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HomeMy WebLinkAbout95-0315~- i - ~~,~ - ~,~~~ y 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 200T Date N1~, IU Rsv. veT TY-EJPRNT NAME Nr ~~ Y,a, ~~ i Z ? ~_ Fran eropoli, ct Division of Vital Records P.O. Box 1528 New Castle, PA 16103 COMMONWEALTH OF PENNSYLIMNIA • DEPARTMENT OF HEALTH • VITAL RECORDS CERTIFICATE OF DEATH tMaran, Dal: Nar1 SWa«Fuagi Cdna'y~ --.'••••••.••••rv~~.,.~,.w ww-aw.m«msanoeyr aeq ratz am.e.,. ^ fNafr,r:..~. n ,,,.. n Nuaiq C369C~ ~N~~n~., 18, 1995 ,rra~nllru DEVN DT;BOIq.TYWOF NAMEtwna.wwn. YNBDECEDEMOFINSPMNICORg1M 9•'e maaand nun.ewl RACE-AmaeeMl Mldal4 Bmck, VAlila. am. Nam w a xT•...P.dI,D,~M,, rsP.anl OCCUaIf10N ~"~"'~` ,white ` MN80ECEDEMEVERN DECEDENT'S EDUCRgN e «acIMYq N*m n«~ araiaG~j U.S.AMEDFDRCEBf N,,,,~~ SINMVNDSPOU9E [~~'77 Ia Wa piranuiean nrna, 1aa^ No3T.~l Ga•Y• DWie,oaa fSPaeaM ADOIIESB Ciry/xawl.'91Ma, caeN DECEDENrs " +'' P'~ 12 (,~A~s.1 ,8idowad ,~fOIIe K rnsum Pannsy7yania ~ „ap,,,,d,e,ei,,~rem~ilver Snrin¢ TwA • 191 Woods Drive ,,~;,, ' 1° "~aPT C] ~ a r ' ,Ta wtm. cara a 8 NAME (Pint Miet/a.laatl oA Aa~ " o' V MOTNEl1'S NAME tFaY. Mid1L. Mrdnsu.wrr) s o ,s. A es Philli a NFORMANT'S MABYMiADOREea ISaa.t CaHrowl, slam, Zocoaa Ave. Enola PA 17025 ~~~ Cnnmtmn0 RMno..I aom sumo Dan 1Yr) D«laeon^ D~~' PLACEOP DISPOBIrnN•Imnm ofCrnK«%pammyY LOCRgN•CBWr«n4 S4MmCob «atn«PUC. gS ~ rwApril 20, 1995 olling Green Manorial Park Camp Hill, Pa 17011 aa/avuREDP LICFAISENUNEA OR PEIIBDN ACTINfi AB stlcll ~+ ='a NAMEANDADaRESSaF '"Myers Blmera me aa.• .ImA "` - Main St. MeahaIIioabur PA 17055 m1OM~ie~••emtnamandremun. ew rw p.w alamd n«a a ~~~ g . g ~ l aM allmd m uCENSE NUMEEN ~~ oa,W, ealw«Mrn. IMOndL Den YaaR Ywr tL1/mulMoanpwaeM OF DF.IPN DATE PRDNOUNLED DEAD plods, O•n Yaarl YiILB CASE RETfRRED RIMEDICAL OfAMM1EACOgpyER, Pn••n nlp PI'a,l•I•eM daaM. / 2 : Z p zl. tj, M. ~ - i : - 4 ~ w ^ ,rp r Tlwr r ~ . . Ed«ar W•n1Y«maMma O11 ~a1JI alMY M1IC11CM~aelM eNtll. DO n01 a111af Ma mOeadeyY10, f11fll bfJl6aC«mp4•m.Y LIaM NOtlt«MYI hiIMa IA p . . ~ylp Aam MR~Ik OIIla1 YaalaalOMwaan •19^~oalAliolno•rrimaYgm daalR Ma ~ IFnal I«wI M00aaYl A01 i••~^Emtlla mMrMYgcYMa9banw PAlli 1. TE ~ 1 nwalaq io a.an)-- . /H6T// S`T/,r'Ti ~ Lym otf o~ KF-co.;.N A ~ . DUETOpR A$ A CONSEQUENCE OFx G ~ Ia•Y. mabgb naa•eIM OUE TO(ON ASACONSEOUENCE OFi: oawa. Edr UIONILVEID t ~ i h,iYlalltl •°•~a• 13UETO IOR ASACONSEQUENCE OFj: naAnp n Dean) LAlT I n W10 AN AUIOPSy MANNER OF DE.VN , PERFORIIEDi EpgpRFB DATE OFINJURY TIME OFINJURY IWURYR WONK7 DESCRIBE NDW WURY OCCURRED. COA~LETION OFCAU$E lMmn.OaY. Ye«1 OF DERNT NamrM ~,] ,pmt, ^ Aaadara ^ PaMrq lmWlytlpn ~ Wa ^ No^ Nm ^ r10^ Ym ^ N• ^ 9WdM ^ CdAd MtWeNamlNad ^ PUCE OfIWURY- M• AA At IbM hfm auM mtlp Olllt ~. ~ ~ . , , y a LOCATION ($F•at.ONR . Sm,N I^,ERTrt1Ep (CMe. ady «yl ]O,. • CEIRIFYNq M,YtK1AN(PnYjraanre,dyyy er,mdMam w.«y.gna pnyyc~an t~s SIO TIiIE RTIF p~ b ~ ~ p y~ . ,am ybc~~q,y~~l ^7 marwmeya. Man ORI1Ir•deWbna uuaalgane mu•lara•I•+•e ................. .................................... / j/N~ 31 ~ I j7a/.[iv^.a .euq cream ane epnyeiq rocaum d neaml LICE MB^E n l ~ DATE SIGNED fMaan, Gan vmn 'T•'pm,r I•`••l•e0•. dNna•a«.w al tlmulm eW ~ , all e Plaea, ane euam Bm•ww(al and«annrmatame .......................... ~ 3/ef ~'~ V~0 ~~ j= 3fa ~~T ~' •'~i1 . NAME ANDAODRESS OF PERSON WHO COMPLETED CAUSE Oi DEATH MEDICAL E7UMBIER/CORONER (Item 271 Typa«PriM /~•-~ in m !`!• ^ t O.m /}~ _ ~ ~?.,. '' On Dm OaaN b aaandrudon and/or Imsalipa,ion ~r~I3r ~* s o i i . , p n manner r autw........ r on, earn «eo.rad ae tM,Ima, data, and plaea, and aw eo ma eause(al and ~ `zc,'/ .._ ~ /L,Yn. n~ ~"" 31a. .............................................. ., . ............ Z4AO ............................ , REGI RAR'S SIGNATURE ANO NUMBE ~• l An^ PY ~ c-:. ~~~, ('7 y ~ Y / A 33. N/ I~r~(i ( i~f I~ A I / ( , ~ Q , J LAST WILL AND TESTAMENT of RUTH N. ORENDORF **** I, RUTH N. ORENDORF, now of 191 Woods Drive, Silver Spring Township (Mechanicsburg), Cumberland County, Pennsyl- vania, being of sound mind, memory and understanding, do hereby make, publish and declare this to be my Last Will and Testament, revoking any and all prior Wills or Codicils, or both, by me made . ITEM I. I do hereby direct my Executrix, hereinafter named, to pay all my just debts, including funeral expenses and costs of my last illness, as soon as conveniently may be done after my decease. ITEM II. I do hereby give, devise and bequeath unto my husband, Charles S. Orendorf, all of my property, real, personal and mixed, wherever situate, of which I may die seised or possessed, should he survive me for a period of thirty (30) days. ITEM III. In the event my said husband, Charles S. Orendorf, shall predecease me or fail to survive me for a period of thirty (30) days, then I do give, devise and bequeath my entire estate, real, personal and mixed, wherever situate, of which I may die seised or possessed, to my daughter, Gail D. Dougherty, absolutely. ITEM IV. I do hereby nominate, constitute and appoint my ( SEAL Ruth ~ Oren orf - 1 - -- ~_ daughter, Gail D. Dougherty, to be the Executrix of this my Last Will and Testament, and do vest in said Executrix full power and authority in all things, matters and issues; and I do empower said Executrix to do any and all acts which I might or .could do myself, if living, including, without in any manner limiting the generality of the foregoing, complete power and authority: A. To lease, mortgage, sell or otherwise dispose of all my property, real, personal and mixed, in her uncon- trolled discretion, at private or public sale, without court order or approval; and B. To execute, acknowledge and deliver all deeds, leases or other documents of whatsoever type and description which may be necessary; and C. To make distribution of all personalty in kind in her uncontrolled discretion; all without court order or approval and all without the requirement of bond. No purchaser shall be required to see to the application of the purchase money. IN WITNESS WHEREOF, I have signed, sealed, published and declared this to be my Last Will and Testament, having affixed my hand and seal to each page for greater security and better (.SEAL) - 2 - ,. . .., . .. , i.~3.e it::i i:ication, this a9~j day of May, 1981. {SEAL) W C T 1:E;:3 S ':['he foregoing Last Will and Testament was on the date hereof s:_gied, sealed, published and declared by the above-named Testa- t:-i c :f_or and as her Last Will and Testament in the presence of us, wl~o, ~:~t her request and in her presence, and in the presence of e.ic:i c;~ther, have hereunto affixed our hands and seals as witnesses. _ n -'`__~--+''-~ ,c~~C/ (SEAL) residing at ~~.3~ ~' 1' . ~ I ,1 ~'~'' ~ (SEAL) residin at a~~?~GtGl~r~2'izd.~~ ~ /701/ - 3 - SS: I, RUTH N. ORENDORF, Testatrix, whose name is signed to =•:'-, e-.attached or foregoing instrument, having been duly qualified ~:.:y .,~:z q,. ~ ~' ~'rdjin to: ,law, •_do hereb acknowled e that I si ned and execute g ,, _ g •~Last~Will.and•Testament; that I signed it • e -ee.:;and voluntary act for ._ _ _. .. , . .. ... _...: :•..-. _ Notary'Public .. ~: My Commission Expires: ~ /y' ~ (SEAL} COM_^_ONT~lEALTH OF PENNSYLVANIA ) SS. COUNTY OF DAUPHIN ) We , ~ .~~ _ ~ and~i~. ~l~w.,'~if rui the witnesses whose names are signed to the attached r foregoing instrument, being duly qualified according to law, do depose and say that we were present and saw RUTH N. ORENDORF, Testatrix, sign and execute the instrument as her Last Will and Testament; that RUTH N. ORENDORF signed willingly and that she executed it as her free and voluntary act for the purposes therein expressed; that each of us in the hearing and sight of the Testatrix signed the Will as witnesses; and that to the best of our knowledge, the Testatrix was at that time 18 or more years of age, of sound mind and under no constraint or undue influence. __-- CL// • /J /YCC~L/ /~/1/~?QJ Sworn to and subscribed before me this ~ ~'~, day of May, 1981. _. ary ruolic _ My CCs:fimission Expires: ," - {-SEAL) G i ~~ REV-1500 EX+ (7-94) ~. FOR DATES OF DEATH AFTER 12131/91 CHECK HERE INHERITANCE TAX RETURN POVERTY CREDIT IS CLAIMED ^ RESIDENT DECEDENT F,LE NUMBER COMMONWEALTH OF PENNSYLVANIA (TO BE FILED IN DUPLICATE DEPARTMENT OF REVENUE r~'J ~ ~ ~ ^ -7 i L( DEPT. 280601 WITH REGISTER OF WILLS) ..~'CC (,/ J I // HARRISBURG, PA 17128.0601 COUNTY CODE YEAR DECEDENT'S NAME (LAST, FIRaT, AND MI E INIT NUMBER /~'~ ~~ ~\ O ~ ~~~ ` ~' DECEDENT'S OMPLETE ADD SS V 1 JIV 1 ~ 1 ~oc~~ jy SOCIAL SECURITY NUMBER DATE OF DEATH DATE OF BIRTH ~ e~~~~`~C ~U ~~ ,. 1~ 0 `J y ~ Counr ~ ` `` O Ilf APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST AND MIDDLE INITIALI SOCIAL SECURITY NUMBER euni urc oe~uven .«...._._..N._.._. "' Y a y ~ 1. Original Return ^ 2. Supplemental Return ^ 3. Remainder Return Y =oo ~ m ^ 4. Limited Estate ^ 4a. Future Interest Compromise f (for dates of death rlor to 12-13-82 ^ 5. Federal Estate Tax Return Re ui d ) ~ a ( or dates of death after 12-12-82) ~ b. Decedent Died Testate ^ 7. Decedent Maintained a Living Trust (Attach copy of Will) (Attach copy of Trust) q re _ 8. Total Number of Safe Deposit Boxes ~ W o= ,. ~ _ .. i ,_.,,n1 ~ _ _ \ ~ COMPLETE ~IL~G AD~ E ~~ 1 C~~ee~ A ~~~ ~~ r,g TELEPHONE N BER a-5~5 ~rc~\~ -~«. ~~~as 1. Real Estate (Schedule A) (1 } _ ~o~ ~QQ„ 00 2. Stocks and Bonds (Schedule B) (2 ) 3. Closely Held Stock/Partnership Interest (Schedule C) (3 ) 4. Mortgages and Notes Receivable (Schedule D) (4 ) 5. Cash, Bank Deposits & Miscellaneous Personal Property (5) _ 7 ~ ~ ~ ~ . _ + (Schedule E) S b. Jointly Owned Property (Schedule F) (b ) ~ 7. Transfers (Schedule G) (Schedule L) (7) a 8. Total Gross Assets (total Lines 1-7} ~ 3 ~ ~ - 3 (8) ~ `I J 9. Funeral Expenses, Administrative Costs, Miscellaneous (9 ) Expenses (Schedule H) t 10. Debts, Mortgage Liabilities, Liens (Schedule I) (10) 11. Total Deductions (total Lines 9 8 10) (11) ' ~ 1 3 5 C~ 7 12. Net Value of Estate (Line 8 minus Line 11) (12) ~ ~J ~ , (7 i ~ Jr7 13. Charitable and Governmental Bequests (Schedule J) (13} ' 14. Net Value Subject to Tax (Line 12 minus line 13) (14} ~ 3 1 t ~ ~ ~ ~'7 15. Spousal Transfers (for dates of death after b-30-94) See Instructions for Applicable Percentage on Reverse (15) Side. (Include values from Schedule K or Schedule M ) x __ . 16. Amount of Line 14 taxable at b% rate (16) ~ ~'t y ~. S ~ (Include values from Schedule K or Schedule M.) ~7 v x .Ob = ! 1 0 Lo ~} , ~ z 17. Amount of Line 14 taxable at 15% rate (17) (Include values from Schedule K or Schedule M ) x .15 = o c . 16. Principal tax due (Add tax From Lines 15, 16 and 17.) (18) _ "~ ~ (~ ©, d ~ 19. Credits Spousal Poverty Credit Prior Payments Discount Interest + ~ + 393 '' 7 _ '~ f- 20. If Line 19 is greater than line 18, enter the difference on Line 20. This is the OVERPAYMENT. (2p) ~ ~ +~ 21. If Line 18 is greater than Line 19, enter the difference on Line 21. This is the TAX DUE. (Y1) A. Enter the interest on the balance due on Line 21A. (21A) B. Enter the total of Line 21 and 21A on Line 21 B. This is the BALANCE DUE. (21 B} Make Cheek Payable to; Register of YVtlls, Agent _..__. _ eve examine t Is return, inc uding accompanying schedules and statements, and to thl it is true, correct and complete. I declare that all real estate has been reported at true market value. Declaration of preparer other based on all information of which preparer has any knowledge. SIGNbLII F AF YFCi[nu neee~ue~e~ ~ ..........._ ___.._.. rt my knowledge and belief, le personal representative is DATE 9- ~ 1- 9S' 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°i6 (..03) will 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 1/1/96 and before 1/1/97 • 1 % (.O1) will be applicable for estates of decedents dying on or after 1 /1 /97 and before 1 /1 /98 • Spousal transfers occurring on or after 1/1/98 will be exempt from inheritance tax. PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING A CHECK MARK (,~) IN THE APPROPRIATE BLOCKS. YES NO 1. Did decedent make a transfer and: 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 on or before December 12, 1982, did decedent within two years preceding death transfer property without receiving adequate consideration$ 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'. bank account at his or her death$ ...................................... IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. ` REV-150 EX+ (12-851 SCHEDULE A COMMONWEALTH OF PENNSYLVANIA REAL ESTATE INHERITANCE TAX RETURN FILE NUMBER jProperty jointly-owned with Right of Survivorship must be disclosed on Schedule F) All real estote should be nportsd at fair market value which is defined as the price of which property would be exchanged between a willing buyer and a willing seller, neither being compelled to buy or sell, both having reosonabie knowledge of the relevant facts. ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH 1. 7, 5 C ~~n~~Cae.~\c~~c~ ~c::~~~c~: .. C~ns~s~i c ;. _ . TOTAL (Also enter on line 1 Recapitulation) Ci[i s fr? 7 5 Dc~ (!f more space a needed, mserl adddional sheets of some size.) ,' , REV-1508 E%+ 12-87) COMMONWEALTH OF PENNSYLVANIA INNERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS AND MISCELLANEOUS PERSONAL PROPERTY tJlAlt (All property jointly-owned with the Right of Survivorship mud be disclosed on schedule F) ITEM DESCRIPTION NUMBER Please Print or Type ~1BER _ ~ 19~-~31y 3 ~ "~\s~ . ~Uv 5~hc~ c~ c~c:~c~ S ~.n~ v~ ~ ~, 5 ~mm o'n ~ C.c~mmur ~ c~~-t~~.~ JeZ ~-~-~ ~~ ~~r~~~ ~c~;~c~-e~n~`c mss, ~~r~c:~~;~t.c~.s ~~ ~~~~ F~~\c~~~~~ ~~~~~ TOTAL (Also enter on line 5, (Attach additional 8%:" x 11" sheets if more space is needed.) VALUE AT DATE OF DEATH t.~ ~, E~ y 5 . ~ to 1 Q r ~ L>7 5~. ~ ~: ~1 OC-'C~. CSC) 11~1~z ~© ~~~y i i~.~~-~ 07. ~~ c~ ~ l .q a ~~, ~~ tecapitulation) ~ $ 7 7 ~ ~] ~ ~ ~ REV-1511 EX+ 17-88) ~r COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ITEM NUMBER A. SCHEDULE H FUNERAL EXPENSES, ADMINISTRATIVE COSTS AND MISCELLANEOUS EXPENSES u~~ ~. OR~~o~~ DESCRIPTION Funeral Expenses: c~\ ~hq C~reex~ ~,e~~e.~ - c~rcav~ e,-~h~r~ ~ U~c~~ B• Administrative Costs: 1. Personal Representative Commissions Social Security Number of Personal Representative: Year Commissions paid 2. I Attorney Fees c. (If more space is needed, insert additional sheets of same size.) 3. I Family Exemption Claimant Relationship Address of Claimant at decedent's death Street Address City State Zip Code o ~f' d2 ~, ~ U t~7G. G ~~9y- y~ 4. Probate Fees ~ ~C~ . ov Miscellaneous Expense 1. ~~ ZG;~S o~~ ~~E'.~ 0 > C7 d ~ ,. 15 2. '`Jc~.,m~MGt1S ~ ~~ce~Vn~.C~~~~~.~ 3~ r 1 ~ 4. `~~ ~ ~- L t a7. a ~3 5. ~ o.~ ~ ~c~.~~~e: nc. E a,~ ~. c:~ a ~} ~~. s. ~-.._~~c1v,51 L~ cx ~R S L~ \~ ~2.~RC~~ . t ~ , (~ y TOTAL (Also enter on line 9, Recapitulation) I $ j Please Print or Type NUMBER ~I~S-_ ~31~1 AMOUNT 59.75 ~~c`n e ~.v~ ~~ <~ 1 ~ 5"- G~ ~ y i ~~ z.. ~~~ m ~me~,m~.n ~ ~~~~~\n ~ t ~ o jai ~~~:~.~~,-~ :~ ~ . ~ ~ ~1 ~ ln~ ~~ ~ C~~c~~.`~c ~ ~7 n~ e c~-~ ~~ ~ ~ 5 . c~ e~' ~ ~-I, ~~ s 9 , -~ ~ ~ Y REV-1513 EX+ (2-87~ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE~,F ITEM NUMBER NAME AND ADDRESS OF BENEFICIARY A. Taxable Bequests: ITEM NUMBER NAME AND ADDRESS OF BENEFICIARY B. Charitable and Governmental Bequests: TOTAL CHARITABLE AND GOVERNMENTAL BEQUESTS (Also enter on line 13 Recapitulation) I $ (If more space Is needed, insert additional sheets of same size) FILE NUMBER RELATIONSHIP AMOUNT OR SHARE OF ESTATE SCHEDULE J BENEFICIARIES ~~~~~~ I t C~~~a AMOUNT OR SHARE OF ESTATE REV-1543 EX AFP (8-94) COMMONiIEALTH DF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 INFORMATION NOTICE AND TAXPAYER RESPONSE FILE N8 : -het ~ ~~'-~`~" ACN 95106294 DATE 02-28-95 ' TYPE OF ACCOUNT ' ESTATE OF MARION W NEFF ^ SAVINGS S.S. N0. 198-40-7433 ^ cNECKINc DATE OF DEATH 08-26-94 ^ TRUST COUNTY MIFFLIN ~ CERT~CATE ROSS M MORROW REMIT PAYME~j;~l}D F`~1S ~; 243 N 29TH ST REGISTER OF WI~t.~ llJJ~ CAMP HILL PA 17011 MEWISTOWN~ PA44~' ~~~ ~~ , ~ i"'"~ ~• ~ --q ~ -`•' ~ ,;,~ t-,-•t MERIDIAN SANK has provided the Department with the inforeation listed below which has boon used in faiciilatinp'the ^ potential tax due. Their rocords indicate that at the death of the above decedent, you were a joint owner/bsnefici ~.£ th If you feel this inforeation is incorrect, please obtain written correction frog the financial institution, attach i~ccoa~j ,~ and return it to the above address. This account is taxable in accordance with the Inheritance Tax Laws of the Co to-tf11s #j"~'nF' gi,e.ttnne may be cruawarec! ny call.tng !717) ~9?-a~Z7. aa6hwealth of Pennsylvania. COMPLETE PART 1 BELOW ~ x ~ SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS -~_, Account No. 4003501402 Date 10-31-88 To insure proper credit to your account, two Established C2) copies of this notice must accompany your Account Balance 25,669.44 payment to the Register of Wills. Make check Percent Taxable Payable to: ^Regiator of Nills, Agent^. x 16.667 Amount Subject to Tax 4, 278.33 NOTE: If tax payments are made within three Tax Rate C3) months of the decedent's date of death, X . 1 5 You may deduct a SX discount of the tax due. Potential Tax Due 641 .75 Any inhsrltance tax due will become delinquent nine C9) months after the data of death. PART TAXPAYER RESPONSE .. rou way cnooas to F~+=pa -ys` +.`+ +~L~ Register of Nills with two copies of this notice to obtain CHECK a discount or avoid interest, or you may chock box ^A^ and return this notice to the Register of 0 N E Nills and an official assessment will be issued by the PA Department of Revenue. BLOCK ~ B. ^ Tha above asset has been or will be r 0 N L Y sported and tax paid with the Pennsylvania Inheritance Tax return to be filed by the decedent's representative. C. ^ The above inforeation is incorrect and/or debts and deductions veers paid by you. You oust templets PART Z^ and/or PART 3^ below. PART If you indicate a different tax rate, please state your °'~~'"~~~~''•• relationship to deceden t: '~ '`'` i~~~°`~~~~~'~'~a°~s'a~~;~~!~'; ;'t fv;,.yr'r: ,',y4 eti ~~yi 'iii3;ii1 ; e~ TAX RE TURN - COMPUT , , , , ? yi r,, ,ti4 , '''~';, '~,~,,',~,,,:~„ ~ ATION OF , TAX ON JOINT/TRUST ACCOUNTS '~,~ ~Ii~i~i'i'i'iti'i'i i~' iti'i i+i ','i'?i~'ti~'~' 'Yri' LINE 1. Date Established 1 ' ~~; ;;"`~ ~; i s~~~ '. y; ; ~~ ~ i;~;~~yii~i~yki~:~;;yr; ~a~' ~ '~ "' ` ~ 2. Account Balance 2 r,~ ;,,d~,~ ° ,5a ,.,i ,f, ,. _ k,~~,r'~ ,, S ~,,.. ,~ 4° 'i~y;; i~i~e 'i'i4 i ' :ti~ii'iii'i~e'i'i i~+i' 5'ii'~i'i~~i4'i'~''i i 3. Percent Taxable 3 , , ; ,,, ~ : X !~;r!~?~,~~..;;i~;;;,~!;"i;r,;i;;'?4i;i~~i;i4~i~~~~~~~; ' 4. Amount Subject to Tax 4 4y.i4ti'i;Py :a :4.d ,aa~,;:fi5 r ~ , r a:4§' , ;';';;;:t'i.,?;~:'!~„~~;:;;:;,4i,',',4<,':' ,'~ :,+,':':':',','; •' ;~4~;~ ~i}i'i'i'?gi4~i';'':''iS iiti~~i ~id't?i!i4i$!;i;ayyi~iii~i'i 5. Debts and Deductions 5 - i~ ;~,a;,,;;~,;~;~~{; ' 6. Amount Taxable 6 . a;.; ~' .,::".~:~,; y;;~;, ,,,,;,;, ~~~~F~yAly'$t;4,ti',`i'r 4'' 4:~, ,: `2 ;tit, ~,?, ;;ii~i:iii;:i;. 4. :V2:~i~i ~~, ,, ~ :: + ~ 7. Tax Rate T ~~'~ ,+r4~h4 x ~'iii;{.';r';;i~,i;';+t:;?nisi=;;;;',,~~~,,,~ ~`€~'af ; 8 . Tax Due $ ~~ ~~~' ~ s i~;;i~~ ~r~~ ~l~ij'~'~~a ti~ ~~~';'~~~ f ;hi: PART ,i' 4'i'',454'i+i44ti4';:;':5'i?r,'i°i':':5'i4:2i5':'.,5: DEBTS AND DEDUCTIONS CLA~I~MED 0 DACE PAID PAYEE DESCRIPTION AMOUNT PAID iuiw~ center on Line 5 of Tax Computation) ; Under penalties of perjury, I declare that the facts I have reported above are true, correct and complete to the best of my knowledge and belief. HOME ( ) WORK ( ) REV-1543 EX AFP (8-941 ~- ~ ! S - d ~? ~ ~ CDMMDNNEAL7H OF PENNSYLVANIA INFORMATION NOTICE DEPARTMENT OF REVENUE FILE NO -xT~~~~` BUREAU OF INDIVIDUAL TAXES AND ----', DEPr. zeoeol TAXPAYER RESPONSE ACN 95106311 HARRISBURG, PA l~iz6-obol DATE 02-28-95 TYPE OF ACCOUNT ESTATE OF MARION W NEFF ^ snvlN~s S.S. N0. 198-40-7433 ^ CHECKING " DATE OF DEATH 08-26-94 ^ TRUST COUNTY MIFFLIN ~ CERTIFICATE NADINE M MORROW REMIT PAYMENT AND FORMS T0: 243 N 29TH ST REGISTER OF WILLS -~ CAMPHILL PA 17011 MIFFLIN CO COU OUP -~ LEWISTOWN, PA ~44u1 =:? m ~°;~; ~, ~..._ Q *;- ..~ ~;,-_ ~ ~, tV -- °~ MERIDIAN BANK "> ; :-~ has provided the Dspartsent with the infonation listed below which has boon used in ~lc'ulat the - ~? potential tax dw. Their records indicate that at the death of the ebovo decedent, you wero a ioint owner/bernficia~y" of th3Faecoagt. If you feel this inforsation is incorroct, please obtain written correction frog the financial institution, attachLar;FCOpy this"'#gra and return it to the above address. This account is taxable !n accordance with the Inheritance Tax Laws of the Co~c~alth•+of PdnTrsylvanls. ^.::::stio.-.s eay bo answs.-ed by tallir.~, ;'1': 'S?-6327. COMPLETE PART 1 BELOW ~ ~ ~ SEE REVERSE SIDE FOR FILING AND PAYMENT INS~TIORS '"•~ • Account No. 4003501394 Date 10-31-88 Established To insure proper credit to your account, two (zl copies of this notice oust accospany your Account Balance 28, 830.67 Paysent to the Register of Nills. Make check Percent Taxable X 16.667 payable to: ^Register of Nills, Agent^. Amount Subject to TaX 4,805.21 NOTE: If tax paysents are wade within three Tax Rats X r C3) soothe of tFw decedent's date of death, , l j you say deduct a 52 discount of the tax due Potential Tax Due 720.78 . Any inheritance tax due will beeose delinquent nirn C9) soothe after the date of death PART TAXPAYER RESPONSE . ..,,, :,, :.,.:.,~.~~~~,:~,,..Yti:~.,.,.,._,.,.,., 1. YOU say choose to resit pay---+ +^ +1+e v.^ister of Nill with two copies of this notice to obtain CHECK a discount or avoid interest, ar you say check box ^A^ and return this notice to the Register of ONE Nills end an official assesssent will be isewd by the PA Departaent of Revenue. BLOCK ~ B. ^ Tha above asset has been or will be r ONLY eportod and tax paid with the Pennsylvania Inheritance Tax return to be filed by the decedent's representative. C. ^ The above inforsation is incorrect and/or debts and deductions ware paid by you. You gust cosplete PART ~ and/or PART 3^ below. PART If you indicate a different tax rate, please state ''~'~"'~'°'°'_'~•'_'_°'_' "~ _ ~• _ _: Your °'_' „~;~,<,,,,;,,,,,;,,;;;,;=,'s;° ~;I~ti ,~ 2 relationship to decedent: ~i5,s;?,i,,~~i~i~s`~?i'i~;,~~~i~;,i~i~~'`~,~.',; • '~4: a!s'~~'~:~,'.;t,;;i;,;s,;~;:.`,, TAX - '~$i~~~''!r+~ ,, ,+~~','~,,'~~, , ~',a~~s'a~i~ ~~itis RETURN COMPUTATION OF TAX ON ~lOIMT/TRUST A ?4~, ,,~,, „~~;y,;~;~;~~;:;~~~,i;;;~~$;:;~~,~;::~:~;~;~s~;;~'~4,i~~;~?~~~~,~~'~,:,~~~;~;~!~~+:!:~~:~s:;;s CCOUNTS ~ ;~;;,,~::;:;.. ,2~.. y., LINE 1. Date Established 1 ~ri~i ~~~~',~',' :;,~;~ ,.ti „'ax, :,:~,.:, , ,',~t~S.~St~y,r7i= ,56,'i'''~'';;,`''''''''''i~'r';;I;ii;;t;;;:;=r,;,;: 2 . Account Balance ~;~;~; ~; ~~ ~,,,;;;;e;t:~~ ~~~~ ~ '' ' ,r;; 4,;5, •;,;~,:,~, ,~'~_,_,_', s,~',s 3. Percent Taxable 3 X ~'s~rl r,'s~;;;;~;:'~~;~?~?$;~~;;,,,}r;i,:;yiE~'~`~`~'~~~`''s~~:,',_;;,;; _'_ ',;,;°;' ,lip,,, ,°,~''' 4. Amount Sub act t i~,~4,'~,,,.'; ;,~~;,;,;,:,~,,,,;,,,,,;,;;;;;,,,,,;,~,:,~,_,:; j o Tax 4 ~~;.;, ,,_,~=rE~:w=,=,=,,,~,~:~=,=,a ~;,;,;~,;,~:,_;,,,,,:r~,. '~_'~:,~~,€ ~s;=a,~~;~;:': 5. Debts and Deductions 5 - ;,;~r}~~;~;;'r,~;~;;;"r.~;;4;.;.;.;i;.;t:i=f;;;r'~;~IIfE~tir't=I~h~},;,;,;,;,~~€I,~'y,;,'r,,;y:=,;.,:.~p~,y::=,y~::=,~~=,s=:,~~_,_~ 6. Amount Taxable 6 ~~~~~~~ii;~i~~''''"?~~;;i;~j~;ri,;;i~s,;"ki,k;,s~ ~~~i;y!!1;4~i~si7~;s~,,;;ifs;;~;;;}~';~'~,_.~;,r;,;;;,,,;;;,;;;;s 7. Tax Rate ~„.'. .~~;,pF;,p,;tiy,,;~,.a,,"Wr~s,,;rot;,~y'r'~r~~h~rNE=N;.4,;;;;4;;,;;;;r~~l,=sF;,;;;:=;;~t,;:;,=:=;u, 7 X ~~t~t;;;yr~;;l;4 rF€'s~=r,td,',,~F~~:,:,;Ipt~,=,~I,=:'~._',~~=a=~ ~~:~:,,'`,p~*I~r;:E=i=2~~I:;a:plt;fs;a, $ . TeX Due $ 'j{S~S~~ t;y5¢;~ 4 ~' t~t~;;~~''"{r ~Ft:rt?E41`'r;v ~;1;~ y~~r'$;~;ra;~lrt;~;~,'s,;;; <;,p:,{ s PART RESTS AND DEDUCTIONS CLAIMED ~E PAID PAYEE DESCRIPTION AMOUNT PAID i ;a,~ v ~~~w~ ~cnter Oft Line 5 of Tax Cowputation) 6 Under penalties of perjury, I declare that the facts I have reported above are true, correct and complet to the es kno dge and belief. HOME ( ) - /Ll~-^-- WORK ( ) REV-1543 EX AFP (8-94) ~ 1 1~5+' ~ 3/S^V COMMONWEALTH OF PENNSYLVANIA INFORMATION NOTICE DEPARTMENT OF REVENUE AND FILE NO.~ DEPTAU280601DIVIDUAL TAXES TAXPAYER RESPONSE ACN 95106312 HARRISBURG, PA 17128-0601 DATE 02-28-95 TYPE OF ACCOUNT ESTATE OF MARION W NEFF ^ saviN~s S.S. N0. 198-40-7433 cHECKINc DATE OF DEATH OS-26-94 ^ TRUSr COUNTY MIFFLIN n L)(1 CERTIFJCATE REMIT PAYMENT AND FORMS T0: ROSS M MORROW REGISTER OF WILLS 243 N 29TH ST MIFFLIN CO COUR HOUSE CAMP HILL PA 17011 LEWISTOWN, PA ~t4 ~ ~`;' t3 >•- xs ; ~ ~ ~ ; N '~~~ ';°~ MERIDIAN BANK has provided the Dapartsant with the inforaation listed below which has bean used in c 1CUlati~ the, = ~ potential tax due. Their records indicate that st the death of the above decedent, you ware a joint owner/beneftc '"ef th~accoaln ~`~- !f you feel this inforaation is ineornct, please obtain written correction frog the financial institution, attachbopy his° arl"" and return it to the above address. This account is taxable in accordance with the Inheritance Tex Laws of the C~pFiwaal~f Ponr~sylvania. q~iectf One !!ey bo ens+.+er!+d by c*ll ing (7).7) 787-~A3?7.. ~.~p.: ,.. COMPLETE PART 1 BELOW ~(~ ~( SEE REVERSE SIDE FOR FILING AND PAYMENT INS~~CTI@,IS `~~ Account No. 4003501394 Dat• ~,:~ 10-31-88 To insure proper credit t your account, two Established (z) copies of this notice oust accospany your Account Balance 28, 830.67 PaYSent to the Ragistar of Wills. Make chock payable to: ^Ragistar of Wills, Agent^. Percent Taxabl• X " 16 .667 AsIOUnt Subject to TaX 4,805.21 N07E: If tax paysents era soda within three (3) aonths of the decedent's dato of death, Tax Rats X .15 You aay deduct a 5iC discount of the tax due. Potential TaX Due 720.78 Any inheritance tax due will bacosa delinquent nine C9) aonths after the data of death. PART TAXPAYER RESPONSE <<,:,< < .:...... .... . ... ti~,:. ~.~:.. ~ i# .~~~s:Ydi .,,,waSWit;:~ riYwfr~.is~4r.,,,~i~~~>.~:L.ur~.,.~.vr.w~ ~.W~;.~.~.r.,.,,:::~.;.;.~~.,.:.:.:.~:~::~.:,.~:,:~..,,~ ............................................. A, f-,l ~ISa above inforaation and tax due is eorrsct.Q~- 1. You aay chooso to rewit pa t to the Ragistar of Wills ;tli two copies of this notice to obtain CHECK a discount or avoid interest, or you say chock box ^A^ and return this notice to the Ragistar of 0 N E Wills and an official assesssent will be issued by the PA Dapartsant of Revanua. B L 0 CK ~ g. ^ 7ha above asset has boon or will ba reported and tax paid with the Pennsylvania Inheritance Tax r 0 N LY to ba filed by the decedent's representative. aturn C. ^ The above inforaation is incorrect end/or debts and deductions ware paid by you. - You lust eosplgte PART 2^ and/or PART 3^ below. PART If you indicat• a different tax rate, phase stag your °~~~""';;s ~ ; relationship to decedent: 2 , ~'~~`'~ ;,;;;r,; !; E;i~ 2 T ~,~ . ;;~;?I~;~7 ;Iti~~tl;; ~ $ AX RETURN.- COMPUTATION OF TAX ON JOZNT~TRUST ACCOUNTS ~ ~' '` ` ~? LINE 1. Dots Established 1 ~ Ski 4~,,' rr~t~r€~;;ah~, a ' 2. Account Balance 2 i 4;~;r~~Yr'~; A"~ ';';rt`,;"''',;'' ` ` ~ ` `' ' ° ' ' ° ' ' ' '' ; i 3. Percent Taxsbl• 3 X ~!!? ;~ '~~~i 4. Amount Subject to Tax 4 ;; ;;; ~; ,; 5. Debts and Deductions 5 - ~'""" ~''~~ ' 6. Amount Taxabl• 6 '''• ~,k,~ai ~k's~ii~;;;~~ iii 7. Tax Rate 7 X '~'''S k 8. Tax Dw g ' PART 0 '~~" ~'' y.~, DEBTS AND DEDUCTIONS CLAIMED DATE PAID PAYEE DESCRIPTION AMOUNT PAID ..~'~ ~~ I TOTAL (Enter on Line 5 of Tax Computation) S Under penalties of perjury, I declare that the facts I have reported shove are true, correct and complete to the bast of my knowledge and belief . HOME C ~ 1"7 ) y ~~ R '~~~ r WORK ( ) REV-1543 EX AFP (8-94) COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 INFORMATION NOTICE AND TAXPAYER RESPONSE ~ f y s--o 3 ~ .5~' FILE N0. - ACN 95108604 DATE 03-18-95 TYPE OF ACCOUNT ESTATE OF MARION W NEFF ^ savlNGs S.S. N0. 198-40-7433 ^ CHECKING DATE OF DEATH 08-26-94 ^ TRUSr COUNTY MIFFLIN LJU CERTIFICATE NADINE ~1` MORROW REMIT PAYMENT AND FORMS T0: 243 N 29TH ST REGISTER OF LS --~ CAMP HILL PA 17011 MIFFLIN CO C~ H E'er LEWISTOWN, PAC7~04'4' °"; Q ~. 7a ' r _~_.. ~ u..r.. j ~. Wit., ~ .T ~ MERIDIAN BANK , .~ ,., ~-' (tea has provided the Department with the information listod below which has been used xEr;calcul potential tax due. Their records indicate that at the death of the above decedent, you ware a joint owner/beneficiary ofs tba '~ If you feel this information is incorrect, please obtain written correction from the financial institution att aCCl~unt. and return it to the above address. This account is taxable in accordance with the Inheritance Tax Laws of thewaa~ of~~Pennsylvania. Questions may bo answered by calling C717) 787-8327. 4. COMPLETE PART 1 BELOW ~ ~ ~ SEE REVERSE SIDE FOR FILING AND PAYMENT IA~TRUCTIONS~° '~~ account No. 4003501410 Data 10-31-88 To insure proper credit to your account, two Established C2) copies of this notice must accompany your Account Balance 42,242.04 payment to the Rogister of Wills. Make check Percent Taxable Payable to: "Register of Wills, Agent". X 16.667 Amount Subject to Tax 7, 040.48 NOTE: If tax payments are made within three Tax Rata (31 months of the decedent's data of death, X .1 5 You may deduct a 5% discount of the tax due. • Potential Tax Due 1 , 056.07 Any inheritance tax due will become delinquent nine C9) months after the date of death. PART TAXPAYER RESPONSE C7k M'll ~aiiil ;.:..i".r.r3::r _..~>.: ~_~;._ .~,:~.~ :•:_,. .. .., ...... _. CHECK ONE BLOCK ONLY a.. w. •s correcLYr~ You may choose to remit payment-#a th~R~i _+ f 4'>>~ith two copies of this notice to obtain a discount or avoid interest, or you may chock box '•A^ and return this notice to the Register of Wills and an official assessment will bo issued by the PA Department of Revenue. B. ^ The above asset has boon or will be reported and tax paid with the Pennsylvania Inheritance Tax return to be filed by the decedent's representative. C. ^ The above information is incorrect and/ d or ebts and deducti You oust complete PART 2^ and/or PART 3^ below. ons ware paid by you. PART If you indicate a different tax rate, please state your relationship to decedent: ~1F'FFCYAL USE ONtY ~I~, TAX RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS PAD- FA bEPAl2tMENT OF 12E1fENUE LINE 1. Date tstablished 1 2. Account Balance 2 1 3. Percent Taxable 3 X 4. Amount Subject to Tax 4 5. Debts and Deductions 5 - 6. Amount Taxable 6 7. Tax Rate ~ X 6 8. Tax Due g PART DEBTS AND DEDUCTIONS CLAIMED DATE PAID PAYEE DESCRIPTION ~~ ~ AMOUNT PAID TOTAL (Enter on Line 5 of Tax Computation) g der penalties of jury, I declare that the facts I have reported above are true, correct and comp to to bast f my nowledge and belief. HOME C ) TA DAVC _ A „D WORK ( ) 2 _ _. _ _ _ _ _ 1 CD nLIC -1 16ADCD A REV-1543 EX AFP ( 8-94 ) ,Z ~ f'~- - G3 ~ ~-- COriMONWEAL%a OF PENNSYLVANIA INFORMATION NOTICE FILE NA: -4~---ems '°~ BUREAUMOFTINOIVIDUALETAXES AND DEPT. 280601 TAXPAYER RESPONSE ACN 95108605 HARRISBURG, PA 17128-0601 DA T E 03-18-95 TYPE OF ACCOUNT ESTATE OF MARION W NEFF ^ SAVINGS S.S. N0. 198-40-7433 ^ CHECKING DATE OF DEATH OS-26-94 ^ TRUST COUNTY MIFFLIN LXl CERT~,FICATE ROSS M'~MORROW REMIT PAY ~.pND ~DRMS ~0: `243 N 29TH'ST REGISTER OF fix. . ` 'CAMP` HiLL`, - , PA 17011 MIFFLIN CO C ~--:HOE LEWISTOWN, PAcr x-704 ' -'~~ _ ~- ~; ~ 4- `~ MERIDIAN BANK has provided the Department with the information listed below which has bean used i~ ~ Qulat ~ the ~~ potential tax due. Their records indicate that at tho death of the abavm decadent, you wero a joint owner/bmnefi Hof account. If you feel this information is incorrect, please obtain writtmn correction from the financial institution, atta a copy ~o thief'form and return it to the above address. This account is taxable in accordance with the Inheritance Tax Laws of the nwealth of Pennsylvania. Questions may ba answered by calling (77.7) 787-8327, COMPLETE PART 1 BELOW ~ ~ ~ SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 4003501410 Data i, n 10-31-88 To insure Established Proper credit to your account, two (2) copies of this notice must accompany your Account Balance 42,242.04 payment to the Register of Wills. Make check Percent Taxable X Payable to: "Register of Wills, Agent^. 16.667 Amount Subject to TeX 7, 040.48 NOTE: If tax payments are made within three Tax Rate (3l months of the decedent's date of death, X . 1 5 You may deduct a 5% discount of the tax due. Potential Tax Due 1,056.07 Any inheritance tax due will become delinquent nine (9) months after the date of death. PART TAXPAYER RESPONSE CHECK ONE BLOCK ONLY urraccv` 1. Vou may choose to remit esvment to the Register of yy~l~s yith two copies of this notice to obtain a discount or avoid intorest, or you may check box ^A^ and return this notice to the Register of Wills and an official assessment wLll be issued by the PA Department of Revenue. 8. ^ The above asset has been or will be reported and tax paid with the Pennsylvania Inheritance Tax return to be filed by the decedent's representative. C. ^ The above information is incorrect and/or debts and deductions were paid by you. Vou must complete PART ^ and/or PART ~ below. PART If you indicate a different tax rats, please state your relationship to decedent: TAX RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS RAC LINE 1. Date Established 1 1 2. Account Balance 2 3. Percent.Taxable 3 X 4. Amount Subject to Tax 4 5. Debts and Deductions 5 6. Amount Taxable 6 ~' 7. Tax Rate ~ X 8. Tax Due g PART RESTS AND DEDUCTIONS CLAIMED DATE PAID PAYEE DESCRIPTION ter---~ AMOUNT PAID (VIAL center on Line 5 of Tax Computation) 5 Under penalties of perjury, I declare that the facts I have reported above are true, correct and complete to the best of my knowledge and belief. ~~~~ HOME ( 7/ ) T~~ ~.. Tr,. ~ II ~ WORK ( ) TCI CDLIn ~I AlI1MDCD REV-1543 EX AFP (8-941 COMMONNEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 z t ~ ~` ~' 3C,r- INFORMA ANDN NOTICE FILE lla=~~-= TAXPAYER RESPONSE ACN 95106293 DATE 02-28-95 TYPE OF ACCOUNT . ESTATE OF MARION W NEFF S . S . NO . ^ SAVINGS 198-40-7433 ^ CHECKING DATE OF DEATH 08-26-94 ^ rRUST COUNTY MIFFLIN ~ ~ CERTI~ATE NADINE M MORROW REMIT PAYME Ff~S 243 N 29TH ST REGISTER OF WI CAMP HILL MIFFLIN CO COU "'~ ~ PA 17011 LEWISTOWN, PA ~7~ff44~~"' .~` ~~ ~~ ~'' ~ .. _ . ' ,-- ..-- MERIDIAN SANK ~ ~ ~,~_,_ --' has provided the Department with the information listed below which has boon used in ca ~ potential tax due. Their records indicate that at the death of the above decedent, you were a joint owner/beneficiar ng ~ - If you feel this information is incorrect, please obtain written correction frog the financial institution, attach a~is ec~COUnt+`. y to this fora and return it to the above address. Fhis account is taxable in accordance with the Inheritance Tax Laws of the Cagonwealth of Pennsylvania. '.5i..:as csy ba :.7~5MiiPsd u,i coiiing C7I:: T37-u327. COMPLETE PART 1 SELOW x ~ ~ SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 4003501402 Date ~~' 10-31-88 To insure proper credit to your account, two Established (2) copies of this notice must accompany your Account Balance 25, 669 .44 payment to the Register of Nills. Make check Percent Taxable K Payable to: ^Register of Nills, Agent^. 16.667 Amount Subject to TaX 4, 278.33 NOTE: If tax payeents era made within three TeX Rata X (3) months of the decedent's data of death, . 1 5 You may deduct a SX discount of the tax duo. Potential Tax Due 641.75 Any inheritance tax due will become delinquent PART nano (9) months after the date of death. Q ,,,, • TAXPAYER RESPONSE A• TI+° above information and tax due is correct~l~~ 1. You may choose to reei ayaent to the aee~.+-- s ut:i~ with two copies of this notice to obtain CHECK a discount or avoid interes , or you may check box ^A^ and return this notice to the Register of C 0 N E ~ Nills and an official assessment will be issued by the PA Department of Revenue. BLOCK 8. ^ The above asset has been or will be re 0 N L Y to be filed by the decedent's representative. tax paid with the Pennsylvania Inheritance Tax return C. ^ The above information is incorrect and/or debts and deductions warn paid by you. You auat complete PART 2^ and/or PART 3^ below. PART If you indicate a different tax rate, please state Your ,;;~;?; relationship to d d t ece e n : i~'s~ << ti~;;;;;~; :,:. sp;r1:~.:: TAx RETURN - COl~!P!lTATIOlM OF T x A.. : 1 ~': ;;;;;';;~t,~~t !?N . ~?INT~T!?~$? A~'=CnuNrc '~;.'~;::, LINE 1. Dots Established 1 ti;,~a i 2. Account Balance 2 ,~,ar~,;iS,;;' ', ''~~"~~~"'''' ;,;~;~'~,; 3. Percent Taxable 3 )( ; i°~'~ti~'~'~~'' 4 . Amount Subject to Tax _ 4 ;s` '~ ~'i~is :: ~~~'~~~~~~~'~'~~~ , 5. Debts and Deductions 5 - , ;,, ~~;:;:;;;~, ~'~'~~~'~'~ ~i~i~4ii'i'i'i'i'''~'f i 6. Amount Taxable 6 °~~~'!; 7. Tax Rats 7 X i`!i;i;~;r 8 . Tax Dw :! i?ti'i~ti'?', PART 8 y,i,.,;;i;a~t~t;;; '_``~'~~~~~~~'~''~,~:::.: DEBTS AND DEDUCTIONS CLAIMED DATE PAID PAYEE .~. DESCRIPTION AMOUNT PAID ~u~w~ ienier on Line 5 of Tax Computation) ~ Under penalties of perjury, I declare that the facts I have reported above are true, correct and cor ate t bas y ledge and belief. ~;r ~_ HOME C~~7 ) 73 7- ~/7~~ _ WORK ( ) -~- --- 'REV-1.x43 EX AFP •(8-94) COMMONNEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUC BUREAU OF INDIVIDUAL TAXES DEPT. 280601 kARRISBURG, PA 17128-0601 INFORMATION NOTICE AND TAXPAYER RESPONSE FILE N0. 21-~~~ -°~ J~ ACN 94154898 DATE 12-20-94 TYPE OF ACCOUNT ESTATE OF MARION W NEFF ^ SAVINGS S.S. N0. 198-40-7433 DATE OF DEATH 08-26-94 ® CHECKING COUNTY ^ reusr CUMBERLAND ^ CERTIFICATE ** NADINE M MORROW REMIT PAYMENT AND FORMS T0: ~ 243 N 29TH ST REGISTER OF WILLS CAMP HILL PA 17011 KISHACOQUILLAS VALLEY has provided the Department wtth the information listed below which has bean used in calculating the potential tax duo. Their records indicate that at the death of the above decedent, you wore a joint owner/beneficiary of this account. If you fool this information is incorrect, please obtain written correction from the financial institution, attach a copy to this form and return it to the above address. This account is taxable in accordance with the Inheritance lax Laws of the Commonwealth of Pennsylvania. Questions may be answered by calling C717) 787-8327. COMPLETE PART 1 BELOW x * * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 38-4992 Data 06-21-94 To insure proper credit to your account, two Established (2) copies of this notice must accompany your 1~"+ Account Balance 8,560.48 Payment to the Register of Wills. Make check -~- ""- ~ payable to: "Register of Wills, Agent^. sreent Taxable X• -'~5~ . 0 0 0 Amount Subject to Tax 4, 280.24 NOTE: If tax payments era made. within throe Tax Rate (3) months of the decedent's date of death, X . 1 5 you may deduct a 5% discount of the tax due. Potential Tax Due 642.04 Any inheritance tax due will become delinquent PART nine (9) months after the date of death. _ TAXPAYER RESPONSE ------ A• ho above information and tax due is correct¢ 1. You may choose to~emit aavmont to the Register of Nills with two copies of this notice to obtain CHECK a discount or avoid Interest, or you may check box ^A^ and return this notice to the Register of 0 N E ~ Wills and an official assessment will be issued by the PA Department of Revenue. BLOCK B. ~ The above asset has been or will bo reported and tax 0 N L Y to be filed by the decedent's representative. paid with the Pennsylvania Inheritance Tax. return C. ~ The above information is incorrect and/or debts and deductions ware paid by you. You must complete PART 2^ and/or PART 3^ below. PART a If you indicate a different tax rate, please state your relationship to decedent: TAX RETURN - COMPUTATION OF TAX ON JOINTiTRUST ACCOUNTS PdD LINE 1. Data Established 1 ~ ~ ~l 2. Account Balance ~ 2 ~, ~ ~rj 1,, 3. Percent Taxable 3 ~ o 4. Amount Subject to Tax 4 ,~ ~. 5. Debts and Deductions 5 - ,~ 6. Amount Taxable 6 ~ 7. Tax Rat• 7__X .~ ~~ 6'. 8. Tax Due g ~~~ ~ ~ ~" - _ $I; :~,y PART .:. ~ " DEBTS AND DEDUCTIONS CLAIMED a ~$"A'r PAID PAYEE DESCRIPTION / IENT OF RE1fE Ii U IYINL itntsr on Line 5 of~Tax Computation) S U dgr penalties of perjury, I declare that the facts I have reported above era true, corre t and, o to ta--t st my knowledge and belief. ~~ HOME ( ~/7 ) 7~~ _ _" ~ '~/Le.~~ WORK / ) ,/'