DATE ,
DATE
ADDRESS 4~11 I' Fid.- ~
~ PA 171~
For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3%
[72 RS. 99116 (a) (1.1)
For dates of death on or after January f, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0% F2 RS. 99116 (a) (1.1) (ii)
The statute does not exemot a transfer th a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even
the surviving spouse is the only beneficiary.
'res of death on or after July 1, 2000:
x rate imposed on the net value of transfers from a deceased child [wenty-one years of age or younger at death to or for the use of a natural parent, an adoptive paren
or a stepparent of the child is 0% [72 P,S. §9116(a)(1.2)].
The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiafies is 4.5%, except as noted in 72 RS. §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% [72 RS. §9116(a)(1.3)]. A sibling is defined, under Section 9102, as
individuai who has at least one parent in common with the decedent, whether by blood or adoption.
SCHEDULE B
STOCKS& BONDS
I
FILE NUMBER
RESIDENT DECEDENT
_. ATE OF
All property jointly-owned ~ right of suwivomhip mu~ ~ disclosed on Schedu~ F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
TOTAL (Also enter on line 2, Recapitulation) $ ~'.~"~ ~' I
(If more space is needed, insert additional sheets of the same size)
Savings Bond Calculator Page 1 of 2
Savim
Series
Denomination
Serial Number
# Bonds Total Price Total Interest Total Value
18 $337.50 $3,306.34 $3,643.84
Issue Interest
Serial Number Issue Date Series Denom Price Interest Value Rate
Q19269325047 12/1961 E $25 $18.75 $188.00 $206.75
Q1920810158 12/1961 E 25 18.75 188.00 206.75
Q1920807174 11/1961 E 25 18.75 187.40 206.15
Q1907129205 11/1961 E 25 18.75 187.40 206.15
Q1907126174 10/1961 E 25 18.75 187.40 206.15
Q1907327064 10/1961 E 25 18.75 187.40 206.15
Q1907324188 09/1961 E 25 18.75 187.42 206.17
Q1907321343 09/1961 E 25 18.75 187.42 206.17
Q1906435488 09/1961 E 25 18.75 187.42 206.17
Q1906432646 08/1961 E 25 18.75 185.13 203.88
Q1894272722 08/1961 E 25 18.75 185.13 203.88
Q1894269773 07/1961 E 25 18.75 183.20 201.95
Q1894267021 07/1961 E 25 18.75 183.20 201.95
Q1894118577 06/1961 E 25 18.75 183.20 201.95
Q1894116338 06/1961 E 25 18.75 183.20 201.95
Q1894114434 05/1961 E 25 18.75 182.61 201.36
Q1665694084 12/1958 E 25 18.75 170.59 189.34
Q1604770202 12/1957 E 25 18.75 162.22 180.97
}~ttI~ Viewing Bonds 1-18
Issue Date
Next
Accrual
YTD In
$0.
Final
Maturit
12/200
12/200
11/200
11/200
10/200
10/200
09/200
09/200
09/200
08/200
08/200
07/200
07/200
06/200
06/200
05/200
12/199
12/199
Note Description
NI Not Issued
NE Not Eligible for Payment
P5 Includes 3-month interest penalty
ME Matured (Exchangeable for H/I)
MN Matured (Not Exchangeable for HH)
Please rate this service.
http://wwws.publicdebt.treas.gov/BC/SB CPrice 11/19/04
Savings Bond Calculator Page 1 of 2
109/2003
Savinc
Series Denomination
Bonds ,-J sJ~'~'~
Serial Number
Issue Date
# Bonds Total Price
26 $487.50
Serial Number Issue Date Series Denom
Q1974776799 12/1962 E $25
Q1970053607 12/1962 E 25
Q1970050443 11/1962 E 25
Q1970047240 11/1962 E 25
Q1966434091 10/1962 E 25
Q1966430915 10/1962 E 25
Q1962908762 09/1962 E 25
Q1962905549 09/1962 E 25
Q1958932375 09/1962 E 25
Q1958929173 08/1962 E 25
Q1958925966 08/1962 E 25
Q1947512770 07/1962 E 25
Q1947509432 07/1962 E 25
Q1947506300 06/1962 E 25
Q1946973269 06/1962 E 25
Q1946970232 05/1962 E 25
Q1946967233 05/1962 E 25
Q1938849185 04/1962 E 25
Q1938846148 04/1962 E 25
Q1938843153 03/1962 E 25
Q1938841760 03/1962 E 25
Q1930697152 03/1962 E 25
Q1930694093 02/1962 E 25
Q1930691084 02/1962 E 25
Q1926331079 01/1962 E 25
Q1926328075 01/1962 E 25
~ J Viewing Bonds 1-26
Total Interest Total Value YTD In,
$5,014.77 $5,502.27 $0.0
Issue Interest Next Final
Price Interest Value Rate Accrual Maturity
$18.75 $196.47 $215.22 12/2002
18.75 196.47 215.22 12/2002
18.75 195.58 214.33 11/2002
18.75 195.58 214.33 11/2002
18.75 195.58 214.33 10/2002
18.75 195.58 214.33 10/2002
18.75 195.57 214.32 09/2002
18.75 195.57 214.32 09/2002
18.75 195.57 214.32 09/2002
18.75 194.06 212.81 08/2002
18.75 194.06 212.81 08/2002
18.75 192.04 210.79 07/2002
18.75 192.04 210.79 07/2002
18.75 192.04 210.79 06/2002
18.75 192.04 210.79 06/2002
18.75 191.49 210.24 05/2002
18.75 191.49 210.24 05/2002
18.75 191.49 210.24 04/2002
18.75 191.49 210.24 04/2002
18.75 191.52 210.27 03/2002
18.75 191.52 210.27 03/2002
18.75 191.52 210.27 03/2002
18.75 190.00 208.75 02/2002
18.75 190.00 208.75 02/2002
18.75 188.00 206.75 01/2002
18.75 188.00 206.75 01/2002
http://wwws.publicdebt.treas.gov/BC/SBCPrice
11/16/2004
Savings Bond Calculator Page 1 of 2
109/2003 [ Upd~e I
Savinc
Series Denomination
Bonds ~ $1~-~'~
Serial Number
Issue Date
# Bonds Total Price
26 $487.50
Serial Number Issue Date Series Denom
Q2030718374 12/1963 E $25
Q2030715565 12/1963 E 25
Q2030712829 11/1963 E 25
Q2030710056 11/1963 E 25
Q2017722282 10/1963 E 25
Q2017719520 10/1963 E 25
Q2017716683 09/1963 E 25
Q2013856881 09/1963 E 25
Q2013853951 08/1963 E 25
Q2013851159 08/1963 E 25
Q2013848326 08/1963 E 25
Q2008320422 07/1963 E 25
Q2008317514 07/1963 E 25
Q2008314585 06/1963 E 25
Q2003291638 06/1963 E 25
Q2003288849 05/1963 E 25
Q2003286038 05/1963 E 25
Q2003283216 04/1963 E 25
Q1992072361 04/1963 E 25
Q1992069475 03/1963 E 25
Q1992066272 03/1963 E 25
Q1985713049 03/1963 E 25
Q1985709800 02/1963 E 25
Q1985706414 02/1963 E 25
Q1974783272 01/1963 E 25
Q1974780062 01/1963 E 25
[~ I Viewing Bonds 1-26
Total Interest Total Value
$5,226.71 $5,714.21
Issue Interest
Price Interest Value Rate
$18.75 $203.59 $222.34 4.00%
18.75 203.59 222.34 4.00%
18.75 202.22 220.97 4.00%
18.75 202.22 220.97 4.00%
18.75 202.22 220.97 4.00%
18.75 202.22 220.97 4.00%
18.75 204.42 223.17
18.75 204.42 223.17
18.75 203.36 222.11
18.75 203.36 222.11
18.75 203.36 222.11
18.75 201.20 219.95
18.75 201.20 219.95
18.75 201.20 219.95
18.75 201.20 219.95
18.75 199.54 218.29
18.75 199.54 218.29
18.75 199.54 218.29
18.75 199.54 218.29
18.75 199.57 218.32
18.75 199.57 218.32
18.75 199.57 218.32
18.75 198.56 217.31
18.75 198.56 217.31
18.75 196.47 215.22
18.75 196.47 215.22
Next
Accrual
12/2003
12/2003
11/2003
11/2003
10/2003
10/2003
YTD lw
$150.
Final
Maturity
12/2003
12/2003
11/2003
11/2003
10/2003
10/2003
09/2003
09/2003
08/2003
08/2003
08/2003
07/2003
07/2003
06/2003
06/2003
05/2003
05/2003
04/2003
04/2003
03/2003
03/2003
03/2003
02/2003
02/2003
01/2003
01/2003
http://wwws.publicdebt.t~eas.gov/BC/SBCPrice
11/16/2004
Savings Bond Calculator Page 1 of 1
[09/2003 I Updma I
Snvinc
Series
J E Bonds
Denomination Serial Number
$125 '1
# Bonds Total Price
I $18.75
Serial Number Issue Date Series
L617100030 12/1963 E
Total Interest Total Value
$203.59 $222.34
Issue Interest
Denom Price Interest Value Rate
$25 $18.75 $203.59 $222.34 4.00%
Note Description
NI Not Issued
NE Not Eligible for Payment
P5 Includes 3-month interest penalty
ME Matured (Exchangeable for HH)
MN Matured (Not Exchangeable for HH)
Please rate this service.
(Please prfnt and/or save this page before submi~ng your survey)
Service Excellent Good Fair Poor
Savings Bond Calculator ~' C ~' ~'
Submit Survey j Reset J
Issue Date
I
YTD In~
$8.63
Next Final
Accrual Maturity
12/2003 12/2003
htlp://wwws.publicdebt.treas.gov/B C/SBCPrice
11/14/2004
Savings Bond Calculator Page 1 of 2
109/2003
Savinc
Series Denomination
IE BonOs
Serial Number
I
Issue Date
# Bonds Total Price
26 $487.50
Serial Number Issue Date Series Denom
Q2096078515 12/1964 E $25
Q2082229747 12/1964 E 25
Q2082226940 11/1964 E 25
Q2082224126 11/1964 E 25
Q2081869227 10/1964 E 25
Q2081866416 10/1964 E 25
Q2081843593 09/1964 E 25
Q2080847723 09/1964 E 25
Q2074554908 08/1964 E 25
Q2074551995 08/1964 E 25
Q2074549149 08/1964 E 25
Q2074546246 07/1964 E 25
Q2064718351 07/1964 E 25
Q2052579693 06/1964 E 25
Q2064713793 06/1964 E 25
Q2064711056 05/1964 E 25
Q2056022747 05/1964 E 25
Q2056020036 04/1964 E 25
Q2052575276 04/1964 E 25
Q2047387508 03/1964 E 25
Q2047384859 03/1964 E 25
Q2047382199 02/1964 E 25
Q2040199447 02/1964 E 25
Q2040196688 02/1964 E 25
Q2040193926 01/1964 E 25
Q2040192829 01/1964 E 25
Viewing Bonds 1-26
Total Interest Total Value YTD ln~
$5,251.79 $5,739.29 $163.
lssue lnterest Next Final
Price Interest Value Rate Accrual Maturity
$18.75 $204.05 $222.80 4.00% 03/2004 12/2004
18.75 204.05 222.80 4.00% 03/2004 12/2004
18.75 202.63 221.38 4.00% 02/2004 11/2004
18.75 202.63 221.38 4.00% 02/2004 11/2004
18.75 202.63 221.38 4.00% 01/2004 10/2004
18.75 202.63 221.38 4.00% 01/2004 10/2004
18.75 202.63 221.38 4.00% 12/2003 09/2004
18.75 202.63 221.38 4.00% 12/2003 09/2004
18.75 201.59 220.34 4.00% 11/2003 08/2004
18.75 201.59 220.34 4.00% 11/2003 08/2004
18.75 201.59 220.34 4.00% 11/2003 08/2004
18.75 199.46 218.21 4.00% 10/2003 07/2004
18.75 199.46 218.21 4.00% 10/2003 07/2004
18.75 203.83 222.58 4.00% 03/2004 06/2004
18.75 203.83 222.58 4.00% 03/2004 06/2004
18.75 202.35 221.10 4.00% 02/2004 05/2004
18.75 202.35 221.10 4.00% 02/2004 05/2004
18.75 202.35 221.10 4.00% 01/2004 04/2004
18.75 202.35 221.10 4.00% 01/2004 04/2004
18.75 202.37 221.12 4.00% 12/2003 03/2004
18.75 202.37 221.12 4.00% 12/2003 03/2004
18.75 201.32 220.07 4.00% 11/2003 02/2004
18.75 201.32 220.07 4.00% 11/2003 02/2004
18.75 201.32 220.07 4.00% 11/2003 02/2004
18.75 199.23 217.98 4.00% 10/2003 01/2004
18.75 199.23 217.98 4.00% 10/2003 01/2004
http://wwws.publicdebt.treas.gov/BC/SBCPrice
11/16/2004
Savings Bond Calculator Page 1 of 2
109/2003 [Upd~t~
Savinc
Series Denomination
Bonds "l $125 '1
# Bonds Total Price
26 $487.50
Serial Number Issue Date Series Denom
Q2155408310 12/1965 E $25
Q2155406393 12/1965 E 25
Q2154584470 11/1965 E 25
Q2149269547 11/1965 E 25
Q2149267557 10/1965 E 25
Q2149265525 10/1965 E 25
Q2138866378 09/1965 E 25
Q2138864264 09/1965 E 25
Q2138862075 08/1965 E 25
Q2132293007 08/1965 E 25
Q2132290656 07/1965 E 25
Q2132288233 07/1965 E 25
Q2122292897 07/1965 E 25
Q2122290307 06/1965 E 25
Q2122287710 06/1965 E 25
Q2115301106 05/1965 E 25
Q2115298579 05/1965 E 25
Q2114904004 04/1965 E 25
Q2109195411 04/1965 E 25
Q2106921780 03/1965 E 25
Q2106919059 03/1965 E 25
Q2102253380 02/1965 E 25
Q2102250621 02/1965 E 25
Q2102247881 01/1965 E 25
Q2096364170 01/1965 E 25
Q2096361396 01/1965 E 25
~ ] Viewing Bonds 1-26
Serial Number Issue Date
Total Interest Total Value YTD In'
$4,281.22 $4,768.72 $124.
Issue Interest Next Final
Price Interest Value Rate Accrual Maturity
$18.75 $109.37 $128.12 12/1995
18.75 109.37 128.12 12/1995
18.75 153.17 171.92 2.51% 02/2004 11/2005
18.75 153.17 171.92 2.51% 02/2004 11/2005
18.75 153.17 171.92 2.51% 01/2004 10/2005
18.75 153.17 171.92 2.51% 01/2004 10/2005
18.75 153.17 171.92 2.51% 12/2003 09/2005
18.75 153.17 171.92 2.51% 12/2003 09/2005
18.75 152.29 171.04 2.51% 11/2003 08/2005
18.75 152.29 171.04 2.51% 11/2003 08/2005
18.75 155.16 173.91 3.09% 10/2003 07/2005
18.75 155.16 173.91 3.09% 10/2003 07/2005
18.75 155.16 173.91 3.09% 10/2003 07/2005
18.75 157.84 176.59 2.51% 03/2004 06/2005
18.75 157.84 176.59 2.51% 03/2004 06/2005
18.75 182.57 201.32 4.00% 02/2004 05/2005
18.75 182.57 201.32 4.00% 02/2004 05/2005
18.75 182.57 201.32 4.00% 01/2004 04/2005
18.75 182.57 201.32 4.00% 01/2004 04/2005
18.75 182.59 201.34 4.00% 12/2003 03/2005
18.75 182.59 201.34 4.00% 12/2003 03/2005
18.75 181.61 200.36 4.00% 11/2003 02/2005
18.75 181.61 200.36 4.00% 11/2003 02/2005
18.75 199.68 218.43 4.00% 10/2003 01/2005
18.75 199.68 218.43 4.00% 10/2003 01/2005
18.75 199.68 218.43 4.00% 10/2003 01/2005
http://wwws.publiedebt.treas.gov/BC/SBCPrice
11/16/2004
Savings Bond Calculator Page 1 of 1
Savinc
Series
IE BonOs
Denomination Serial Number
# Bonds Total Price Total Interest
2 $37.50 $218.74
Issue
Serial Number Issue Date Series Denom Price Interest
L666076424 12/1965 E $25 $18.75 $109.37
L666076425 12/1965 E 25 18.75 109.37
Issue Date
I
Total Value
$256.24
Interest
Value Rate
$128.12
128.12
YTD In,
$0.0
Next Final
Accrual Maturity
12/1995
12/1995
Note Description
NI Not Issued
NE Not Eligible for Payment
P5 Includes 3-month interest penalty
ME Matured (Exchangeable for HH)
MN Matured (Not Exchangeable for HH)
Please ral~ this service.
(Please print and/or save this page before submitting your suryey)
Service Excellent Good Fair Poor
Savings Bond Calculator ~' ¢' ~' ¢'
Submit Survey I ResetI
http://wwws.publicdebt.treas.gov/BC/SBCPrice
11/14/2004
7
Savings Bond Calculator Page 1 of 2
109/2003 ~
Savinc
Series
IE Bonds ,-j
Denomination Serial Number
$125 I
Issue Date
I
# Bonds Total Price Total Interest
28 $525.00 $2,952.98
Issue
Serial Number Issue Date Series Denom Price Interest
Q2230036211 12/1966 E $25 $18.75 $107.10
Q2220624269 12/1966 E 25 18.75 107.10
Q2220623312 11/1966 E 25 18.75 105.71
Q2206090437 11/1966 E 25 18.75 105.71
Q2206090436 11/1966 E 25 18.75 105.71
Q2220622435 11/1966 E 25 18.75 105.71
Q2209901561 10/1966 E 25 18.75 104.52
Q2209900712 10/1966 E 25 18.75 104.52
Q2209899872 10/1966 E 25 18.75 104.52
Q2201323152 09/1966 E 25 18.75 104.52
Q2201323978 09/1966 E 25 18.75 104.52
Q2201321504 08/1966 E 25 18.75 104.52
Q2201322336 08/1966 E 25 18.75 104.52
Q2194326628 07/1966 E 25 18.75 104.52
Q2194325723 07/1966 E 25 18.75 104.52
Q2187941924 06/1966 E 25 18.75 104.53
Q2187941104 06/1966 E 25 18.75 104.53
Q2182806311 05/1966 E 25 18.75 103.27
Q2182805462 05/1966 E 25 18.75 103.27
Q2182804609 04/1966 E 25 18.75 103.19
Q2171746810 04/1966 E 25 18.75 103.19
Q2171745373 03/1966 E 25 18.75 103.19
Q2171744045 03/1966 E 25 18.75 103.19
Q2167492596 02/1966 E 25 18.75 109.38
Q2167491026 02/1966 E 25 18.75 109.38
Q2164112449 01/1966 E 25 18.75 109.38
Q2164110829 01/1966 E 25 18.75 109.38
Q2164109141 01/1966 E 25 18.75 109.38
Total Value
$3,477.98
Interest
Value Ra~
$125.85
125.85
124.46
124.46
124.46
124.46
123.27
123.27
123.27
123.27
123.27
123.27
123.27
123.27
123.27
123.28
123.28
122.02
122.02
121.94
121.94
121.94
121.94
128.13
128.13
128.13
128.13
128.13
Next
Accrual
YTD In~
$0.0
Final
Matufi~
12/1996
12/1996
11/1996
11/1996
11/1996
11/1996
10/1996
10/1996
10/1996
09/1996
09/1996
08/1996
08/1996
07/1996
07/1996
06/1996
06/1996
05/1996
05/1996
04/1996
04/1996
03/1996
03/1996
02/1996
02/1996
01/1996
01/1996
01/1996
http://wwws.publicdebt.treas.gov/BC/S BCPrice 11/14/2004
Savings Bond Calculator Page 1 of 2
109/2003 i Updml ~
Savinc
Series Denomination
Bonds ~_J $~'~ I
Serial Number
Issue Date
I
# Bonds Total Price Total Interest
26 $487.50 $2,834.29
Issue
Serial Number Issue Date Series Denom Price Interest
Q2301434956 12/1967 E $25 $18.75 $112.53
Q2301433917 12/1967 E 25 18.75 112.53
Q2284223797 11/1967 E 25 18.75 110.95
Q2284222721 11/1967 E 25 18.75 110.95
Q2284221685 10/1967 E 25 18.75 109.70
Q2284220669 10/1967 E 25 18.75 109.70
Q2279584035 09/1967 E 25 18.75 109.70
Q2279582956 09/1967 E 25 18.75 109.70
Q2279581878 09/1967 E 25 18.75 109.70
Q2279580873 08/1967 E 25 18.75 109.70
Q2268552435 08/1967 E 25 18.75 109.70
Q2268551423 07/1967 E 25 18.75 109.70
Q2268550375 07/1967 E 25 18.75 109.70
Q2267604359 06/1967 E 25 18.75 109.71
Q2254572373 06/1967 E 25 18.75 109.71
Q2254571430 05/1967 E 25 18.75 108.31
Q2249434473 05/1967 E 25 18.75 108.31
Q2249433516 04/1967 E 25 18.75 107.11
Q2249432541 04/1967 E 25 18.75 107.11
Q2249431632 04/1967 E 25 18.75 107.11
Q2235271714 03/1967 E 25 18.75 107.11
Q2235270813 03/1967 E 25 18.75 107.11
Q2235269854 02/1967 E 25 18.75 107.11
Q2230038908 02/1967 E 25 18.75 107.11
Q2230038006 01/1967 E 25 18.75 107.11
Q2230037129 01/1967 E 25 18.75 107.11
[~ I Viewing Bonds 1-26
Total Value YTD lw
$3,321.79 $0.0
Interest Next Final
Value Rate Accrual Maturity
$131.28 12/1997
131.28 12/1997
129.70 11/1997
129.70 11/1997
128.45 10/1997
128.45 10/1997
128.45 09/1997
128.45 09/1997
128.45 09/1997
128.45 08/1997
128.45 08/1997
128.45 07/1997
128.45 07/1997
128.46 06/1997
128.46 06/1997
127.06 05/1997
127.06 05/1997
125.86 04/1997
125.86 04/1997
125.86 04/1997
125.86 03/1997
125.86 03/1997
125.86 02/1997
125.86 02/1997
125.86 01/1997
125.86 01/1997
http://wwws.publicdebt.treas.gov/BC/SBCPrice
11/15/2004
q
Savings Bond Calculator Page 1 of 2
109/2003
Savinc
~ries
Bonds
Denomination
Serial Number
Issue Date
I
# Bonds Total Price
26 $487.50
Serial Number
Q2374219309
Q2374218145
Q2374216987
Q2374215807
Q2359823638
Q2359822512
Q2359821371
Q2359820235
Q2359819105
Q2347147980
Q2347146910
Q2333859814
Q2333858696
Q2333857574
Q2333856469
Q2333855416
Q2316619376
Q2316618353
Q2316617259
Q2316616185
Q2316615176
Q2311870159
Q2311869132
Q2311868080
Q2311867001
Q2301435991
~J Viewing
Total Interest Total Value
$2,980.18 $3,467.68
Issue Interest
Issue Date Series Denom Price Interest Value Rate
12/1968 E $25 $18.75 $118.53 $137.28
12/1968 E 25 18.75 118.53 137.28
11/1968 E 25 18.75 116.69 135.44
11/1968 E 25 18.75 116.69 135.44
10/1968 E 25 18.75 115.39 134.14
10/1968 E 25 18.75 115.39 134.14
09/1968 E 25 18.75 115.39 134.14
09/1968 E 25 18.75 115.39 134.14
08/1968 E 25 18.75 115.39 134.14
08/1968 E 25 18.75 115.39 134.14
08/1968 E 25 18.75 115.39 134.14
07/1968 E 25 18.75 115.39 134.14
07/1968 E 25 18.75 115.39 134.14
06/1968 E 25 18.75 1t5.41 134.16
06/1968 E 25 18.75 115.41 134.16
05/1968 E 25 18.75 113.82 132.57
05/1968 E 25 18.75 113.82 132.57
04/1968 E 25 18.75 112.53 131.28
04/1968 E 25 18.75 112.53 131.28
03/1968 E 25 18.75 112.53 131.28
03/1968 E 25 18.75 112.53 131.28
03/1968 E 25 18.75 112.53 131.28
02/1968 E 25 18.75 112.53 131.28
02/1968 E 25 18.75 112.53 131.28
01/1968 E 25 18.75 112.53 131.28
01/1968 E 25 18.75 112.53 131.28
Bonds 1-26
Next
Accrual
YTD ln~
$0.0
Final
Maturity
12/1998
12/1998
11/1998
11/1998
10/1998
10/1998
09/1998
09/1998
08/1998
08/1998
08/1998
07/1998
07/1998
06/1998
06/1998
05/1998
05/1998
04/1998
04/1998
03/1998
03/1998
03/1998
02/1998
02/1998
01/1998
01/1998
http://wwws.publicdebt.treas.gov/BC/SBCPrice
11/15/2004
lo
Savings Bond Calculator Page 1 of 2
109/2003 i UPtime I
Savinc
Series Denomination
# Bonds Total Price
26 $487.50
Serial Number Issue Date Series Denom
Q2452873377 12/1969 E $25
Q2452872249 12/1969 E 25
Q2452871091 11/1969 E 25
Q2452869955 11/1969 E 25
Q2445584797 10/1969 E 25
Q2445583638 10/1969 E 25
Q2445582521 09/1969 E 25
Q2445581309 09/1969 E 25
Q2445580178 08/1969 E 25
Q2421144015 08/1969 E 25
Q2421142752 08/1969 E 25
Q2421141634 07/1969 E 25
Q2421140456 07/1969 E 25
Q2415132300 06/1969 E 25
Q2415131138 06/1969 E 25
Q2415129972 05/1969 E 25
Q2415128854 05/1969 E 25
Q2394704709 04/1969 E 25
Q2394703549 04/1969 E 25
Q2394702389 03/1969 E 25
Q2394701225 03/1969 E 25
Q2394700100 03/1969 E 25
Q2387777932 02/1969 E 25
Q2387776773 02/1969 E 25
Q2387775591 01/1969 E 25
Q2381969435 01/1969 E 25
Viewing Bonds 1-26
Serial Number
Total Interest
$3,047.98
Issue
Price Interest Value
$18.75 $116.97 $135.72
18.75 116.97 135.72
18.75 116.27 135.02
18.75 116.27 135.02
18.75 116.27 135.02
18.75 116.27 135.02
18.75 116.27 135.02
18.75 116.27 135.02
18.75 116.26 135.01
18.75 116.26 135.01
18.75 116.26 135.01
18.75 115.96 134.71
18.75 115.96 134.71
18.75 114.67 133.42
18.75 114.67 133.42
18.75 119.85 138.60
18.75 119.85 138.60
18.75 118.52 137.27
18.75 118.52 137.27
18.75 118.52 137.27
18.75 118.52 137.27
18.75 118.52 137.27
18.75 118.52 137.27
18.75 118.52 137.27
18.75 118.52 137.27
18.75 118.52 137.27
Issue Date
I
Total Value
$3,535.48
Interest
Rate
YTD In~
$0.0
Next Final
Accrual Maturity
12/1999
12/1999
11/1999
11/1999
10/1999
10/1999
09/1999
09/1999
08/1999
08/1999
08/1999
07/1999
07/1999
06/1999
06/1999
05/1999
05/1999
04/1999
04/1999
03/1999
03/1999
03/1999
02/1999
02/1999
01/1999
01/1999
http://wwws.publicdebt.treas.gov/BC/SBCPrice
11/16/2004
Savings Bond Calculator Page 1 of 2
109/2003 i uP'l~t. I ~
Savinc
Series Denomination Serial Number
BonOs ~J ,[~'~ I
# Bonds Total Price Total Interest Total Value
26 $487.50 $3,114.29 $3,601.79
Issue Interest
Serial Number Issue Date Series DehOrn Price Interest Value Rate
Q2539338081 12/1970 E $25 $18.75 $121.26 $140.01
Q2527830000 12/1970 E 25 18.75 121.26 140.01
Q2527828971 11/1970 E 25 18.75 120.94 139.69
Q2527827874 11/1970 E 25 18.75 120.94 139.69
Q2527826862 10/1970 E 25 18.75 120.94 139.69
Q2527825785 10/1970 E 25 18.75 120.94 139.69
Q2514055717 09/1970 E 25 18.75 120.94 139.69
Q2514054683 09/1970 E 25 18.75 120.94 139.69
Q2514053625 08/1970 E 25 18.75 120.94 139.69
Q2514052588 08/1970 E 25 18.75 120.94 139.69
Q2514051525 08/1970 E 25 18.75 120.94 139.69
Q2514050443 07/1970 E 25 18.75 120.61 139.36
Q2494494400 07/1970 E 25 18.75 120.61 139.36
Q2494493331 06/1970 E 25 18.75 119.25 138.00
Q2494492317 06/1970 E 25 18.75 119.25 138.00
Q2494491257 05/1970 E 25 18.75 118.61 137.36
Q2494490220 05/1970 E 25 18.75 118.61 137.36
Q2481078198 04/1970 E 25 18.75 118.61 137.36
Q2481077126 04/1970 E 25 18.75 118.61 137.36
Q2481076107 03/1970 E 25 18.75 !18.61 137.36
Q2481075043 03/1970 E 25 18.75 118.61 137.36
Q2467064920 02/1970 E 25 18.75 118.59 137.34
Q2467063855 02/1970 E 25 18.75 118.59 137.34
Q2467062717 01/1970 E 25 18.75 118.25 137.00
Q2467061644 01/1970 E 25 18.75 118.25 137.00
Q2467060510 01/1970 E 25 18.75 118.25 137.00
~ I Viewing Bonds 1-26
Issue Date
I
Next
Accrual
YTD In~
$0.0
Final
Maturity
12/2000
12/2000
11/2000
11/2000
10/2000
10/2000
09/2000
09/2000
08/2000
08/2000
08/2000
07/2000
07/2000
06/2000
06/2000
05/2000
05/2000
04/2000
04/2000
03/2000
03/2000
02/2000
02/2000
01/2000
01/2000
01/2000
http://wwws.publicdebt.treas.gov/BC/SBCPrice
11 / 16/2004
Savings Bond Calculator Page 1 of 2
109/2003
Savinc
Series Denomination
IE Bonds
Serial Number
I
Issue Date
I
# Bonds Total Price Total Interest
26 $487.50 $2,800.48
Serial Number Issue Date Series Denom
Q2610662903 12/1971
Q2610661801 12/1971
Q2610660698 11/1971
Q2610654625 11/1971
Q2598044539 10/1971
Q2598043458 10/1971
Q2598042365 09/1971
Q2598041264 09/1971
Q2598040209 08/1971
Q2597703101 08/1971
Q2553480052 07/1971
Q2553478940 07/1971
Q2553477855 07/1971
Q2553476777 06/1971
Q2553475706 06/1971
Q2564854659 05/1971
Q2564853606 05/1971
Q2564852531 04/1971
Q2564851517 04/1971
Q2564850441 03/1971
Q2564669430 03/1971
Q2547919359 02/1971
Q2547918304 02/1971
Q2547917262 01/1971
Q2547916207 01/1971
Q2547915162 01/1971
~ [ Viewing Bonds 1-26
Issue
Price Interest Value
E $25 $18.75 $107.91 $126.66
E 25 18.75 107.91 126.66
E 25 18.75 107.61 126.36
E 25 18.75 107.61 126.36
E 25 18.75 107.61 126.36
E 25 18.75 107.61 126.36
E 25 18.75 107.61 126.36
E 25 18.75 107.61 126.36
E 25 18.75 107.61 126.36
E 25 18.75 107.61 126.36
E 25 18.75 107.31 126.06
E 25 18.75 107.31 126.06
E 25 18.75 107.31 126.06
E 25 18.75 108.20 126.95
E 25 18.75 108.20 126.95
E 25 18.75 107.85 126.60
E 25 18.75 107.85 126.60
E 25 18.75 107.85 126.60
E 25 18.75 107.85 126.60
E 25 18.75 107.85 126.60
E 25 18.75 107.85 126.60
E 25 18.75 107.85 126.60
E 25 18.75 107.85 126.60
E 25 18.75 107.55 126.30
E 25 18.75 107.55 126.30
E 25 18.75 107.55 126.30
Total Value
$3,287.98
Interest
Rate
YTD ln~
$0.0
Next Final
Accrual Maturity
12/2001
12/2001
11/2001
11/2001
10/2001
10/2001
09/2001
09/2001
08/2001
08/2001
07/2001
07/2001
07/2001
06/2001
06/2001
05/2001
05/2001
04/2001
04/2001
03/2001
03/2001
02/2001
02/2001
01/2001
01/2001
01/2001
http://wwws.publicdebt.treas.gov/BC/SBCPrice
11 / 16/2004
Savings Bond Calculator Page 1 of 2
109/2003 I Updme I
Savinc
Series Denomination
Serial Number
I
# Bonds Total Price
27 $506.25
Serial Number lssue Date Series Denom
Q5056733428 12/1972 E $25
Q5056732303 12/1972 E 25
Q5056731171 12/1972 E 25
Q5056730031 11/1972 E 25
Q5037638894 11/1972 E 25
Q5037637773 10/1972 E 25
Q5037636670 10/1972 E 25
Q5037635547 09/1972 E 25
Q5037634429 09/1972 E 25
Q5037633315 08/1972 E 25
Q5020820200 08/1972 E 25
Q5020819100 07/1972 E 25
Q5020818015 07/1972 E 25
Q5020816873 07/1972 E 25
Q5020815731 06/1972 E 25
Q5004834601 06/1972 E 25
Q5004833485 05/1972 E 25
Q5004832380 05/1972 E 25
Q5004831283 04/1972 E 25
Q5004830145 04/1972 E 25
Q5004824025 03/1972 E 25
Q2611458935 03/1972 E 25
Q2611457826 02/1972 E 25
Q2611456722 02/1972 E 25
Q2611455619 01/1972 E 25
Q2611454535 01/1972 E 25
Q2610664473 01/1972 E 25
Viewing Bonds 1-27
Total Interest
$2,926.65
Issue
Price Interest Value
$18.75 $109.58 $128.33
18.75 109.58 128.33
18.75 109.58 128.33
18.75 109.30 128.05
18.75 109.30 128.05
18.75 109.30 128.05
18.75 109.30 128.05
18.75 109.30 128.05
18.75 109.30 128.05
18.75 109.30 128.05
18.75 109.30 128.05
18.75 109.02 127.77
18.75 109.02 127.77
18.75 109.02 127.77
18.75 107.79 126.54
18.75 107.79 126.54
18.75 107.44 126.19
18.75 107.44 126.19
18.75 107.44 126.19
18.75 107.44 126.19
18.75 107.44 126.19
18.75 107.44 126.19
18.75 107.42 126.17
18.75 107.42 126.17
18.75 107.13 125.88
18.75 107.13 125.88
18.75 107.13 125.88
Issue Date
I
Total Value
$3,432.90
Interest
Rate
YTD ln~
$0.0
Next Final
Accrual Maturity
12/2002
12/2002
12/2002
11/2002
11/2002
10/2002
10/2002
09/2002
09/2002
08/2002
08/2002
07/2002
07/2002
07/2002
06/2002
06/2002
05/2002
05/2002
04/2002
04/2002
03/2002
03/2002
02/2002
02/2002
01/2002
01/2002
01/2002
http://wwws.publicdebt.treas.gov/BC/SBCPrice 11/16/2004
Savings Bond Calculator Page 1 of 2
[09/2003
Savin:
Series Denomination Serial Number
Bonds ~a $125 '-I I
Issue Date
# Bonds Total Price Total Interest Total Value
29 $712.50 $4,226.42 $4,938.9'2
Issue Interest
Serial Number Issue Date Series Danom Price Interest Value Rate
Q5146568903 12/1973 E $25 $18.75 $107.21 $125.96 4.00%
Q5146567837 12/1973 E 25 18.75 107.21 125.96 4.00%
Q5146566735 12/1973 E 25 18.75 107.21 125.96 4.00%
Q5146565657 11/1973 E 25 18.75 112.15 130.90 4.00%
Q5125677536 11/1973 E 25 18.75 112.15 130.90 4.00%
Q5125676447 10/1973 E 25 18.75 112.15 130.90 4.00%
Q5125675325 10/1973 E 25 18.75 112.15 130.90 4.00%
Q5125674244 09/1973 E 25 18.75 113.01 131.76
Q5125673115 09/1973 E 25 18.75 113.01 131.76
Q5111109988 08/1973 E 25 18.75 112.99 131.74
Q5111108859 08/1973 E 25 18.75 112.99 131.74
Q5111107744 07/1973 E 25 18.75 112.71 131.46
Q5111106608 07/1973 E 25 18.75 112.71 131.46
Q5111099488 06/1973 E 25 18.75 111.45 130.20
Q5111098251 06/1973 E 25 18.75 111.45 130.20
Q5082001058 06/1973 E 25 18.75 111.45 130.20
Q5081999892 05/1973 E 25 18.75 111.14 129.89
Q5081998783 05/1973 E 25 18.75 111.14 129.89
Q5081997652 04/1973 E 25 18.75 111.14 129.89
Q5081996547 04/1973 E 25 18.75 111.14 129.89
Q5075680406 03/1973 E 25 18.75 111.14 129.89
Q5075679277 03/1973 E 25 18.75 111.14 129.89
Q5075678130 02/1973 E 25 18.75 111.14 129.89
Q5075677021 02/1973 E 25 18.75 111.14 129.89
Q5075675696 01/1973 E 25 18.75 110.81 129.56
Q5056734554 01/1973 E 25 18.75 110.81 129.56
C1008240187 03/1973 E 100 75.00 444.56 519.56
C1008240186 03/1973 E 100 75.00 444.56 519.56
YTD Iw
$117.
Next Final
Accrual MatuHO
12/2003 12/2003
12/2003 12/2003
12/2003 12/2003
11/2003 11/2003
11/2003 11/2003
10/2003 10/2003
10/2003 10/2003
09/2003
09/2003
08/2003
08/2003
07/2003
07/2003
06/2003
06/2003
06/2003
05/2003
05/2003
04/2003
04/2003
03/2003
03/2003
02/2003
02/2003
01/2003
01/2003
03/2003
03/2003
http://wwws.publicdebt.treas.gov/BC/SBCPrice
11/16/2004
Savings Bond Calculator Page 1 of 2
09/2003 ~
Savinc
Series Denomination
JE Bonds ,,J $ ~'~[
Serial Number
I
Issue Date
I
# Bonds Total Price
26 $487.50
Serial Number Issue Date Series Denom
Q5218326841 12/1974 E $25
Q5218325725 12/1974 E 25
Q5218324573 11/1974 E 25
Q5218323443 11/1974 E 25
Q5217914854 11/1974 E 25
Q5210065164 10/1974 E 25
Q5210064014 10/1974 E 25
Q5210062898 09/1974 E 25
Q5210061768 09/1974 E 25
Q5197908649 08/1974 E 25
Q5197907495 08/1974 E 25
Q5197906378 07/1974 E 25
Q5197905230 07/1974 E 25
Q5197904115 06/1974 E 25
Q5175221974 06/1974 E 25
Q5175220858 06/1974 E 25
Q5175219757 05/1974 E 25
Q5175218682 05/1974 E 25
Q5175217609 04/1974 E 25
Q5159945530 04/1974 E 25
Q5159944426 03/1974 E 25
Q5159943354 03/1974 E 25
Q5159942262 02/1974 E 25
Q5159941196 02/1974 E 25
Q5159940105 01/1974 E 25
Q5146570008 01/1974 E 25
~ J Viewing Bonds 1-26
Total Intere~ T~al Value
$2,753.44 $3,240.94
Issue In.rest
Price Interest Value Ra~
$18.75 $105.25 $124.00 4.00%
18.75 105.25 124.00 4.00%
18.75 104.94 123.69 4.00%
18.75 104.94 123.69 4.00%
18.75 104.94 123.69 4.00%
18.75 103.77 122.52 4.00%
18.75 103.77 122.52 4.00%
18.75 106.22 124.97 4.00%
18.75 106.22 124.97 4.00%
18.75 106.22 124.97 4.00%
18.75 106.22 124.97 4.00%
18.75 106.22 124.97 4.00%
18.75 106.22 124.97 4.00%
18.75 106.22 124.97 4.00%
18.75 106.22 124.97 4.00%
18.75 106.22 124.97 4.00%
18.75 105.93 124.68 4.00%
18.75 105.93 124.68 4.00%
18.75 104.74 123.49 4.00%
18.75 104.74 123.49 4.00%
18.75 107.21 125.96 4.00%
18.75 107.21 125.96 4.00%
18.75 107.21 125.96 4.00%
18.75 107.21 125.96 4.00%
18.75 107.21 125.96 4.00%
18.75 107.21 125.96 4.00%
YTD ln~
$92.,
Next Final
Accrual Maturity
12/2003 12/2004
12/2003 12/2004
11/2003 11/2004
11/2003 11/2004
11/2003 11/2004
10/2003 10/2004
10/2003 10/2004
03/2004 09/2004
03/2004 09/2004
02/2004 08/2004
02/2004 08/2004
01/2004 07/2004
01/2004 07/2004
12/2003 06/2004
12/2003 06/2004
12/2003 06/2004
11/2003 05/2004
11/2003 05/2004
10/2003 04/2004
10/2003 04/2004
03/2004 03/2004
03/2004 03/2004
02/2004 02/2004
02/2004 02/2004
01/2004 01/2004
01/2004 01/2004
http://wwws.publicdebt.treas.gov/BC/SBCPrice
11/16/2004
Savings Bond Calculator Page 1 of 2
109/2003
Savinc
Series Denomination
Bonds ~l *~
# Bonds Total Price
26 $487.50
Serial Number Issue Date Series Denom
Q6043425408 12/1975 E $25
Q6043424266 12/1975 E 25
Q6043423084 11/1975 E 25
Q6043421955 11/1975 E 25
Q6039918805 11/1975 E 25
Q6039917668 10/1975 E 25
Q6039916504 10/1975 E 25
Q6039915382 09/1975 E 25
Q6039914197 09/1975 E 25
Q6016194098 08/1975 E 25
Q6016192959 08/1975 E 25
Q6016190641 07/1975 E 25
Q6007021510 06/1975 E 25
Q6016191802 07/1975 E 25
Q6007020336 06/1975 E 25
Q6006574220 05/1975 E 25
Q6006573078 05/1975 E 25
Q5249452966 05/1975 E 25
Q5249451837 04/1975 E 25
Q5249450741 04/1975 E 25
Q5249449620 03/1975 E 25
Q5249448498 03/1975 E 25
Q5244192365 02/1975 E 25
Q5244190236 02/1975 E 25
Q5244189101 01/1975 E 25
Q5238562994 01/1975 E 25
Viewing Bonds 1-26
Serial Number Issue Date
Total Interest Total Value YTD ln~
$2,702.36 $3,189.86 $91.~
lssue lnterest Next Final
Price Interest Value Rate Accrual Maturity
$18.75 $103.30 $122.05 4.00% 12/2003 12/2005
18.75 103.30 122.05 4.00% 12/2003 12/2005
18.75 103.03 121.78 4.00% 11/2003 11/2005
18.75 103.03 121.78 4.00% 11/2003 11/2005
18.75 103.03 121.78 4.00% 11/2003 11/2005
18.75 101.85 120.60 4.00% 10/2003 10/2005
18.75 101.85 120.60 4.00% 10/2003 10/2005
18.75 104.26 123.01 4.00% 03/2004 09/2005
18.75 104.26 123.01 4.00% 03/2004 09/2005
18.75 104.26 123.01 4.00% 02/2004 08/2005
18.75 104.26 123.01 4.00% 02/2004 08/2005
18.75 104.26 123.01 4.00% 01/2004 07/2005
18.75 104.26 123.01 4.00% 12/2003 06/2005
18.75 104.26 123.01 4.00% 01/2004 07/2005
18.75 104.26 123.01 4.00% 12/2003 06/2005
18.75 103.97 122.72 4.00% 11/2003 05/2005
18.75 103.97 122.72 4.00% 11/2003 05/2005
18.75 103.97 122.72 4.00% 11/2003 05/2005
18.75 102.80 121.55 4.00% 10/2003 04/2005
18.75 102.80 121.55 4.00% 10/2003 04/2005
18.75 105.23 123.98 4.00% 03/2004 03/2005
18.75 105.23 123.98 4.00% 03/2004 03/2005
18.75 105.23 123.98 4.00% 02/2004 02/2005
18.75 105.23 123.98 4.00% 02/2004 02/2005
18.75 105.23 123.98 4.00% 01/2004 01/2005
18.75 105.23 123.98 4.00% 01/2004 01/2005
http://wwws.publicdebt.treas.gov/BC/SBCPrice 11/16/2004
Savings Bond Calculator Page 1 of 2
109/2003 ~ ~
Savinc
Series Denomination Serial Number Issue Date
Bonds "1 $125 '1 I I
# Bonds Total Price Total Interest Total Value YTD ln~
26 $487.50 $2,651.03 $3,138.53 $89.:
Issue Interest Next Final
SeriaINumber IssueDete Series Dehorn Price Interest Value Rate Accrual Maturity
Q6142294746 12/1976 E $25 $18.75 $101.42 $120.17 4.00% 12/2003 12/2006
Q6142293556 12/1976 E 25 18.75 101.42 120.17 4.00% 12/2003 12/2006
Q6142292326 11/1976 E 25 18.75 101.08 119.83 4.00% 11/2003 11/2006
Q6142291153 11/1976 E 25 18.75 101.08 119.83 4.00% 11/2003 11/2006
Q6120842915 10/1976 E 25 18.75 99.92 118.67 4.00% 10/2003 10/2006
Q6120841746 10/1976 E 25 18.75 99.92 118.67 4.00% 10/2003 10/2006
Q6112379577 10/1976 E 25 18.75 99.92 118.67 4.00% 10/2003 10/2006
Q6118861409 09/1976 E 25 18.75 102.30 121.05 4.00% 03/2004 09/2006
Q6118860212 09/1976 E 25 18.75 102.30 121.05 4.00% 03/2004 09/2006
Q6105239065 08/1976 E 25 18.75 102.30 121.05 4.00% 02/2004 08/2006
Q6105237874 08/1976 E 25 18.75 102.30 121.05 4.00% 02/2004 08/2006
Q6105236726 07/1976 E 25 18.75 102.30 121.05 4.00% 01/2004 07/2006
Q6105235561 07/1976 E 25 18.75 102.30 121.05 4.00% 01/2004 07/2006
Q6091177418 06/1976 E 25 18.75 102.32 121.07 4.00% 12/2003 06/2006
Q6091176261 06/1976 E 25 18.75 102.32 121.07 4.00% 12/2003 06/2006
Q6091175140 05/1976 E 25 18.75 102.05 120.80 4.00% 11/2003 05/2006
Q6091173963 05/1976 E 25 18.75 102.05 120.80 4.00% 11/2003 05/2006
Q6075707818 05/1976 E 25 18.75 102.05 120.80 4.00% 11/2003 05/2006
Q6075706666 04/1976 E 25 18.75 100.91 119.66 4.00% 10/2003 04/2006
Q6075705517 04/1976 E 25 18.75 100.91 119.66 4.00% 10/2003 04/2006
Q6075704340 03/1976 E 25 18.75 103.31 122.06 4.00% 03/2004 03/2006
Q6075703209 03/1976 E 25 18.75 103.31 122.06 4.00% 03/2004 03/2006
Q6056357006 02/1976 E 25 18.75 103.31 122.06 4.00% 02/2004 02/2006
Q6056355862 02/1976 E 25 18.75 103.31 122.06 4.00% 02/2004 02/2006
Q6056354690 01/1976 E 25 18.75 103.31 122.06 4.00% 01/2004 01/2006
Q6056353559 01/1976 E 25 18.75 103.31 122.06 4.00% 01/2004 01/2006
~ [ Viewing Bonds 1-26
http://wwws.publicdebt.treas.gov/BC/SBCPriee 11/16/2004
Savings Bond Calculator Page 1 of 2
109/2003 I Updmte I
Savinc
Series Denomination
IE [ onds "1
# Bonds Total Price
26 $487.5O
Serial Number Issue Date Series Denom
Q6223562355 12/1977 E $25
Q6223561148 12/1977 E 25
Q6204170968 11/1977 E 25
Q6204169775 11/1977 E 25
Q6204168535 10/1977 E 25
Q6204167339 10/1977 E 25
Q6204166079 10/1977 E 25
Q6191488905 09/1977 E 25
Q6191487694 09/1977 E 25
Q6191486482 08/1977 E 25
Q6191485198 08/1977 E 25
Q6182941983 07/1977 E 25
Q6182940729 07/1977 E 25
Q6182939494 06/1977 E 25
Q6182938246 06/1977 E 25
Q6169914019 05/1977 E 25
Q6169912779 05/1977 E 25
Q6169911614 04/1977 E 25
Q6169910380 04/1977 E 25
Q6155575188 04/1977 E 25
Q6155573961 03/1977 E 25
Q6155572770 03/1977 E 25
Q6155571566 02/1977 E 25
Q6150084404 02/1977 E 25
Q6150083173 01/1977 E 25
Q6150081952 01/1977 E 25
~ [ Viewing Bonds 1-26
Serial Number Issue Date
Total Interest Total Value YTD In,
$2,558.56 $3,046.06 $87.~
Issue Inl~rest Next Final
Price Interest Value Rate Accrual Maturity
$18.75 $88.73 $107.48 4.00% 12/2003 12/2007
18.75 88.73 107.48 4.00% 12/2003 12/2007
18.75 88.43 107.18 4.00% 11/2003 11/2007
18.75 88.43 107.18 4.00% 11/2003 11/2007
18.75 98.12 116.87 4.00% 10/2003 10/2007
18.75 98.12 116.87 4.00% 10/2003 10/2007
18.75 98.12 116.87 4.00% 10/2003 10/2007
18.75 100.46 119.21 4.00% 03/2004 09/2007
18.75 100.46 119.21 4.00% 03/2004 09/2007
18.75 100.46 119.21 4.00% 02/2004 08/2007
18.75 100.46 119.21 4.00% 02/2004 08/2007
18.75 100.46 119.21 4.00% 01/2004 07/2007
18.75 100.46 119.21 4.00% 01/2004 07/2007
18.75 100.48 119.23 4.00% 12/2003 06/2007
18.75 100.48 119.23 4.00% 12/2003 06/2007
18.75 100.23 118.98 4.00% 11/2003 05/2007
18.75 100.23 118.98 4.00% 11/2003 05/2007
18.75 99.06 117.81 4.00% 10/2003 04/2007
18.75 99.06 117.81 4.00% 10/2003 04/2007
18.75 99.06 117.81 4.00% 10/2003 04/2007
18.75 101.42 120.17 4.00% 03/2004 03/2007
18.75 101.42 120.17 4.00% 03/2004 03/2007
18.75 101.42 120.17 4.00% 02/2004 02/2007
18.75 101.42 120.17 4.00% 02/2004 02/2007
18.75 101.42 120.17 4.00% 01/2004 01/2007
18.75 101.42 120.17 4.00% 01/2004 01/2007
http://wwws.publicdebt.treas.gov/BC/SBCPrice
11/16/2004
§avings Igond Calculator
109/2003
Page 1 of 2
Savinc
Series Denomination
$12s _:1
Serial Number Issue Date
I
# Bonds Total Price Total Interest
38 $937.50 $3,938.75
Issue
SerialNumber IssueDate Series Dehorn Price
Q6291805553 12/1978 E $25 $18.75
Q6291804379 12/1978 E 25 18.75
Q6291803125 11/1978 E 25 18.75
Q6291478843 11/1978 E 25 18.75
Q6291477657 10/1978 E 25 18.75
Q6291476467 10/1978 E 25 18.75
Q6291475232 09/1978 E 25 18.75
Q6286434041 09/1978 E 25 18.75
Q6286432805 09/1978 E 25 18.75
Q6286431606 08/1978 E 25 18.75
Q6286430398 08/1978 E 25 18.75
Q6279345164 07/1978 E 25 18.75
Q6270803915 07/1978 E 25 18.75
Q6270802801 06/1978 E 25 18.75
Q6270801590 06/1978 E 25 18.75
Q6270800410 05/1978 E 25 18.75
Q6245594206 05/1978 E 25 18.75
Q6245593009 04/1978 E 25 18.75
Q6245591833 04/1978 E 25 18.75
Q6245590715 04/1978 E 25 18.75
Q6232510364 03/1978 E 25 18.75
Q6232509178 03/1978 E 25 18.75
Q6232507977 02/1978 E 25 18.75
Q6232506810 02/1978 E 25 18.75
Q6223564760 01/1978 E 25 18.75
Q6223563612 01/1978 E 25 18.75
L2106219772 03/1978 E 50 37.50
L2106219768 03/1978 E 50 37.50
Total Value YTD In,
$4,876.25 $186.
Interest Next Final
Interest Value Rate Accrual Maturity
$68.32 $87.07 4.00% 12/2003 12/2008
68.32 87.07 4.00% 12/2003 12/2008
68.09 86.84 4.00% 11/2003 11/2008
68.09 86.84 4.00% 11/2003 11/2008
67.27 86.02 4.00% 10/2003 10/2008
67.27 86.02 4.00% 10/2003 10/2008
69.00 87.75 4.00% 03/2004 09/2008
69.00 87.75 4.00% 03/2004 09/2008
69.00 87.75 4.00% 03/2004 09/2008
69.00 87.75 4.00% 02/2004 08/2008
69.00 87.75 4.00% 02/2004 08/2008
69.00 87.75 4.00% 01/2004 07/2008
69.00 87.75 4.00% 01/2004 07/2008
68.98 87.73 4.00% 12/2003 06/2008
68.98 87.73 4.00% 12/2003 06/2008
68.76 87.51 4.00% 11/2003 05/2008
68.76 87.51 4.00% 11/2003 05/2008
73.59 92.34 3.09% 10/2003 04/2008
73.59 92.34 3.09% 10/2003 04/2008
73.59 92.34 3.09% 10/2003 04/2008
75.01 93.76 2.51% 03/2004 03/2008
75.01 93.76 2.51% 03/2004 03/2008
88.73 107.48 4.00% 02/2004 02/2008
88.73 107.48 4.00% 02/2004 02/2008
88.73 107.48 4.00% 01/2004 01/2008
88.73 107.48 4.00% 01/2004 01/2008
150.02 187.52 2.51% 03/2004 03/2008
150.02 187.52 2.51% 03/2004 03/2008
http://wwws.publicdebt.treas.gov/BC/SBCPrice
11/16/2004
Savings Bond Calculator Page 1 of 2
Io9/2oo3 [Updm~
Savinc
Series Denomination
IE Bonos '_1 $l25
Serial Number Issue Date
# Bonds Total Price Total Interest
26 $487.50 $1,754.46
Issue
Serial Number Issue Date Series Denom Price
Q6380710718 12/1979 E $25 $18.75
Q6380709920 12/1979 E 25 18.75
Q6380709079 11/1979 E 25 18.75
Q6380708261 11/1979 E 25 18.75
Q6368402101 10/1979 E 25 18.75
Q6368401559 10/1979 E 25 18.75
Q6368400703 09/1979 E 25 18.75
Q6357727789 09/1979 E 25 18.75
Q6357726870 09/1979 E 25 18.75
Q6357725997 08/1979 E 25 18.75
Q6357725035 08/1979 E 25 18.75
Q6349834119 07/1979 E 25 18.75
Q6349833146 07/1979 E 25 18.75
Q6349832141 06/1979 E 25 18.75
Q6349831114 06/1979 E 25 18.75
Q6349830095 05/1979 E 25 18.75
Q6326669004 05/1979 E 25 18.75
Q6326667898 04/1979 E 25 18.75
Q6326666716 04/1979 E 25 18.75
Q6326665632 03/1979 E 25 18.75
Q6312149491 03/1979 E 25 18.75
Q6312148391 03/1979 E 25 18.75
Q6312147179 02/1979 E 25 18.75
Q6312146014 02/1979 E 25 18.75
Q6291807949 01/1979 E 25 18.75
Q6291806754 01/1979 E 25 18.75
~ I Viewing Bonds 1-26
Total Value YTD In1
$2,241.96 $67.~
Interest Next Final
Interest Value Rate Accrual Maturity
$66.76 $85.51 4.00% 12/2003 12/2009
66.76 85.51 4.00% 12/2003 12/2009
66.76 85.51 4.00% 11/2003 11/2009
66.76 85.51 4.00% 1t/2003 11/2009
65.96 84.71 4.00% 10/2003 10/2009
65.96 84.71 4.00% 10/2003 10/2009
67.66 86.41 4.00% 03/2004 09/2009
67.66 86.41 4.00% 03/2004 09/2009
67.66 86.41 4.00% 03/2004 09/2009
67.66 86.41 4.00% 02/2004 08/2009
67.66 86.41 4.00% 02/2004 08/2009
67.66 86.41 4.00% 01/2004 07/2009
67.66 86.41 4.00% 01/2004 07/2009
67.66 86.41 4.00% 12/2003 06/2009
67.66 86.41 4.00% 12/2003 06/2009
67.46 86.21 4.00% 11/2003 05/2009
67.46 86.21 4.00% 11/2003 05/2009
66.63 85.38 4.00% 10/2003 04/2009
66.63 85.38 4.00% 10/2003 04/2009
68.34 87.09 4.00% 03/2004 03/2009
68.34 87.09 4.00% 03/2004 03/2009
68.34 87.09 4.00% 03/2004 03/2009
68.34 87.09 4.00% 02/2004 02/2009
68.34 87.09 4.00% 02/2004 02/2009
68.34 87.09 4.00% 01/2004 01/2009
68.34 87.09 4.00% 01/2004 01/2009
http://wwws.publicdebt.treas.gov/BC/SBCPrice
11/16/2004
Savings Bond Calculator Page 2 of 2
L2106219767 03/1978 E 50 37.50 150.02
L2106219766 02/1978 E 50 37.50 177.46
L2106219765 02/1978 E 50 37.50 177.46
L2106219763 02/1978 E 50 37.50 177.46
L2106219762 02/1978 E 50 37.50 177.46
L2070215677 01/1978 E 50 37.50 177.46
L2070215676 01/1978 E 50 37.50 177.46
L2098595512 01/1978 E 50 37.50 177.46
L2098595511 01/1978 E 50 37.50 177.46
L2098595505 01/1978 E 50 37.50 177.46
~lView~g Bondsl-38
187.52
214.96
214.96
214.96
214.96
214.96
214.96
214.96
214.96
214.96
2.51%
4.00%
4.00%
4.00%
4.00%
4.00%
4.00%
4.00%
4.00%
4.00%
03/2004 03/2008
02/2004 02/2008
02/2004 02/2008
02/2004 02/2008
02/2004 02/2008
01/2004 01/2008
01/2004 01/2008
01/2004 01/2008
01/2004 01/2008
01/2004 01/2008
Note Description
NI Not Issued
NE Not Eligible for Payment
P5 Includes 3-month interest penalty
ME Matured (Exchangeable for HH)
MN Matured (Not Exchangeable for HH)
Please rate this service.
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http://wwws.publicdebt.treas.gov/BC/SBCPrice 11/16/2004
Savings Bond Calculator Page 1 of 2
109/2003
Savinc
Series
I~ Bonds
Denomination
Serial Number Issue Date
I
# Bonds Total Price Total Interest
17 $506.25 $1,951.24
Issue
Serial Number Issue Date Series Denom Price
K14965545 12/1980 EE $75 $37.50
K14965101 11/1980 EE 75 37.50
K13237963 10/1980 EE 75 37.50
K13237553 09/1980 EE 75 37.50
K13237202 08/1980 EE 75 37.50
K13236929 08/1980 EE 75 37.50
K13236411 07/1980 EE 75 37.50
K5927321 06/1980 EE 75 37.50
K5925874 05/1980 EE 75 37.50
K5925475 04/1980 EE 75 37.50
Q6388338907 03/1980 E 25 18.75
Q6388338527 03/1980 E 25 18.75
Q6388338045 03/1980 E 25 18.75
Q6390364495 02/1980 E 25 18.75
Q6390363867 02/1980 E 25 18.75
Q6390363154 01/1980 E 25 18.75
Q6390362474 01/1980 E 25 18.75
~ ] Viewing Bonds 1-17
Total Value YTD ln,
$2,457.49 $74.~
Interest Next Final
Interest Value Rate Accrual Maturity
$133.50 $171.00 4.00% 12/2003 12/2010
133.50 171.00 4.00% 11/2003 11/2010
149.07 186.57 4.00% 10/2003 10/2010
152.82 190.32 4.00% 03/2004 09/2010
152.82 190.32 4.00% 02/2004 08/2010
152.82 190.32 4.00% 02/2004 08/2010
152.82 190.32 4.00% 01/2004 07/2010
152.82 190.32 4.00% 12/2003 06/2010
152.82 190.32 4.00% 11/2003 05/2010
150.93 188.43 4.00% 10/2003 04/2010
66.76 85.51 4.00% 03/2004 03/2010
66.76 85.51 4.00% 03/2004 03/2010
66.76 85.51 4.00% 03/2004 03/2010
66.76 85.51 4.00% 02/2004 02/2010
66.76 85.51 4.00% 02/2004 02/2010
66.76 85.51 4.00% 01/2004 01/2010
66.76 85.51 4.00% 01/2004 01/2010
Note Description
NI Not Issued
NE Not Eligible for Payment
P5 Includes 3-month interest penalty
ME Matured (Exchangeable for HH)
MN Matured (Not Exchangeable for HI-I)
Please rate this service.
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http://wwws.publicdebt.treas.gov/BC/SBCPrice
11/l 6/2004
Savings Bond Calculator Page 1 of 1
109/2003
Savinc
Series
lEE Bonds
Denomination
$175 "1
Serial Number
# Bonds Total Price Total Interest Total Value
13 $487.50 $1,628.22 $2,115.72
Issue Interest
Serial Number Issue Date Series Denom Price Interest Value Rate
K17002864 12/1981 EE $75 $37.50 $119.85 $157.35 4.00%
K17002553 11/1981 EE 75 37.50 119.85 157.35 4.00%
K17002284 10/1981 EE 75 37.50 119.85 157.35 4.00%
K17002019 09/1981 EE 75 37.50 123.00 160.50 4.00%
K15589223 08/1981 EE 75 37.50 123.00 160.50 4.00%
K15588941 08/1981 EE 75 37.50 123.00 160.50 4.00%
K15588619 07/1981 EE 75 37.50 123.00 160.50 4.00%
K15588335 06/1981 EE 75 37.50 123.00 160.50 4.00%
K15588074 05/1981 EE 75 37.50 123.00 160.50 4.00%
K15587678 04/1981 EE 75 37.50 130.17 167.67 4.00%
K14966554 03/1981 EE 75 37.50 133.50 171.00 4.00%
K14966204 02/1981 EE 75 37.50 133.50 171.00 4.00%
K14965889 01/1981 EE 75 37.50 133.50 171.00 4.00%
Viewing Bonds 1-13
Issue Date
I
YTD In~
$63.:
Next Final
Accrual Maturity
12/2003 12/2011
11/2003 11/2011
10/2003 10/2011
03/2004 09/2011
02/2004 08/2011
02/2004 08/2011
01/2004 07/2011
12/2003 06/2011
11/2003 05/2011
10/2003 04/2011
03/2004 03/2011
02/2004 02/2011
01/2004 01/2011
Note Description
NI Not Issued
NE Not Eligible for Payment
P5 Includes 3-month interest penalty
ME Matured (Exchangeable for HH)
MN Matured (Not Exchangeable for HH)
Please rate this service.
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11/16/2004
~3
Savings Bond Calculator Page 1 of 1
lo9/2oo3 I'~ ~
Savinc
Series Denomination Serial Number
lEE Bonds ~.~ $[75 -~ I
# Bonds Total Price Total Interest Total Value
13 $487.50 $1,504.50 $1,992.00
Issue Interest
Serial Number Issue Date Series Denom Price Interest Value Rate
K34886486 12/1982 EE $75 $37.50 $106.83 $144.33 4.00%
K33505391 11/1982 EE 75 37.50 106.83 144.33 4.00%
K33505068 10/1982 EE 75 37.50 113.76 151.26 4.00%
K33504762 09/1982 EE 75 37.50 116.79 154.29 4.00%
K32969514 08/1982 EE 75 37.50 116.79 154.29 4.00%
K32969279 07/1982 EE 75 37.50 116.79 154.29 4.00%
K32968968 07/1982 EE 75 37.50 116.79 154.29 4.00%
K32968629 06/1982 EE 75 37.50 116.79 154.29 4.00%
K28571750 05/1982 EE 75 37.50 116.79 154.29 4.00%
K28571586 04/1982 EE 75 37.50 116.79 154.29 4.00%
K28571311 03/1982 EE 75 37.50 119.85 157.35 4.00%
K28571063 02/1982 EE 75 37.50 119.85 157.35 4.00%
K28545535 01/1982 EE 75 37.50 119.85 157.35 4.00%
Viewing Bonds 1-13
Issue Date
YTD In~
$603
Next Final
Accrual Maturity
12/2003 12/2012
11/2003 11/2012
10/2003 10/2012
03/2004 09/2012
02/2004 08/2012
01/2004 07/2012
01/2004 07/2012
12/2003 06/2012
11/2003 05/2012
10/2003 04/2012
03/2004 03/2012
02/2004 02/2012
01/2004 01/2012
Note Description
NI Not Issued
NE Not Eligible for Payment
P5 Includes 3-month interest penalty
ME Matured (Exchangeable for HH)
MN Matured (Not Exchangeable for HH)
Please rate this service.
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Savings Bond Calculator (' (' ¢' ~'
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http://wwws.publicdebt.treas.gov/BC/SBCPrice
J Reset I
11/16/2004
Savings Bond Calculator Page 1 of 1
Savim
Denomination
Serial Number
Issue Date
# Bonds Total Price TotalInterest
13 $487.50 $1,183.29
Serial Number Issue Date Series Dehorn Price Interest
K39616021 12/1983 EE $75 $37.50 $82.86
K38354668 11/1983 EE 75 37.50 82.86
K38335689 10/1983 EE 75 37.50 86.34
K34894352 09/1983 EE 75 37.50 88.20
K34166999 08/1983 EE 75 37.50 88.20
K34166690 07/1983 EE 75 37.50 88.20
K34166398 07/1983 EE 75 37.50 88.20
K34143003 06/1983 EE 75 37.50 88.20
K34142782 05/1983 EE 75 37.50 88.20
K34142504 04/1983 EE 75 37.50 93.18
K34134642 03/1983 EE 75 37.50 95.19
K34134348 02/1983 EE 75 37.50 106.83
K34886716 01/1983 EE 75 37.50 106.83
Viewing Bonds 1-13
Total Value YTD In
$1,670.79 $47.
Interest Next Final
Value Rate Accrual Maturit
$120.36 2.50% 12/2003 12/201
120.36 2.50% 11/2003 11/201
123.84 3.04% 10/2003 10/201
125.70 2.48% 03/2004 09/201
125.70 2.48% 02/2004 08/201
125.70 2.48% 01/2004 07/201
125.70 2.48% 01/2004 07/201
125.70 2.48% 12/2003 06/201
125.70 2.48% 11/2003 05/201
130.68 3.09% 10/2003 04/201
132.69 2.51% 03/2004 03/201
144.33 4.00% 02/2004 02/201
144.33 4.00% 01/2004 01/201
Note Description
NI Not Issued
NE Not Eligible for Payment
P5 Includes 3-month interest penalty
ME Matured (Exchangeable for HI-I)
MN Matured (Not Exchangeable for HH)
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Savings Bond Calculator Page 1 of 1
Io9/2oo3
Savinc
Series Denomination
lEE Bonds -_J $175 ~
# Bonds Total Price
13 $487.50
SerialNumber IssueDate Series Denom
K43841452 12/1984 EE $75
K43355339 11/1984 EE 75
K43355108 10/1984 EE 75
K43501291 09/1984 EE 75
K43501054 08/1984 EE 75
K43354956 07/1984 EE 75
K34354766 06/1984 EE 75
K39637083 06/1984 EE 75
K39636823 05/1984 EE 75
K39636582 04/1984 EE 75
K39636353 03/1984 EE 75
K39636161 02/1984 EE 75
K39635912 01/1984 EE 75
Viewing Bonds 1-13
Serial Number Issue Date
Total Interest Total Value YTD In~
$1,014.12 $1,501.62 $35.:
Issue Interest Next Final
Price Interest Value Rate Accrual Maturity
$37.50 $72.21 $109.71 4.00% 12/2003 12/2014
37.50 72.21 109.71 4.00% 11/2003 11/2014
37.50 75.66 113.16 3.04% 10/2003 10/2014
37.50 77.40 114.90 2.88% 03/2004 09/2014
37.50 77.40 114.90 2.88% 02/2004 08/2014
37.50 77.40 114.90 2.88% 01/2004 07/2014
37.50 77.40 114.90 2.88% 12/2003 06/2014
37.50 77.40 114.90 2.88% 12/2003 06/2014
37.50 77.40 114.90 2.88% 11/2003 05/2014
37.50 81.06 118.56 3.05% 10/2003 04/2014
37.50 82.86 120.36 2.50% 03/2004 03/2014
37.50 82.86 120.36 2.50% 02/2004 02/2014
37.50 82.86 120.36 2.50% 01/2004 01/2014
Note Description
NI Not Issued
NE Not Eligible for Payment
P5 Includes 3-month interest penalty
ME Matured (Exchangeable for HH)
MN Matured (Not Exchangeable for HH)
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11/16/2004
Savings Bond Calculator Page 1 of 1
[09/2003
Savinc
Series Denomination Serial Number Issue Date
lEE Bonds .:J $175 -I I I
# Bonds Total Price Total Interest Total Value YTD In~
13 $487.50 $911.22 $1,398.72 $38.,
Issue Interest Next Final
Serial Number Issue Date Series Denom Price Interest Value Rate Accrual Maturity
K51463120 12/1985 EE $75 $37.50 $67.95 $105.45 4.00% 12/2003 12/2015
K51462873 11/1985 EE 75 37.50 67.95 105.45 4.00% 11/2003 11/2015
K51457425 10/1985 EE 75 37.50 67.95 105.45 4.00% 10/2003 10/2015
K51457215 09/1985 EE 75 37.50 70.05 107.55 4.00% 03/2004 09/2015
K51242881 08/1985 EE 75 37.50 70.05 107.55 4.00% 02/2004 08/2015
K51242654 07/1985 EE 75 37.50 70.05 107.55 4.00% 01/2004 07/2015
K49769685 06/1985 EE 75 37.50 70.05 107.55 4.00% 12/2003 06/2015
K49769449 06/1985 EE 75 37.50 70.05 107.55 4.00% 12/2003 06/2015
K47438482 05/1985 EE 75 37.50 70.05 107.55 4.00% 11/2003 05/2015
K47425569 04/1985 EE 75 37.50 70.44 107.94 4.00% 10/2003 04/2015
K47425352 03/1985 EE 75 37.50 72.21 109.71 4.00% 03/2004 03/2015
K43841886 02/1985 EE 75 37.50 72.21 109.71 4.00% 02/2004 02/2015
K43841665 01/1985 EE 75 37.50 72.21 109.71 4.00% 01/2004 01/2015
Viewing Bonds 1-13
Note Description
NI Not Issued
NE Not Eligible for Payment
P5 Includes 3-month interest penalty
ME Matured (Exchangeable for HH)
MN Matured (Not Exchangeable for HH)
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11/16/2004
RESIDENT DECEDENT
SCHEDULE F
JOINTLY-OWNED PROPERTY
FILE NUMBER
· rE OF
If an asset was made joint within ODS year of the dscsdsnt'a dab of death, il must be reperted on Schedule G.
SURV~VING JOINT TENANT(S) NAME ADDRESS RELATIONSHIP TO DECEDENT
JOINTLY-OWNED PROPERTY:
LETTER DATE DESCRIPTION OF PROPERTY % OF DATE OF DEATH
iTEM FOR JOINT MADE Include name of financial instltuden ~ bank a~z:e~t numbar or similar I~en~in9 number. At, ch DATE OF DEATH DECD'S VALUE OF
NUMBER TENANT JOINT deed for jointly-held ~eat estate. VALUE OF ASSET ,INTEREST DECEDENT'S INTERE8
1.
A.
~-I~-~
TOTAL (Also enter on line 6, Recapitulation) $ ,7. q~ ¥o
more space is needed, insert additional sheets of the same size)
Savings Bond Calculator Page 1 of 1
Savil
Series
I.EE.B~d~
Denomination
Serial Number
Issue Date
# Bonds Total Price Total Interest
5 $25,000.00 $2,040.00
Serial Number Issue Date Series Denom
X5662933EE 06/2001
X5662932EE 06/2001
X566293 lEE 06/2001
X5662930EE 06/2001
X5662929EE 06/2001
Price
EE $10,000 $5,000.00
EE 10,000 5,000.00
EE I0,000 5,000.00
EE 10,000 5,000.00
EE 10,000 5,000.00
Interest Value
$408.00 $5,408.00
408.00 5,408.00
408.00 5,408.00
408.00 5,408.00
408.00 5,408.00
Total Value YTD In
$27,040.00 $700
Interest Next Final
Rate Accrual Maturit
2.66% 10/2003 06/203
2.66% 10/2003 06/203
2.66% 10/2003 06/203
2.66% 10/2003 06/203
2.66% 10/2003 06/203
Note Description
NI Not Issued
NE Not Eligible for Payment
P5 Includes 3-month interest penalty
ME Matured (Exchangeable for HH)
MN Matured (Not Exchangeable for HI-I)
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10v200a'"i
Savin~
Series
Denomination
Serial Number
Issue Date
# Bonds
5
Serial Number Issue Date Series
X5662938EE 06/2001
X5662937EE 06/2001
X5662936EE 06/2001
X5662935EE 06/2001
X5662934EE 06/2001
Total Price Total Interest Total Value
$25,000.00 $2,040.00 $27,040.00
Issue Interest
Dehorn Price Interest Value Rate
EE $10,000 $5,000.00 $408.00 $5,408.00 2.66%
EE 10,000 5,000.00 408.00 5,408.00 2.66%
EE 10,000 5,000.00 408.00 5,408.00 2.66%
EE 10,000 5,000.00 408.00 5,408.00 2.66%
EE 10,000 5,000.00 408.00 5,408.00 2.66%
YTD In
$700
Next Final
Accrual Maturit
10/2003 06/203
10/2003 06/203
10/2003 06/203
10/2003 06/203
10/2003 06/203
Note Description
NI Not Issued
NE Not Eligible for Payment
P5 Includes 3-month interest penalty
ME Matured (Exchangeable for HH)
MN Matured (Not Exchangeable for HH)
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COMMONWEALTH OF PENNSYLVANI~
INHERITANCE TAX RETURN
RESLDENT DECEDENT
ATE OF
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
FILE NUMBER
Debts of decedent must be reported on Schedule I.
iTEM
NUMBER DESCRIPTION AMOUNT
FUNERAL EXPENSES:
ADMINISTRATIVE COSTS:
Personal ,%presentalJve's Commissions
Name of Personal Representative (s)
Social Secudty Number(s) / EIN Number of Personal Representative(s)
Street Address
City State
Year(s) Commission Paid:
Attorney Fees
Family Exemption: (if deeedent's address is not the same as cidimant's, attach explanation)
Claimanl
Zip
Street Address
Relationship of Claimant to Decedent
Pmbata Fees
Accountant's Fees
Tax Return Preparer's Fees
State __ Zip
TOTAL (Also enter on line 9, Recapitulation)
(if more space is needed, insert additional sheets of the same size)
Margaret Mans
4613 Hampden Avenue
3ames R. G.ingrich Memorials
5243 Simpson Ferry Road
I~lechanicsbur~, PA 17055
('717') 766-5622
invoice
10/15/2004
Camp Hill, PA 17011
28439 5/17/2004 Walter- Margaret Mans Ron Colvin
2 Split Wing
1 Base
1 Statue
2 Vase
1 Sand Blast
1 Foundation
Order Total: $6,000.00
Payments: $3,000.00
Balance Due: $3,000.00
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
REV 1162 EX{11 96J
NO. CD 004742
MANS MARGARET R
4613 HAMPDEN AVENUE
CAMP HILL, PA 17011-4034
fold
ESTATE INFORMATION: SSN: 202~16-2407
FILE NUMBER: 2103-0801
DECEDENT NAME: MANS WALTER R
DATE OF PAYMENT: 12/15/2004
POSTMARK DATE: 12/15/2004
COUNTY: CUMBERLAND
DATE OF DEATH: 09/28/2003
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 (;1,217.00
REMARKS:
TOTAL AMOUNT PAID:
$1,217.00
SEAL
CHECK//1302
INITIALS: JA
RECEIVED BY:
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
REGISTER OF WILLS
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIV1DUAL TAXES
INHERITANCE TAX DIVISION
PO BOX 280601
HARRISBURG PA 171Z8-0601
NOTICE OF INHERITANCE TAX
APPRAISEMENT, ALLOWANCE OR DISALLOWANCE
OF DEDUCTIONS ANO ASSESSMENT OF TAX
:21
02-14-2005
MANS
09-28-2003
21 03-0801
CUMBERLAND
101
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
r..'
JOHNN BISBANO JR
STE 232
4811 JONESTOWN
HBG
*'
REV-IS47EllAFPllZ-D4l
WALTER
R
Allount Rellitted
RD
PA 17109
MAKE 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 =r!?;'f-lx..AF)--CB1-.-6!').-NoiTci.oF-tN'HEi-iflJrci-TAirl.pPRA.fsiM.€NT~.-A[tOQANCE.OR..---._...._- - ...
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF MANS WALTER R FILE NO. 21 03-0801 ACN 101 DATE 02-14-2005
TAX RETURN WAS: (X) ACCEPTED AS FILED
) CHANGED
NOTE: I~ an assessment was issued previously, lines 14, 15 and/or 16, 17, 18 and 19 will
re~lect ~igures that include the total o~ ALL returns assessed to date.
ASSESSMENT OF TAX:
15. Allount of Line 14 at Spousal rate (15)
16. Allount of Line 14 taxable at Lineal/Class A rat. (16)
17. Allount of Line 14 at Sibling rate (17]
18. Allount of Line 14 taxable at Collateral/Class B rate (18)
19. Principal Tax Due
451,525.00 X 00 = .00
454,103.00 X 045 = 20,435.00
.00 X 12 = .00
.00 X 15 = .00
(19)= 20,435.00
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: SUPPLEMENTAL RETURN
1. Real Estate (Schedule AJ (1)
2. Stocks and Bonds (Schedule 8) (2)
3. Closely Held stock/Partnership Interest (Schedule C) (3)
4. Mortgages/Notes Receivable (Schedule D) (4)
5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) (5)
6. Jointly Owned Property (Schedule F) (6)
7. Transfers (Schedule G) (7)
8. Total Assets
NO. 01
.00
85.781. 00
.00
.00
.00
27, 040.00
.00
(8)
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H)
10. Debts/Mortgaga Liabilities/Liens (Schedule I)
11. Total Deductions
12. Net Value of Tax Return
13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J)
14. Net Value of Estate Subiect to Tax
(9)
(10)
6,000.00
.00
(11)
(12)
(13)
11~)
NOTE: To insure proper
credit to your account,
submit the upper portion
of this form with your
tax paymant.
112,821.00
6 nnn nn
106,821. 00
.00
905,628.00
AX CREDITS:
r..".". l+j AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
12-10-2003 CD003323 960.89 18,257.00
12-15-2004 CD004742 .00 1,211 .00
INTEREST IS CHARGED THROUGH 03-01-2005 TOTAL TAX CREDIT 20,434.89
AT THE RATES APPLICABLE AS OUTLINED ON THE BALANCE OF TAX DUE .11
REVERSE SIDE OF THIS FORM INTEREST AND PEN. 22.76
TOTAL DUE 22.87
~.
IF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A .'CREDIT" (CR), YOU MAY BE DUE
A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.)
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COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG. PA 17128-0601
REV- 1 162 EX(11-96)
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
MANS MARGARET R
4613 HAMPDEN AVENUE
CAMP Hill, PA 17011-4034
_nn_n fold
ESTATE INFORMATION: SSN: 202-16-2407
FILE NUMBER: 2103-0801
DECEDENT NAME: MANS WALTER R
DATE OF PAYMENT: 03/28/2005
POSTMARK DATE: 03/28/2005
COUNTY: CUMBERLAND
DATE OF DEATH: 09/28/2003
NO. CD 005124
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 I $22.87
I
I
I
I
I
I
I
I
TOTAL AMOUNT PAID:
REMARKS:
CHECK# 1351
SEAL
INITIALS: JA
RECEIVED BY:
REGISTER OF WILLS
$22.87
GLENDA FARNER STRASBAUGH
REGISTER OF WillS
BUREAU OF INDIVIDUju.nr~.s>'-.~. r:~: ,{';-
INHERITANCE TAX DlVISIOfrf.:"J,-,,' ,,__:":'i..i Ji,j[
PO BOX 280601 ." 1\"
HARRISBURG PA 17lZ8~D6Dl r:-;
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
I:NHERI:TANCE TAX
STATEMENT OF ACCOUNT
*'
REV-16D7 EX AFP (03-05
200S HA Y 16 P 2: 41
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
05-09-2005
MANS
09-28-2003
21 03-0801
CUMBERLAND
101
Amount R_itted
WALTER
R
CLERI< Of-
()PP!-l~~!'c; r( ! !PT
JOHN N 1ti~,^!!lIt~':-'((~. ""6
STE 232 "." .., "" !"
4811 JoNESToWN RD
HBG PA 17109
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CD COURT HOUSE
CARLISLE, PA 17013
NOTE: To insure proper cred t to your account, sub.it the upper portion of this for. with your tax paYMent.
CUT ALONG THIS LINE _~~ RETAIN LOWER PORTION FOR YOUR RECORDS ~
............................... .......~........................................................................
REV-1607 EX AFP (03-05) *** INHERITANCE TAX STATEMENT OF ACCOUNT ...
ESTATE OF MANS
THIS STATEHENT IS PROVIDED TO Al
IS A SUHHARY OF THE PRINCIPAL T'
A PROJECTED INTEREST FIGURE.
WAL TER R FILE NO.21 03-0801 ACN 101 DATE 05-09-2005
ISE DF THE CURRENT STATUS OF THE STATED ACN IN THE NAHED ESTATE. SHOWN BELOW
DUE, APPLICATION DF ALL PAYHENTS, THE CURRENT BALANCE, AND, IF APPLICABLE,
DATE OF LAST ASSESSMENT 0 RECORD ADJUSTMENT: 02-14-2005
PRINCIPAL TAX DUE:
20,435.00
PAYMENTS (TAX CREDITS):
PAYMENT
DATE
12-10-2003
12-15-2004
03-28-2005
RECEIPT
NUMBER
CD00332
CD00474
CD00512
DISCOUNT (+)
INTEREST/PEN PAID (-)
960.89
.00
22.76-
AMOUNT PAID
18,257.00
1,217.00
22.87
TOTAL TAX CREDIT
'<"
IF PAID AFTER THIS DATE, S E REVERSE
SIDE FOR CALCULATION OF AD ITIONAL INTEREST.
TOTAL DUE
20,435.00
.00
.00
.00
BALANCE OF TAX DUE
INTEREST AND PEN.
I IF TOTAL DUE IS LESS THAN 1,
NO PAYHENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED S A "CREDIT" ICRJ,
YOU HAY BE DUE A REFUND. S E REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS. J
~
Date of Death:
STATUS REPORT UNDER RULE 6.12
WAL T~~ r<. t'\A,J S
$iP-r~J"\I?>'E~ 2<1) ;1003
Name of Decedent:
Will No.:
..21- ~oe3"- go J
Admin. No.:
Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the
following with respect to completion of the administration of the above-captioned estate:
1. State whether administration of the estate is complete:
Yes Qg No 0
2. If the answer is No, state when the personal representative reasonably believes
that the administration will be complete:
3. If the answer to No.1 is Yes, state the following:
a. Did the personal representative file a final account with the Court?
Yes No 5{l
b. The separate Orphans' Court No. (if any) for the personal representative's
account is:
c. Did the personal representative state an account informally to the parties
in interest? Y es ~ No 0
c. Copies of receipts, releases, joinders and approval of formal or
informal accounts may be filed with the Clerk of the. Orphans' Court
and may be attached to this report.
Date: .t/itI",.
~i-$~;-.u
Sign e
-=r
I'\Arzr;,A(l..i.T ~. fl1AI\IS
Name
lf~ 13 ~A-M pDi N A \/'E.
CA"'" c1 H H..t.. P A J 70 t\
I
Address
C';
'717 - 73'1 - }If '3 0
Telephone No.
Capacity: ~ Personal Representative
o Counsel for personal representative
@
Cumberland County - Register Of Wills
One Courthouse Square
Carlislel PA 17013
Phone: (717) 240-6345
Date: 8/30/2005
MANS MARGARET R
4613 HAMPDEN AVENUE
CAMP HILLI PA 17011-4034
RE: Estate of MANS WALTER R
File Number: 2003-00801
Dear Sir/Madam:
It has come to my attention that you have not filed the Status
Report by Personal Representative (Rule 6.12) in the above captioned
estate.
As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES I NO.
103 SUPREME COURT RULES DOCKET NO. 11 for decedents dying on or after
July 11 19921 the personal representative or his counsel, within two
(2) years of the decedent's deathl shall file with the Register of
Wills a Status Report of completed or uncompleted administration.
This filing is due by:
9/28/2005
Your prompt attention to this matter will be appreciated.
Thank You.
SincerelYI
~L~~
f" / ,I
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
cc: File
Counsel
Judge
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