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Home My WebLink About95-0197~,i-qS-o~R~ This is to certify that the certificate hereunto attached is a true and accurate copy of the original death record on file with the Division of Vital Records, and that Frank Yeropoli, whose name is subscribed thereto, was at the time of subscribing the same and now is Director, Division of Vital Records of the Department of Health, for the Commonwealth of Pennsylvania, duly appointed and commissioned as directed by Act 66 of the General Assembly, approved 29 June 1953, P.L. 304. AUG 16 20p1 Date H706.1 e3 R•v. 2/67 TYPHPRIhli w PEtiMANENT xwcK Sac 2 ? • Fran eropoli, ct Division of Vital Records P.O. Box 1528 New Castle, PA 16103 COMMONWEALT#1 OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS CERTIFICATE OF DEATH Q25r4~ NAME OF DECEDENT (F6eL Midas, Ledj SOCIAL 9ECURffY NUMBER DATE OF OERN pAaM,DM•`.bsr) t.George F. Douglas Jr. tMale a 161 - 24 - 1952 ..March 1, 1995 ADE M1AK BieMaY) UhgER1YEAR UNDER, d+i' avEaPBlmtl emTNPLACE tCWend OAaeh D t Yeap SI N P C PLACEOP DF QN (L7Mr A abY ar-aaeiueuotiais an dnw ddN Madh ( Days Nov = MMAaa , g e w aeiDn anby) t108PILH. 69 Y~ 12-7-1925 hiladelphia,PA "0""'"^ ""d^ 00iA^ ~ ^ R..M.~K.~ ~y)^ COUNTYOP DERV CIT',BORO,TWPOF DEAaN PACUJrr NAMEtll not:aNu6on,pwetadandnanewl DECEDENTaPt6sRwlc DRID6J7 RACE-AmwkanlMrl.BNd~, vmh., de. ~~ Cumberland w W. Pennsboro Tw ~. P 399 Barnstable Rd. w. No~ Yee^aY•••NNdN CUWn, ""•~'t•^~^~"•~••~•~ ., lSPrd~ ,a White DECEDENT'S U&MLOCClAR10N qND OF Sl18N/ESSRIDUSTRY YWSDECEDEM EVERM DECEDEM'9 EDUGPK)N M,4MtKSTRUB•Mr.Ne SIJRVIVal6 SPOUSE (Oi..NroawNdane nwd u.s. ARMED F011CE67 l N.w,M.MwwMw.a m•w•.a»m.a.nnem.> «.awraN.:eond~: ~,.a . ~+n+seaa~r Cdw~ Dir•~ted fSPeoef1 ,+. Law er "N~X"°^ ' 12 5+ Married y ,,., Pr=4B~e_$~actice ,x „ ~ a ("as*~ ,~ , Sylvia H. Rambo DECEDENT'a MABYIO ADDRESS IStreet. Cd1'/Tam, Stw. Zro Cade) DECEDENT'S SYaN Pa tA ACTUAL rn W. Pennsboro tTe ~ W a . . ., aa.ded w.a In d n P 399 Barnstable Rd. RESIDENCE d.a.d.,^ ~~ Carlisle, PA 17013 ~ ,~ Cumberland"'"""p7 „d,^ ""a' ~~d FRlIER'S NAME IFea Midas. Lrq George F. Douglas '8 NAME (Fid, Midas. Heiden SanameJ ,~ Regina Flynn BIFORMANT'9 NAME (TYD•'Pn.V ItrcReLANT's MALBq ADDRESS Ise.eLCeyrtaim, sm., ZlpCode) Sylvia H Rambo . 399 Barnstable Rd. Carlisle Pa 17013 METHOD CF DIBP08fT10N OF DISP081TIO/J RACEOP DNPOSRK)N•Named Beh1® CremaYon^ Rwnwd ham SbM^ .DaKYebl a'OBrrPlaw %Q•n~Y LOCRION'CN,/Ibim•9hM.21PCab Da`~°n^ °r"'"~0°"i0 ^ r. 3-6-1995 „•. St. Patrick's Cemeter :,N. Middleton Tw Pa 81°"R"'iE aF PUNEIIAL OR PER A8 LICENSE NUMBER ~ NAMEANDADDaEasaP PACE,*Y o man- o llner8 e ,~. 008102 L 19 N. Hanover St. Carlisle PA 17013 CanpNN Aenr2YeayebwtaANfyhq tlM 4edd dedhoauraddlM611N,dW bidpleu dWd. LICENSE NUMBER PhydtlMl4 nd ewYMadIYMd WMhm (SiBne4eeW DRE 8KiNED n,..dd.dl,. m S~iu.,ti ~a N 3 ba~(.~4 -L .~.~ 3 - - S ~~~~ 1«. M DF DERN DRE DEAD (MOrMh.O.S 16er) NNaCASE REPERRED70 MEDK;AL E%AMa1EtVCORONER7 .. ~ Sa ~M. .3 -~ 1Ye^ r~ !~ t7. MRT1: Edgar elaaew~InjaNeamnpbYipr wlYCn awNedth.4ath. DaMbA«IM modeddrtia NMUabd4ca LMI MyaIr CaYNMeetl~YM. mepYdaY aned,dwtlcahMd fYra. tMpmYnw MRf ll: D1MrypWlw~t mntllhrca4ppnOro OWK~W j aeaKiAd n01 reeWrpNar arayYg cease alwnin PARTI. `one' `R'"' Resn~ T*, ~ rh, mfD++ASA OUENCE OF$ "~S' •' . ~M b ~ n + ~ , ~~ S•ny pUE Tp CR ASACONSEOUENCE OFx I taw.EderUlO9LLYN16 _ t t:MIBE(Diasea Y*ry c ~ t ti~On OeM1 WT DUErofOR ASA SEQUENCE OFy. I Va1$AN AUTOPSY WERE AVBDPSY FlNDINGS MANNER OF OERN DQE OF aL11/RY TINE OFIWURY aUURYRNORKT DESCRIBE N0IY INJURY OCCURRED. PEPFORMED7 A1/1RABLE PIaOq 10 ~,aN, C•,,, Y~ oPCAUSE ~~ .OI Nm~idd. ^ ` - AccMMN ^ Pen&plmYliBdbn ^ Ne ^ W ^ M. Wa ^ No ~ Yea ^ No ~ Sukre ^ CaYd not W ddemmed ^ PLACE OF aLA1RY • N hang lum Ned Iecb oMM LOCRION S . , . ry, ( trde, CIy/bwn, Sale) 4EanB. ete ($pedy) 284. ?•. a0e. ad C~f1E1'ICCIMCA aiy arse) . SIONRURE •T1791TIFYBiD PNYa1fJAM (PhYddn oaayvq caused deM W.enandtw PnYddea hY Aaalu 'a00YN antl CanpldW IYm 23) L7 •rY ~••+•dIM• dWh eeearW dw to tlr u~re(e) arr mnxrr r ddetl ..................................................... ER ~/~ • ~ W 77b. 'PRDNOIRICBID AND CERfIFYMOINYSICIIW (PhYeiden tpQi ponae~uq deM aM grNynO toww d GMIh) roar 4.ddmr ~e+tww.swB~«a.nadln.Bm..aw.anawee. M~eawaa.t+aw•I.nem.a~w..daNe.. ........................ ^ LICENSE NUMBER ORE 9gNED , D•1'• fir) a7e. WIp O E3 L ,a 1 y .~~~~ NAMEANDADORESSOF PERSON YNW COMPIETED~C`A1USEy DME~R. .l1 (gem 2T)Type or Print y~ ~i` JT' f~..e \~~~~ee OWE OR Ilse beds Marz••tlmtfan ard/w MeeMlpaHOn, in my Ogden, death oeetrnd M tlr rhos, dete, and pleee, rrW eua to ar eauea(a) uw mM~.T..d~.d ................................................................................................ ^ ~,.. ' ~. GK-1~L~ ~'i t~o~3 REGISTRAR S SgNRIIRE BER \ DATE FlLED PAadn.OeY 1§b) ~. Z o~y~e e~.ac V~ ~ ~.. ~~ . a. ~°~~ ~. 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(~.(' ` ~ ' :7 ~... ... -'° 1 , -. .. _._.__ - c . . '<Ci. ~ ti .. e f~~r / ~/{... i I .i~~7J}~~G-I6~. la~" '~/• ULC~ ~y7~-I~~ ~___ ~-~! •y .s II ~ j*- - ~ ~~_' ~~Qr~=..~1- - _ _ ~ .G'Z~GC'. ~ ___ ~ c'am' :!~~ ~e~ ._ uJ / (y~. ~ 1 ac y/iJ _ ~ ~ ~ c(-- =- -~ - - - .. _,~a *G9~_~I._ H G.S_i_ ~ /.c"a"l ~7_../Z-GliIGCC~-~G,/__dp~ 'Cul.~ra:, ~~.- ~ !-'==~y~'_.i?a~,__ Z=%7 G1~L.._~1~-G22Y/l~c~ ~~/37~+~T- ~"-=~'~ ~:;I V _ i I _ .. I r~,~- _~,-- - --- -=------ --_ --_ __---------- -- • REV: 1500 EX -+7.941 E- z 0 W D w F- Y ¢ Y wd~ =oo ~' a m a /~ ~ wz W cc ° oz U ~ .5010'73/ ~ - - _ -" /5- ~~~ y -•~~v INHERITANCE TAX RETURN RESIDENT DECEDENT 1LTH OF PENNSYLVANIA (TO BE FILED IN DUPLICATE RENT OF REVENUE EPT.2eobol WITH REGISTER OF WILLS) IRG, PA 17128-0601 ov~wL atCURITY NUMBER V -'- 161-24-1952 F APPUUBLEt SURVIVING SPOUSE'S NAME (LAST, FIRST Rambo, Sylvia H. [~ 1. Original Return ^ 4. Limited Estate (~ 6. Decedent Died Testate (Attach copy of Will) 3/1/95 '12/.7/25 i0 MIDDLE INITIAL CoVnl SOCIAL SECURITY NUMBER - 186-28-4338 ^ 2. Supplemental Return ^ 4a. Future Interest Compromise (for dates of death aker 12.12-82) ^ 7. Decedent Maintoinad o Living Trust (Attach copy of Trust) FIDENTIAL7AX INFORMATIDN`sHnurn-'ii George F. Douglas, III FOR DATES OF DEATH AFTER 12/31 /91 CHECK HEA IF A SPOUSAL POVERTY CREDIT IS CLAIMED ^ FILE NUMBEQ 2195-0197 )LINTY CODE YEAR NUMBE 399 Barnstable Rd. .,Carlisle, Pa. 17013 507 of residue ^ 3. Remainder Return (for dates of death prior to 12-13.82 ^ 5. Federal Estate lax Return Required - 8. Total Number of Safe Deposit Boxes GTED ?O', - - 27 ia. HighJSt,, Carlisle, Pa. 17013 1. Real Estate (Schedule A) (1 ) 2. Stocks and Bands (Schedule B) (2) 12, 642.00 3. Closely Held Stock/Partnership Interest (Schedule C) (3) ""A-"~";"~"?"-`R$ p 4. Mortgages and Notes Receivable (Schedule D ) (•t1 5.-Cash, Bank Deposits $ h1iscellaneous Persanal Property (Schedule E) (S) __ _14',563.37 z 0 _ a 6. Jointly Owned Property (Schedule r') (b) ~ 7. 7rar.sfers (Schedule G) (Schedule L) (7) 7 ~ ,nit , '' '~ S`j ~ P;'~-~ I ~... ,-~,~~ 3 °- 8. Total Gross Assets (total Lines 1-7) _ _ 9. Funerol Expenses, Administrative Costs, Misceilanecus Expenses (Schedule H) (9) _ ($) _271,780.02 _ sJ ' e.r td -^~~~4M~. ,~j,G„r yt;. !f - ~ ~_. _ 10. Debts, Mortgage Liabilities, Liens (Schedule I) (10) 11. Tote/ Deductions (total Lines 9 c~ 10) __ - 12. Net Value of Estate (Line 8 minu<_ Line 11) , (11) -_348 ~ 8-,$Z___-_ 236 921 13 13. Charitable and Governmental Bequests (Schedule J) ~~r ~ ' ~ ~` , . (tz) - 11 ~ 000 00 74`Net Value Subject to Tax (Line 12 tni ,us Line 13) I^ ~~ ~ J ~( (1 ,) , . 15. Spousal Transfers (for dates of death after S ~ ~ \1 ~ , (14) -_„'~~"~_~1"~ ee Instructions for Applicable Percentage on Reve'se Side. (Include values from S h d l / '''°®~•"- 03 q___~-(1/~_!n(~~~~ (1~ x c e u e K or Schedule M.) 16. Amount of Line 14 taxable at 6°,o rove I l ( ~) • ,~ ~.. ~,<, r 5 ~ ~~ ~~ {( --= F ( nc ude values from Schedule K or Schedule ht.) 17 A ~ ~ x . ' ~ s ~~ 66'- 7 ~ 4U4_. z _0 . mount of line 14 taxable at 15D/o rata _ (Include values from Schedule K or Schedule M.) (17) J3(1 ' ~_"v' x • , y~ v 15 ---~-.r~'~~E2(~-.-0~ '~' - r i$. Principal tax due (Add tax from Lines 15, 16 and 17.) 9 ~ ~- ~ ~"~ # 0 14. Credits Spousal Poverty Credit Prior Payments Di scount Interest ~. x 20. IF Line 19 is greater than Line 18, enter the difference on Line 20. This is the OVERPAYM (20) 21, If Line 18 is greater than Line 19, enter the difference on•Line 21. This is the TAX DUB. A. Enter the interest on the bolanco due on Line 21A. (21) 1S , 493.00 Bi Enter the total of Line 21 and 21A on -Line 218. This is the BALANCE DUE. (21A) 15 493.00 Make Check Payable to: Rogister of Wills, Agent (21 B) n Under; penaltie#'of p9rjury, I declare that I have examined this return inducting accompanying schedules and`statemeMs; and.to the bast of m, know/ t is true" correct and complete: I docl6re shat all'real estate ha; been reported at trvo market value. Dedaration of pfeparar other thou the personal ropresentativa is ; bas'edon all information of 1 praparar ds"any knowledge: Y edge and belief, iIGNATl1jtE O PERSON P.F.S SI PO FIIING R URN ADDRESS ` 27 W. High St. , Carlisle, Pa: 17013 DATE ~,~-• 'IGNATURE OF PREPARER OTHER THAN REPRESEN IYE °!~ 9l - ADDFFSS _,~ DATE Act #48 of 1994 provides for the reduction of the tax rates imposed on the net value of transfers to or for the use of the spouse. The rates as prescribed by the statute will be: • 3% (.03j wilt be applicable for estates of decedents dying on or after 7/1/94 and before 1/1/96 • 2% (.02) will be applicable for estates of decedents dying on or after ]/1/96 and before 1/1/97 _~.~ • 1% (.0]j will be applicable for estates of decedents dying on or after 1/]/97 and before ]/i/98 • Spousal transfers occurring on or after 1/1/98 will be exempt from inheritance tax. ~Y p~.A~a~l~ .~~~~E ~ MARK ~~C~3 ~N T~ APP~it,~~Rt~TE [3~ . ~Gl~S. l . Did decedent make a transfer and: a. retain the use or income of the property transferred, ................................. ...................... b. retain the right to designate vrho shad use the property transferred or its income, ............... c. retain a reversionary interesr; or ................. ......................................................... d. receive the promise far lif4 of either paymants, benefits or care? .,,,,..,,, ............................. 2: if death occurred ~~n or before December 12, 14$], did decedent within two years preceding death transfer property without receiving adequate consideration? if death occurred after Qecerrrber 12, i9$~, did decedent transfer property within one year of death vrithout receiving adequate .consideration? .......... .......................................................... 3. Uid decedent Quin an `in trust for`. bank acct unt at his or her death? ................... REV•1507 EX+ 14.66) IA SCHEDULE B STOCKS AND BONDS George F. Douglas, Jr. (All property jointly-owned with Right of Survivorship must be disclosed on Schedule F.) ITEM NUMBER DESCRIPTION ~, 431 shares common PNC Financial @25 .25 (s 2. 46.5080 shares PNC Financial (DRIP) (25.25 3. 45 shares Esterline Tech @13 - ---_ TOTAL (Also enter on line 2, Recapitulation) nr ~ .... _ 2195-0197 VALUE AT DATE OF DEATH 10,883.00 1,174.00 585.00 $1~6 _ ... .; t REV-1504 Ex+ (7.83) COMMONWEALTH OF PENNSYLVANIA SCHEDULE "C" INHERITANCE TAX RETURN- CLOSELY HELD STOCK, RESIDENT DECEDENT PARTNERSHIP AND PROPRIETORSHIP ESTATE OF George F. Douglas, Jr. FILE NUMBER 2195-0197 (Schedule "C•1" or "C-2" must be attached for each business Interest of the'deeedent, other than a proprietorship-) ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH 1. Douglas Property Management, see attached K-1 2. Douglas, Douglas & Douglas, see attache~~~K-1 _.t` '~ .:'a (Note: The withdrawal as indicated on Schedule K-1, Line >.*V' ~t,.~ . > •,.. J (d) consists of $131,250 in cash taken in 1994, and the distribution of the remaining capital account of ~ $32,678.00) REV-1508 EX+ (2.87) COMMONWEAIiH OF PEI INHERITANCE TAX R RESIDENT DECED SCHEQULE E CASH, BANK DEPOSITS AND MISCELLANEOUS PERSONAL PROPERTY ueorge F. Douglas, Jr. (All property jointly-owned with the Right of Survivorship must be disclosed on Schedule F) ITEM NUMBER DESCRIPTION 1. I American Express Travelers Checks 2. 1990 Plymouth Voyager see`~ttached appraisal 3. 1984 Chev. 5.10 Pickup see attached appraisal 4. CBR, cancellation premium 5. Farmers Trust Co., checking account 4641006 6. ATLA, refund premium 7. Paid Prescriptions, refund 8. Marine Corps, final pay 9. CBC Commercial Life disability payments ].0. Educators Mutual, disability payments 11. American Bar Assoc., refund premium 12. Albert Wohlers refund premium 13. Hartford Ins, refund of premium 14. Sedgewick Jones, ins. refund of premium TOTAL (Also enter an line 5, Reca (Attach additional 8%" x .11" sheets if more space is Headed.) Please Print or TyF ER 2195-0197 VALUE AT DATE OF DEATH 300.00 4,700.00 1,700.00 625.10 364.75 910.00 259.03 832.25 228.57 4',133.32 5.00 25.17 302.18 178.00 $ 14,56:37 REV-+S II EX+ (/-88J t ~~ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ca~H~e yr George F. Douglas, Jr. ITEM NUMBER SCHEDULE H FUNERAL EXPENSES, ADMINISTRATIVE COSTS AND MISCELLANEOUS EXPENSES DESCRIPTION A• Funeral Expenses: ~• Hoffman Roth Embers Restaurant, reception after funeral Carol Turner, soloist Kathy Noaker, organ Father Daniel Menniti B• Administrative Costs: 1. Personal Representative Commissions Social Security Number of Personal Representative: Year Commissions paid 2. ~ Attorney Fees C. 3. Family Exemption Sylvia H. Rambo Claimant _ Relationship Address of Claimant at decedent's death Street Address 399 Barnstable Rd. City Carlisle, StatePa. wife Zip Code 17013 4. Probate Fees Miscellaneous Expenses: ~' Cumberland Law Journal Evening Sentinel 2' Cora D. Douglas, .last check Deb Piper, Tax collector, 1994 personal taxes 3' National Geographic, final bill 4 Carlisle Country Club, final bill Homedco, Jan. rental 5 Homedco, Feb. rental Masland Associates, final bill Danbury Mint, final bill 6' Graham r~utor Co. , final bill David Bronstein, M.D. ~' Cellular One, final bill $ St. Patrick's Church, burial lot Farmers Trust Company, ~: personal note debt~c~z ~,,i,~i Register of Wills, fil:in inventor and a ~') g Y ppraisement TOTAL (Also enter on line 9, Recapitulaiionj AMOUNT 6,827.00 2,247.88 50.00 50.00 100.00 3,500.00 303.00 40.00 80.00 300.00 588.50 87.95 57.37 24.38 24.38 100.00 19.95 239.58 5.00 29.38 450.00 25.00 (If more space is needed, insert additional sheets of same size.) Please Print or ABER 2195-0197 George F. Douglas, Jr. 2195-0197 Funer.Expenses, Administrative Costs and Miscellaneous Expenses, Schedule H Capital Tax Collection Bureau, 1994 income taxes Pennsylvania Department of Revenue, 1994 income taxes 995.00 Internal Revenue Service, 1994 income taxes 940.00 W.H.. Newbolds, commission on sale of PNC stock and Esterline stock. 3,254.09 PNC, administrative fee on sale of PNC (DRIP) stock American Express, final bill 15.00 87.33 Total $34,858.89 REV•L'10 EX+ (2-87) ~: "' ~ SCHEDULE G COMMONWEALTH OF PENNSYLVANIA TRANSFERS INHERITANCE TAX RETURN _ ~ RESIDENT DECEDENT ESTATE OF _ -- __ PLEASE PRINT OR TYPE ;~ FILE NUMBER ~ George F. Douglas Jr. 2195-0 197 THIS'SCHEDULE MUST BE COMPLETED AND FILED IF THE ANSWER TO ANY OF THE QUESTIONS ON THE REVERSE SIDE OF THE COV ITEM NUMBE DESCRIPTION OF PROPERTY R Include name of the transferee, their relationship to decedent, f of transfer. EXCLUSION --- TOTAL VALUE OF ASSET DECD. oho ER SHEET IS YES. DOLLAR VALUE OF DECEDENT'S INT. INTEREST 1• I CGM Mutual Fund, Sep Ira `~ ~~ none 9,_6.70.42 100 9,670.4 2 2• i Oppenheimer Main St. Income, Sep Ira . none 9,924.70 100 9,924.70 3• I Lindner Div., Sep Ira none 10,300.98 100 10,300.98 4• W.H. Newbolds, Sep Ira none 128,757.55 100 128,757.55 ~ rl ~ ~ ~_x. ' w (~ .. I {//~ t.,J J r } ~ ~~~~ r ~ ~~e.e. 1 __ TOTAL (Also enter on line T, (!f more space is needed, insert additional sheets of same size.) ~VJ tom, `~ .~~. t ~tion) S 5.8 ~ 653.65 REV-1513 EX+ ~2-B7i ~ ~ ' SCHEDULE J COMMONWEALTH Of PENNSYLVANIA BENEFICIARIES INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER George F. Douglas, Jr. 2195-0197 ITEM NUMBER NAME AND ADDRESS OF BENEFICIARY RELATIONSHIP AMOUNT OR SHARE OF ESTATE A. Taxable Bequests: 1• 2. Anne M. Cox, 631 W. Old York Rd.,Carlisle,Pa. Janet M La 5 Sh None $10 000 00 -,.,,3. . irle Ln.Boilin S y' y g pgs.,Pa. V.J. Donnelly, 53 Piedmont Rd. Rutland VT 0570 None , . •5,000.00 4. , Katie Donnelly 53 Piedmont Rd., Rutland~VT 0570 gr•son 1,000.00 5. Andrea Stoup,1209 Sherwood Dr.,Carlisle~ gr.dau 1,000.00 6. Elizabeth Stoup, 1209 Sherwood Dr .Carlisle gr.dau 1,000.00 7. . Zoe Douglas, 2127 Walnut Bot.Rd. Carlisle gr.dau 1,000.00 8. , George F. Douglas, IV, 1000 Forbes Rd. Carlisle gr•dau 1",000.00 9. 10 , Sylvia H. Rambo, 399 Barnstable Rd.,Carlisle pa, gr.son wife 1,000.00 . 11. Cora D. Douglas, 37 E. Ridge St.,Carlisle,pa, William P. Douglas 2127 ~ former wif 1/2 of residue 1/4 of residue 12. , Walnut Bot.Rd.,Carlisl George F. Douglas, III, 1000 Forbes Rd. Carlisl son 1/16 of residue 13. 14 Patricia Donnelly, 53 Piedmont Rd., Rutland,VT son dau I/16 of residue . Deborah Stoup,1209 Sherwood Dr.,Carlisle,pa, dau 1/16 of residue 1/16 of residue ITEM NUMBER NAME AND ADDRESS OF BENEFICIARY AMOUNT OR SH B. Charitable and Governmental Bequests: i - ARE OF ESTATE ------_-- 1' 2 St. Columbans, St. Columbans, NE 68056 . 3 nary Queen/Parish, Carlisle Barracks, Pa. 17013 1,000.00 • 4 St. Patricks Church, Carlisle, Pa 17013 1,000.00 • 5 Waldron Academy, 511 Montgomery Ave., Merton, Pa. St. ' 19066 1,000.00 • 6• Joseph s Prep, 1733 Girard Ave., Phila., Pa. Dickinson College Carli l 191.30 1,000.00 1,000 00 7• , s e, Pa. 17013 Dickinson School of Law, Carlisle, Pa. 17013 . 1,000.00 5,000.00 TOTAL CHARITABLE AND GOVERNMENTAL BEQUESTS (Also enter on line 13, Recapitulation} $ 1 1 , 000.00 (If more space is needed, insert addltlonal sheets of same size) -~-- _~---., REV-1547 EX AFP C12-94) COMMONNEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF INHERITANCE TAX BUREAU OF INDIVIDUAL TAXES APPRAISEMENT, ALLOWANCE OR DISALLOWANCE DEpr. 28o6oi OF DEDUCTIONS AND ASSESSMENT OF TAX HARRISBURG, PA 17128-0601 ACN 101 DATE 12-11-95 DATE OF DEATH 03-01-95 ~~`~~ ~ FILE N0. 2I -0 COUNTY CUMBERLAND NOTE: TO INSURE PROPER CREDIT TO YOUR ACCOUNT, SUBMIT THE UPPER PORTION OF THIS FORM WITH YOUR TAX PAYMENT TO THE REGISTER OF WILLS. HAKE CHECK PAYABLE TO "REGISTER OF WILLS, AGENT^ REMIT PAYMENT T0: GEORGE F DOUGLAS III 27 W HIGH ST CARLISLE PA 17013 Asxxnt RNittad CUT ALONG THIS LINE - RETAIN LOWER PORTION FOR YOUR RECORDS ~ _ ---------- KEV-1547 EX AFP t12-94) N07ICE OF INHERITANCE TAX APPRAISEMENT,~ ALLOWANCE OR- - - DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF DOUGLAS GEORGE F FILE N0. 21 95-0197 ACN 101 DATE 12-11-95 TAX RETURN WAS: ( ) ACCEPTED AS FILED ( Xl CHANGED SEE ATTACHED NOTICE RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Estate (Schedule Al 2. Stocks and Bonds (Schedule B) 3. Closely Held Stock/Partnership Interest (Schedule C) 4. Mortgages/Notes Revivable (Schedule D) 5. Cash/Bank DePosits/Misc. Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) 7. Transfers (Schedule 6) 8. Total Assets APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule Hl 10. Debts/Mortgage Liabilities/Lions (Schedule I) 11. Total Deductions 12. Net Valw of Tax Return 13. Charitable/Governeental Begwsts (Schedule J) 14. Net Valw of Estate Subject to Tex REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 (1) .00 (2) 12.642.00 (3) .00 (4) . 00 (5) 14.563.37 (6) .00 (7) 263.166.55 (8) 290,372.02 21,524.89 (9) (lo) .00 (11) 91.594 89 (12) 258,847.13 (13) 11, 000.00 (14) 257,847.13 NOTE: If an assessment was issued previously, reflect figures that incl d t lines 14, 15 andior 16, 17 and 18 will u e he total of ALL returns assessed to date ASSESSMENT OF TAX: . 15. Amount of Line 14 at Spousal rate (15) 71,002.28 x .00_ .00 16. Amount of Line 14 taxable at Lineal/Class A rate (16) 141,178.89 x.06= 8,470.74 17. Amount of Line 14 taxable at Collateral/Class B rate (17) 45,555.95 x . 15. 6,849.90 18. Principal Tax Dw (lg) 15,320.64 TAX CREDITS: PAYMENT DATE RECEIPT NUMBER DISCOUNT (t) INTEREST (-) AMOUNT PAID 05-02-95 AA047710 766.03 15,493.00 TOTAL TAX CREDIT 15,259.03 BALANCE OF TAX DUE 938.39CR INTEREST .00 TOTAL DUE 938.39CR * IF PAID AFTER DATE INDICATED, SEE REVERSE ( IF TOTAL DUE IS LESS THAN 91, NO PAYMENT IS REQUIRED. FOR CALCULATION OF ADDITIONAL INTEREST. IF TOTAL DUE IS REFLECTED AS A ••CREDIT^ (CRI, YOU MAY BE DUE ~' REV-1470 EX (5-94) PROBATE DATE: 10N3/95 INHERITANCE TAX EXPLANATION COMMONWEALTH OF PENNSYLVANIA OF CHANGES DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG PA 17126.0601 A George F. Douglas, Jr. -~ - 21 95-0197 ACN SCHEDULE ITEM 101 NO. EXPLANATION OF CHANGES C 1 Moved to Schedule G items 5 and 6 C 2 Adjusted to 0.00. This partnershi p interest was transferred January 1, 1994. G 5 Item added: 16.67% interest in Douglas Property Management transferred to William P. Douglas on December 29,1994 - $55,256.50 less $3,000 exclusion = $52,256.50 G 6 Item added: 16.67% interest in Douglas Property Management transferred to George F. Douglas, III on December 29,1994 - $55,256.50 less $3,000 exclusion = $52,256.50 H C(8) Disallowed -~~ .~ i ~ 1 r C'~4c~(. jGj U-7~ 0-- ~,~ ~ ' ,~ L l ~ ~S ~. /I ~ ~ 4~z.~ v ,rz ~~ tXAMINER: LUCIWig Steigler ~~J PAGE 1 ORIGINAL >r v~~~~I~i~~yo~~t'wIP~T ~ L_. REV-1500 EX+ (7-941 r ,~~ , INHERITANCE TAX RETURN RESIDENT DECEDENT COMMONWEALTH OF PENNSYLVANIA (TO BE FILED IN DUPLICATE DEPARTMENT OF REVENUE DEPT.2epaol WITH REGISTER OF WILLS) HARRISBURG, PA 17128.0601 t3 ~ ~ A 5 ~~ 12r,~; t F S~ ._~ w 0 SOCIAL SECURITY NUMBER DATE OF DEATH DATE OF BIRTH "' /~~'Zc~-tyJZ 3 --f -per fL/7/-~~ D tlf ADPr~~ABIEI SURVIVING SGOUSE'S NAME (LAST, FIRST AND MIDDLE INITIALI _~ SOCIAL SECURITY NUMBER Count u-l l~(~. 5 ~ v r t-1 13' ~ ~-Z~'y- 33 g F x a w ~{ 1. Original Return •L--t ~ 2. Supplemental Return w a ~ ~ ~ m ^ 4. Limited Estate ^ 4a. Future Interest Compromise o_ a ^ 6. Decedent Died Testate ^ 7 (for dates of death after 12-12-82) D d Attach co of Will ( Py ) . ece ent Maintained a Living Trust (Attach copy of Trust) :All !'ntaoeeor~uneu.~~ FOR DATES OF DEATH AFTER 12!31 f91 CHECK HERE IF A SPOUSAL POVERTY CREDIT IS CLAIMED ^ rLLC 1YYM6ER 1000NTY CODE ~-I `I,~ YEAR b( ~/ 7 ~ COMPLETE ADDRESS 3 9 `1 ~cr-rv srr~6 ~~ t~aL.. C~~Itsl~. Pa. 11or 3 C~~„r3e~\a,~d, UNT RECEIVED (SEE INSTRUCTIONS) 5J ~a e r 1~eJ~~'VVe. ^ 3. Remainder Return (for dates of death prior to 12-13-82) ^ 5. Federal Estate Tax Return Required 8. Total Number of Safe Deposit Boxes - ----- - -- ... ~.vr~nvcryuNL tA1C InFVRMATION SHOULD BE DIRECTED TO: y ~ NAME;' • ~ w -~- ''\\ ~ COMPLETE-7MAILING~ADDRESS J - °~ z - r={ - C ~ l~v Lj~L_~ ~ Z 1 lei ~ (~ l/' S j V ~ TELEPHONE NUMBER - ~'7 z -11`0 ~~rl1s ~~-- ~ ~. I~c.~r3 z 0 J ~- a. s z 0 a 0 v 1 . Real Estate (Schedule A) (1 ) 2 . Stocks and Bonds (Schedule B) (2 ) 3 . Closely Held Stock/Partnership Interest (Schedule C)' (3 ) 4 . Mortgages and Notes Receivable (Schedule DJ (4 ) 5. Cash, Bank Deposits 8~ Miscellaneous Personal Property (Schedule E) (5 ) 6. Jointly Owned Property (Schedule F) (b ) 7. Transfers (Schedule G) (Schedule L) (7 ) 8. Total Gross Assets (total Lines 1-7) 9. Funeral Expenses, Administrative Costs, Miscellaneous Expenses (Schedule H) (9 ) 10. Debts, Mortgage Liabilities, Liens (Schedule f) (10) 11. Total Deductions (total Lines 9 8~ 10) 12. Net Value of Estate (Line 8 minus Line 11) 13. Charitable and Governmental Bequests (Schedule J) 14. Net Value Subject to Tax (Line 12 minus Line 13) ?13. acs (8) (11) (12) (13) ., ~, IJ. Jpousal Transfers (for dates of death after b-30-94) See Instructions for A plicable Percentage on Reverse (15) Side. (Include values ~rom Schedule K or Schedule M.) x•-- 16. Amount of Line 14 taxable at 6% rate _'~ ~„,~ (Include values from Schedule K or Schedule M.) (16) x .06 17. Amount of Line 14 taxable at 15% rate ~ t' (Include values from Schedule K or Schedule M.) (17) }' " ~ x .15 18. Principal tax due (Add tax from Lines 15, 16 and 17.) '9. Credits Spousal Povert Credit (18) Y Prior Payments Discount Interest + .~ NUMBER ~- j 3 C` (/ ,.? 13 . ~~ - '~ ::n ,: f, x ~- - (19) a 20. If Line 19 is greater than Line 18, enter the difference on Line 20. This is the OVERPAYMENT. (20) ~ ~ ^ 21. If Line T8 is greater than Line 19, enter the difference on•Line 21. This is the TAX DUE. A. Enter the interest on the balance due on Line 21A. (21) 13 UU B. Enter the total of Line 21 and 2)A on Line 21B. This is the BALANCE DUE. (21A) Make Check Payable to: Register of Wills, Agent (2 T B) _- •' 3 . V U ~ ~ BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND TO RECHECK MATH ~ ~ Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct and complete. I declare that all real estate has been reported at true market value. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. SIG/NATURE OF PERSON RESPONSIBLE FOR Fll RETURN ADDRESS V ~ • ~ _ DATE ~ SIGNATURE OF R E I ~XC~L U / C) ~ / - ADDRESS UULA.I pAT (Q r '- CARLISLE, PA 17013 .. .....•! ~ . • . ~" J! ~ .. ... , r 1. r•:Si ( ..t d V r -T ~r i r - ~ , r` _ _ _. _ _ _ _ __ _ _ • -~-... I REV.J308 E%• 17.e71 ,~, CONhSONWEAIiH Of PENNSYLVANIA INHERfTANCE TAX RETURN RESIDENT DECEDENT ESTATE OF .- SCHEDULE E CASH, BANK DEPOSITS AND MISCELLANEOUS PERSONAL PROPERTY Please Print or Type E NUMBER _ '~ ~ ~-'E~~ Iti~ k ~ ~- I~~ (All property jo;mly-owned ,.,tl. ~~_ ~ .. . _ U.~ L' ~ ~ ~U\ TOTAL (Also enlor on lino S, Reca ilulolion) $ ~~ z.~ r r • NOTICE OF INHERITANCE TAX ACN 101 APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX DATE 07-08-96 REV-1547 EX AFP (12-95) COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TA%ES DEPT. 280601 HARRISBURG PA 17128-0601 ESTATE OF LUUIiLNJ LituKtit r FILE N0. cl y7-U17/ DATE OF DEATH 03-01-95 COUNTY CUMBERLAND NOTE: TO INSURE PROPER CREDIT TO YOUR ACCOUNT, SUBMIT THE UPPER PORTION OF THIS FORM WITH YOUR TAX PAYMENT TO THE REGISTER OF WILLS. MAKE CHECK PAYABLE TO "REGISTER OF WILLS, AGENT" REMIT PAYMENT TO: GEORGE F DOUGLAS III REGISTER OF WILLS 27 W HIGH ST CUMBERLAND CO COURT HOUSE CARLISLE PA 17013 CARLISLE, PA 17013 Amount Remitted CUT ALONG THIS LINE - RETAIN LOWER PORTION FOR YOUR RECORDS ~ ----------------------------------------------------------------------------------------------- REV-1547 EX AFP (12-951 NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF DOUGLAS GEORGE F FILE N0. 21 95-0197 ACN 101 DATE 07-OS-96 TAX RETURN WAS: ( ) ACCEPTED AS FILED ( Xl CHANGED SEE A TTACHED NOTICE RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: SUPPLEMENTAL RETURN N0. O1 1. Real Estate (Schedule A) (1) .00 2. Stocks and Bonds (Schadula B) (2) .00 3. Closely Hsld Stock/Partnership Interest (Schedule C) (3) .00 4. Mortgages/Notes Receivable (Schadula D) (4) .00 5. Cash/Bank Deposits/Misc. Personal Property (Schedule EI (5) 21 3.00 6. Jointly Owned Property (Schadula F) (6) .00 7. Transfers (Schadula G) (7) .00 8 . • Total Asses{s ( g ) 213.0 0 APPROVED DEDUCTIONS AND EXEMPTIONS: • .00 9. Funeral Expenses/Adm. Costs/Misc. Expanses (Schedule H) (9l 10. Debts/Mortgage Liabilities/Liens (Schedule I) (10) .00 11. Total Deductions (11) .00 12. Nat Value of Tax Return (12) 213.00 13. Charitable/Governmental Bequests (Schadula J) (13) .00 14. Nat Values of Estate Subject to Tax (14) 258, 060.13 NOTE: if an assessment was issued previous)y, lines 14, 15 andior 16, 17 and 18 will reflect figures that include the total of ALL returns assessed to date. ASSESSMENT OF TAX: 15. Anount of Lines 14 at Spousal rata (15) 71,108.78 X .00_ .00 16. Anount of Line 14 taxable at Lineal/Class A rata (16) 141,232.14 X .06. 8,473.94 17. Amount of Lines 14 taxable at Collateral/Class B rata (17) 45,719.21 X .15. 6,857.89 18. Principal Tax Duo (lg) 15,331.83 TAX CREDITS: PAYMENT DATE RECEIPT NUMBER DISCOUNT (+) INTEREST (-) AMOUNT PAID 05-02-95 AA047710 766.59 15,493.00 12-27-95 REFUND .00 938.39- 05-03-96 AA112804 .34- 13.00 TOTAL TAX CREDIT 15,333.86 BALANCE OF TAX DUE 2.03CR INTEREST AND PEN. .00 TOTAL DUE 2.03CR ( IF TOTAL DUE IS LESS THAN 41, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE * IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. M REV. 1470 EX (6-86)r COMMONWEALTH OF PENNSYLVANIA DEPARTMENT Of REVENUE BUREAU Of INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 DECEDENT'S NAM,Ftj///fj SCHEDULE I ITEM NO. INHERITANCE TAX EXPLANATION OF CHANGES ~l~s =~/ ACN / ~~ ! TAX EXAMINER: ~~ GL-~-Lc- C.L=~~..~_.__ ,, PAGE _~