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HomeMy WebLinkAbout12-19-13 � _ _ ,T_ _ _ _ : ° �� � 15056b1184 �����'��IX(oz-tt)(�� . .' , OFFiC1At.USE ONLY , PA Depa�ment of Revenue . Bureau of Individual Ta��es �•""►"`"•°`"`"°�` Co� Code Year Fiie Number INHERITANGE T�1X RETURN /j� � P(�Bt�c z8o6os � �� .; .��_7 Harr�st� t�i4� �2�-c�6ot RESIQEMT DECEDEI�IT � ° � ENTER DECEDENT tNFORN1�tTK}N BELO►hf. _ . Socia)SecuRty Number Date of Death MMDD'�'YYY Date of Birth` MMt�YYYY � 11162012 04131935 : Decedent's Last Name Suffix DececlenYs FirsY Name Mi MELNICK NICHOLAS. (If Applicab�e�fnter Surviving Spouse's Infomfation Below Spouse's Last Name Suffix Spouse's First Name � MI " CFi�RYL MELNI�K Spouse's Social Security Number � THIS RETURN MUST BE�FiLED iN[�PLICATE WfTH THE 1:9e-3�-$�22 REG[STER OF VIFILLS ^FILL IN��APPRE)PRIATE 01f�1LS B�ELOW � �:,., : : , ; , ._ . , � 1.Origi�al Retum Q 2.Supplemerrtal Retum , Q 3: Remainder Retum(date of.d.e�th ` , . prior ta 12-13-82) Q 4.Umited Estate Q 4a.Fuhue interest Compromise(date.of .' ,.Q! 5. Federad Estate Tax Retam Rlei�uired . death afte�12-12-82) Q 6: Deoedent Died Testate `' Q fi Decederrt Maintained a Living Trust ` 8.Total Number of Sate Depc�it:Bo�ces . (AtEach Copy�VI�N) (AtEat;h Copy of'Fn,s#) . , , O 9.Litigation Proceeds Received Q 10.Spousaf Poverty Credit(date of de�th; Q . t1. Eledion to tax under Sec.91:��(A) between 12-31-51 and 1-1-95} (Attach Schedule O} CORRESRpNDENT-TMIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTULL TAX INFORNATION SHOULD BE D�tECTED TO:� � Name Daytime Telephone Number CHERLYL MELNICK . REGISTER OF WILLS USE ONLY � � �....,. �j First line of address ;,;� � � � � � 52 CENTER DR ' � � � � '� � � Second line of address � � t� � � � � � � � �° � _ CI Of PQSt OffIC@ � t3 � D�FILED � tY State ZtP Code .,,_, .: _ .�,.M.,...,_ ......�.�... • . ...,, :..w...,,... ...�,.:_ ,.. :.�.,.,.�..A...�-.,�.,,,�,�:... .,...,.-.- ..�,.._.._ '�"�' .y....,.w......_. ....W.�, ..,..t� _.+� _..._... t�--:• ,�.,,.. _..,_„ _ CAM P H�LL PA 17 011 -� "� �°- � .� - �s c.r� cr� c� rv � Corresponderrt's e-maif address: Und�penaltles of perjury.I dedane that I t�re ex�mined this netum�indudm9 aocomPanyi�9 sc�edules and staGements,and to the best of mY M�o�edye►and b�is�, it(s true,oorrect eu�d compl�e.Dedaratlon of prepsrer olher than the personai�presentative is based on aA information of which prepaner has arry iv�ovaledge. S OF SP IBLE F FIUNG R RN pq � �l3 ESS � 52 CENTER DR CAMP HILL PA 17011 SIGNATURE OF PREPARER OTHER THAN REPRESENTATNE DATE ADDRESS PLEASE USE ORIGINAL FORM ONLY Side 1 L 1505611184 1505611184 � '__ . 3 � � . r � � ]��05611284 REV 1500 EX(FI) _. , . DecedertYs Sociat Security Number �enrs�ame:NICHOLAS MELNSGK " _ RECAPITULATION` - _ _ . 1. Reat Estate(Schedute A). ...................... ....... ........... .. 1. , . 0.0 0 2. ,Stocks and Bonds(�chedu�B) ............. ........... ............. 2. , 4.0 0 3. Closely He�Corporation,Partnership or Sole-Proprieto�ship(Schedule C},..... 3. 0.0 0 4; Mortgages:and Nates Receivable(Schedule D). .. . ....... ............ 4. . . ; 'S. Cash,Bank Deposi�s and Miscellarneous Personal Property(Schedule E)...:... 5. ' . , 7,5��.�0 ;,�-: 6. .Janty�;Owned Property(5chedule F) O SeParate B�Nng R+equested ....... 6. : � , _ , '' 7. Inter-V'NOS Transfers 8�MisEellaneous Non-P�robate Property ` (Sc�clule G). O�eparate.Bilfinng Reqt�sted........ T. . � �. Totat,Gross Assets(total Lines 1 through 7).. ....... ... ••- .. �. _ 7�-5.�0�.0_0 .: 9. Funeral Ezpenses and Administrative Costs(Schedute H)...... .. ......... 9. - . 9,8 3�.0 0 , 10.: pel�#s:of Dreoedent.Mart9a9e Liabibdes,and Liens(Sc�edule I). ..........�:.. 10. •` '�.�Q � - 11. Total Deductions(total Lines 9 and 10).................... ....... . .. 11. . . . � - -� � 9,8 7.00 12. Net Vatue of Estate(Une 8 minus Une 11� ................. ............. 12. . (2, 3 3�7.0 0) 13. Charitable and Govemmental Bequests/Sec 9113 Trusts for which an eledion to tax has not been made(Schedule J) ........... ............. 13. . 14. Net Value Subject to Tax(Une 12 minus Line 13) ........... ............. 14. (2, 3 3 7•�0) TAX CALCULATION-SEE INSTRUCTIONS FOR APPLICABLE RATES ' 15. Amount of Line 14 taxable at the spousat teuc rate,or transfers under Sec.9116 (a)(1.2)X.0_ . 15. 16. Amount af Une 14 taxable • at lineat rate X.0_ . 16. . 17. Amou�t of Line 14 taxable at slbling rate X.t2 . 17. . 18. Amount of Line 14#axa�le at c�llateral rate X.15 • 18. . 19. TAX DUE............................................ ............. 19. 0.�0 20. FILL IN THE�VAL IF YOU ARE REQUESTING A REFUND OF AN OYERPAYMENT p Sid@ 2 � 1505611284 1505611284 J .. 1.....0� _ .:Y�!'!�1 ..l"1 � � � . . - � � � . .. � . REV 1:500 EX(FI) ;Pa�3 . ENe Nurribe` 2113—0 7 5 7 : Deceden�'s Complete Adc�ress: . • OEGEDENTS N�4ME _ . Ni�holas Melnick � . . . � . . _ . sTRFET AE�RESS . . . ,52 Cent�r Dr _ , �� STATE �p .�n .; C Hill Pa 27011 . Tax Payments and Credits: . , ; 1. Tax Due(Page 2,Une 18}- . _ (1} 0.00 ' 2. CreditsJPayments . . . A.Prio�PaymeMs . � : ... 8.Discaunt ,, ' . . . Total Credits(A+$) (2) . 0.0 0 3. fnt+erest - : . �g� . 4. If Line 2 is greater than Line 1+Une 3;enter the diffener�ce. This is the OVERPAYMENT. . Fi�M bvai+�n Pa�ge 2,L�►e�to irequ+est a retur�l. � :. (4). . . : ` 5. If Line 1+L'me 3 is.great�than Line.2,enter the differenoe:This is fhe TAX DUE. ;' - : .� (5) _ �.: .:: .:� . ,4.0 0 , . Make chedc �a�ab��ta: REGISTER �F W�LLS,AGEl�T. � -� ' . �Y. . . PLEASE ANSWER THE FOLLOWING QUfSTIONS BY PLACING AN "X"uV THE APPF�OPRIAfiE BLOCKS 1. Did decedent make a transfer and: Yes t� a. retain the use or inc�me of the propert�r transferred:................................................................... .. ❑ (� ..................... b. retain the right to designate who shalt use the property transfemed or its income:............................................ ❑ � c. r�tain a reversionary interest.................................................................................. ❑ � d. receive the promise for life of�her payments,benefits or care?.................................................................. ❑ � 2. If dea�h occurred after Dec.12,1982,did decedent transfer property within one year of death . without reoeivirtg adequate c�onsiderabon?.............................................................................................................. ❑ � 3. Did devedent ovm an'�n trust for or payable-upon-death bank account or security at his or her death?.............. ❑ [� 4. Did decedent own an individu�r�ett�eemenf acoount,annuiiy or other non-probate property,which confiains a benefici�ry designation? ........................................................................................................................ ❑ � IF THE AI�S1�ItER�A�f t)F THE A�QVE QUESTII�,S IS YES,Y�pt!MUST C�IIPLETE SCF�D�lLE.G AND Flt�RAS PART�TEtE RETURN. �� . _ For dates of death on or after July 1,1994,and before Jan. t, 1995,the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3 pe�cent[72 P.S.§9116(a)(1.1�(i)]. For dates of death on or aft� Jan. 1, 1995, the tax rate imposed on the net value of transfers �o a� for the use of the surviv ing spaise is 0 pen;ent [72 P.S.§9116(a�(1.1)(iij].The statute does not exempt a transfer to a surviving spouse from tax,and the statutay requir ements for discbsure of assets and filing a tax retum are stiq appiicable even if the surviving spouse is the only benefiaary. For dates of death on or after July 1,2000: • The tax rate imposed on the net value of bansfers from a deceased chiid 21 years of age or younger at death to or for the use of a natural parent, an adopfive parent or a stepparent of the child is 0 percent[72 P.S.§9116(a)(1.2)J. • The tax rate imp�ed on the net value of transfers to or for the use of the decedent's lineal benefiaaries is 4.5 peroent,exc ept as noted in(72 P.S.§9116(a)(1)J. • The tax rate imposed on the net value of transfers to or for the use of the decedent's sibiings is 12 percent[72 P.S.§9116(a)(1.3)).A sibling is defined: under Section 9102,as an individual who has at least one parent in common with the decedent,whether by blood or adop�on. ' ,� �� � � � . y REV 1508 EX+(08-12) - ., , SCN�0►1�L� E . . .. . .. - p�n�sylvan�a . DEPARTMfNT'Of REI/ENUE � W�7H,.BANK,QEPOSITS 8c�I.��C.' INHERITANCE TAX RETURN . . . . PERSONAL PRQPERTY - t�SIDEf+FI'OECEDENT .,. . - . �ESTATE OF: FTlE NUMBER: Nicholas Melnick ' _ ,. _ ,. �� 2113-0757 Uidude t�e prooeeds of lidgatiori and the dabe the proceeds were received by the esbbe. . . �Pr'oP�Y�+�h►owned with right o#survivorahip m�t be disdosed on Schedu#e F, . , IT�M VALUE AT DATE �a''� NUMBER ;F� DESCRIP'fION OF DEATH `}; 1. 20t�0 r Chevrolet Silverado Truck . �� - � 2,800 . Basa Tra�er Boat Sale Value . . 4,200 ,: `,'- Ice .Shed and Fishing Equipment ' S00 .�,. . . . . , � , ..� ._ . .. TOTAL(Alsa enter on Line 5, Recapitulation) $ 7 500.00 If more space is needed,use additional sheets of paper of fihe same size. � i � � J REV-1511 EX+(10-09) enns lvania �CHEDULE H p y FUNERAL EXPENSES & DEPARTMENT OF REVENUE INHERITANCE TAX RETURN ADMINISTRATIVE.COSTS KESIDENT DECEDENT ESTATE OF FILE NUMBER Nicholas Melnick 2113-0757 Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: �• Funeral Lxpenses g,837 B. ADMINISTRATIVE COSTS: 1. Pe�sonal Representative's Commissions Name of Personal Representative(s) StreetAddress City State ZIP Year(s)Commission Paid: 2. Attomey Fees 3. Family Exemption:(If decedent's address is not the same as claimant's,attach explanation) Claimant S�reetAddress Cit�r State ZIP Relationship of Claimant to Decedent 4. Probate Fees 5. Aa;ountant's Fees 6. Tax Retum Preparer's Fees 7. TOTAL(Also enter on line 9,Recapitulation) s 9,8 37.0 0 (If more space i�needed,insert additional sheets of the same size) � .irr " RT�� ., ..� � .. � . . � �:._ . � � . . . .�. .. . . . . . ' ... , . �'e. ► . ` � t " � � . �R . . f . . . . . .. '. . . r ` � � . .. ` .... `. . .. . r 1 � . . . .. �..� ,t `' t . . . � �'. . � ./ .. . . . . - .. ... . ..... .. '� ..�., . S . � y . � �,�.. .M... . . . � � - ..7F. . . i� ... .. .:.,. i w.. , ;�....�. , �. .: . ... ' . ..,:.��.a, . � . ., . . .. ,... ...�.. ., .. . . . � . ' . . . _ . ... .;. .. ..,....�. ,:a..... . .......�r,. . . . . . . . .. . .. . .,.. .......�,. ... . , .. . . . . . , ,���� . ,_ _ ' .. � �,1�� �.. . ��. � �i�� . �. �1 l����� � . . . . . . .. . . . .. . T . ' .. . . . � . t •� • . � .�� 'a�R,{: � ,fz� � .>x�' � � � . r e ..�"�L',_�., M •xAr.�+.d''iR . ..st:' 1F_�'�f�x:-r� `.. ... . .. . . � . . . . .. . . . : ,.�. Y. .... .. _.... ...0. . . . . .. �.. . ... ..... ..�.. ,.. . .� :, ., . .. � ����� Sr. , . . . . I, �iichola� �slnick, Sr. , of Cac�p Sill, F�; ci�sc�.ar� this ta be'. ag I.aat':1�ill aa�d �esta�eat b�erebg re�vo]c�.ag, �.I -prio=�:�trs:�.ls aad . Codici.ts. 1�►RSICLSS � I. I am sarried to CherYl D. �elaic]�, he=eiaa€t�r� ssfsrred to as ay apo�ase, aaed hav�e t�o childr�n �rho are. na�r livi�g, x�ase siam�s sre �Ticholas �e3.nic]c, Sr. , ac,�e 43, of l�rysv�.11+s, PA, aad Lisa �t. _ , , �a r �9'`",'��.. -`e� ��a�Y��� �- �l �'4��. 3:a t�f.s 1�s.'�i` #+4�, .- � "my childra�" 3.aclnd�s only the al�ovrs childre�. II. T3� �cpeaa�s of acy last il].a�ss aad fmr�ral shall be pai.d fra�a tha fnn�ds of my estate. Page 1 of 6 _ : �,: ,�� . _ . ��-> ... ... .�.,: +:� :.n .. .�`b.Fk<, . . �y 4t . . � ' . . . � . . . . . , .. � .. . . - . . � � • . ' � $ � ' .. ' � f r III`• I qlv�e t0 � spo�ae� �,f =Y apo�se �nr�i.Y±e� �a�e bY 34 .c3aYs� ::all" .. � of� mcg �j�elsy. cl.oth.inq fnraitats aad ' ' ft�ra : . .c��i.su��rar�s . . �,i .. _. � ,. � , � ;., ailv+sr��� ictiar+�c� ��o�lca of art boo�a � �: ♦ g r� r • �s0�'�i1.�;�:R"��.l�:r�b!Oi�II.' .��. . ��tAC� .:O'�Y' '�it1�'i�'�le �=�3.C.�.tB Of S piltSO�ii� �'�;� �� IIO�;: O���ff3.�`�- . . . . .. � . �1�3.Ci„�. . , !� O f � . • ... , � � � �i3.S �..1.� �lLd II�t 1llC�1iC�7..�`,.�,i�, , � ��k° : , , . , - ; ��O�jiA�� 81�4�1 a8` t�8�1 Cf= 3ACtti�lt:lel . . . • • ;,. , _ . , - . _ i tOtJ��,.�E3:�i i�._,. ., . , , . � '�ti=00�1. I� !� Sp07t�! �_ =LO't �ZYY�! f! �� 3Q,:C��i .�.,.i�1/►��;�-i.�], � ; � ; _ . .. . . ., ... , ... � .Y . �.. � .� .. � . � . . oi� �ch Pra�,rtY to aY c�i.ldrea �rho snrgiv�s are b� 30 .daY�.� ia .ac�a3.. :,�' shares. lY. I qive all of ti�e resi.dae o� �g estat�e to arY spo�ase, if �Y- spo�a,ae snrviv+ea se by 30 dsys. �. v• �a t� �t a�: a�crw�a do�g not s�uz�viv�s a� b� 30 c�a�r$. I Qsv�e all. of the s�sidu+s of ary estate t� mc� childrea xho s�arvive are b►y � �='tiY �a, i.a ec�u�l shares. S�, i� a al�i].cI does aot snr�►iv� me � 3� days aad l0av�es iaane �rho so surPiv+� me, auch issv�e ahall z�c�aiv+e, per stispes, t� s�a,re t�e cl�3:ld Monld ha�v�s �iv�ad had he or she so snrvived ae. Ia cas� of the failnre of snch iasne, thea such child's shas� ahall gsss 3.a equal a�iares nato m� ahild �rho snrvi.v+ss �e. Page 2 of 6 ; �, .: _. _ _ _ - - --- ___ _ . � - � �' . , + , , . . . , t , . . '� ` ? ' • , . ,, �. � ; � VT. I�'�a�.titm�;,tC��p�o�Ne=at v�eated ia_th�ot �,.;Z�tM,.`:�g, �;�,to�cs:;,astd:� . - � : :.. _ ; ,� :: tbe.ir� .�acac�esao�s s�d, asai . ,. ....�.,_ � s1�a11 hav+� th� __:fo#3:a�ri�ng�..��;���:� .. . _ r a�ic�ar�3.� ��o� s�1:I:� gs�vp�tyr�;:::he1d �g thet f i:a�cl�+di � ,�:a�i�:r , � �i!rty'� . � . � . . . : . , ., , , � �. � . . � �held: fo���.s�o�s�,�=�feetivrs`�ritbo�t the order c�►f, - . . .: � �' �. .::�t�. . � _ . . �:�utti.oa of all� a�h , , . ac�aal�c�i�tar P=�=� � b .. . . .. . .. . :� � . 4 �. a .: f ,; � :,� :.: . .� , , � . '` � - . , : , ta3.a , �Y P��rtY � .,:�'h��-�cl�q , . .. . . . . � .. v+eKl � . . - .re : :, .. _ w � . ... . . � � t�e atc�ek of t.o : . ,. � aacy rporata fidn c3:asg a`ctia�q l��p�r; . . .� B. �o s�.t�. raal eatat� for aay P'arpoa�, P�blielg ar privately, for aach prio�s aa�d c� anch te�. ss th�y cZaas proper. �rithant liabilitg aa th� p�nrchaaers to see to applica�tiv� of th�e p�nrchaae moai�a; C. To co■prae.iae c'oatravrraies; _ D. To diatrib�te ia cash or ki�d or part],y ia each at valuatio�a fi�oad b� t�esa: aad 8. To hold iavea�ta ia the �sa�e of acraiae�- VII. Al-1 t�az�a an�d int�seat aa�d pea�alti�s theraoa payable b� z�aao� of � d�eath �r�.th rs�et �tor Proper't3t cawPriaiaq m�Y qroaa ta�cable estate, �hethe= os aot pa.ssisLg �r this i�il2, ahall ba p�a�id from the priaeipsi. of a`y rssi.dusr� eatat�. VIII- I appoiat mY ��, ��'Yl D. �6elnick, as �cutor of this, �y I�ast �ill aad T�stam�at. If Cheryl D. �laick is uaable o= Page 3 of 6 � . ` ' .� � - . �' . - , .� , na�ll�-�ng to act or coatiaue as R�oecator fOr aay reaso� �r�t�o�v�a►z� � . ,, ; . .. I a�ppoia,� �iicholas ' J� . . �fe�Iasc�c f :�. . . .� . �...._ . .� . . . , I.ssa . _. . � ., . .. , � �r:� of ' . ,� $?-�� _, . �. . � . � , :. , . , ... .. _ . .,. . , ., PA, suc:oes:or Co-��tora. � , ._,..; . w - .. . , . ..., ..5 , . , ., � . ,� .� ... ; .. , - . : , �� . ,_ . ,be r�a�.rid to �st aater . bo�c3 or . µ. . � . . . . . : , . ; . . .. ,. . ... ..., v. : . : : � .s�eari ut . a�ny.` ��sd.i�tz.a�a. . . . . . . ,. ,. �: ,. . - , . . . . . . . , , �' . �, . . .. �.. _... .. F ... ' � , � . . , ., . . . . ;. . '. - .: � ' ' - . ,.: ' � . :. .": ,..�r � .. , . ;.. . � . t .'. f m .. a ��... i ..• . � . . ':. i � ��- G' . I8. $'Ot 'h3��3 P'a�Po is� d�et��_..,.____ _ ses of ;��;�,, . �r � _ . ,. . th.is Will .�.. � �. , ,_. . , , �. . . . . . � . � �. .. . .: ; . . ,. ,,a -,. . : � : .P�?� , ... h�as �nrviv+�d me Q�c .��w s� ' _ , : . ..y . .. �� ., . , w . �i�M� . ., . Q�=3�II s 2.. �� ' , j.lAr�� �`�W�� . . . . w , , . . _ . . . . ,_ ,. . .. , : . �-.. . �. . , , . . . _ . - .. _ . C�AC� 't'+O . , , , .. ,. ,� , _ . , ,.. �;�, �1/� V!!!� � � �� � ' � �1 . or sbe d.i+as �rithi� .th� f 3t�, �s� of ay c�ath ai o� tt� cieath of t1a� other persaa. _ � ° X. Ia al.l refer�ces here.i.a to `��catar" or "Teatator� tho uss oi� an�' particalar g�ea�er o= plvral or ain�qalar av�r is iat+ea�d�ed to iaclnc�e tl�e a�progri.ate g�e�d�er or nnebe.r �a t�s tezt af t�ie xa►thia iastsu�nt a�ay ragnir4_ Il� �iI�ESS �OF, I, �Ticholas �e].nick, Sr. , hera�n=tto set my baad, �nd seal this -- ?��" c��y of _+�i��r.�-�rr�` ,2007. to th�.s my Last 1�i11 and Test�at. .. , l�icholas �elaictc, S=. SIt�18D, S�AT�D, P�TTffi.I� A'�?D DSCI.ARF.D, by]�icholas �e�l.aic�c, Ss• ► th� Testator abo�v�s na�d, as �a�d �or t�e T�stator's I.�t 1ri11 aad Teataa�at, sad ia the p►reseace of ua, �rho, at tl�e Tastator'a r�qa�est, ia t�s 1'estator'a pr�aeace and ia tltis pre�ace of each ot�r hav�e avbacribed anr nasas aa �ritaeaae�s. Page 4 of 6 . , �. . . . , , � � � � . . , , y ; , . . f, _ ;. . _ , *��,. �_ �. �. : � .: . , , . , . ,,. � , .. , , - � .' . . , . : .. _ ,, . '�itt�tas` � �bdicise�g . . , . . , . . . : . .. . . . . . _ }� „ �; , . . . , . . . _ ,. . . , � �`.u,�- � � ^ : _ �'� ��t � . � . " . .. . . r ��.c. �. ; . . .._ � . , . ; . ... �rz�s � . . � . - - . . :��� ..... ,x ,. . . � : . � . � CCli�ft�ALTB OF I�5]C�vA1�IA � . , -. . ... .,.. . . . , .� , ; : ,. . _ . ,� . , , . . _. _ d„ . . .. � _. . . ;- . . - , . , . ; : ss. : . . , � .. , .�. . . �� ' ��z 0� 3 a . . . . . , . . . . . � . . : ., .. . ., ,. . . , , . , , : _ . ; . ; � I, �ticho],.as l�ilnicic, 5.=. ; Testator �rho�e aa■s: . , _' ;, . . , , � . , : : . . _ . ., �: . . .: . , �, ths itt;ach�d �ar fo ' . ,,. . , � . : reg�os.�g i�sts�at, havia#g beea . . . � .�� -aceording �o l.a�r, c10.b�r� aalcn�oMlec�g�e that�.I: aigsas : _ - ., . , . . . thia i.astrv�nt ss a� I�aat �ill, that I �ig�ed i-� _ � `t�t I siqn� it aa a� frae and v+alnntary. aet fc . . � th�rrin c:oataised. " �icholas �e�ui.c]c, 3r�ora or affiraad to aad ackao�r�ed�g!�ad befor� �QlniClr, .S'r• , 't�ts ?e�tatAr� ttLis _�._.Zb__` �'�,sy o.. , 2007. coMMat�at�o�a�,snv�a �� � � '�Y t�L�DR��Pub�c �f t a r Y M!► Nar.����l�9 Gal�i11g11�LT'8 OI�' PBI�SYI�itAi�IA ) : ss. : C'O�tT� OF D�TPHII� } �, l�.i.17�.� L. l�dl��r , a�d � �� �ritn�saea �rhoss aamea ars siq�ed to t1�e tzch� � iastro�arat, beiacl dnly qo�alified �acos�d3.a�g to la�r say that �e �are prea�nt aad sa�r t�e T�stator siga instru�at as the 'restator�s I.ast 1�i11; that tl�,e � Page 5 of 6 _ �:,_ -�� .,�, ...� _ . _ _ ��,; � � .�c .a r - ► - � r a + t -� i � . ' _ � � , ' w r, e . . � � � 4 1 ' a�'!� ..�.�� ,�;:� �rilli�g3y- ai�d t�at- the 'T�tstor e�taod it as � �tstor�s�fri� - � - a�ad vnl�atary =et for tb�e �es � �� � �er�.�eia , . . . . _ . . , . . : PQ� � � �a- '� h�arsa� 8�d aiqh , �estat��sad w,x - . ho t a� �; : that `ea,c� of . , . . . . .. �� � . , . , . �= . . . 1��..�1 �as . , , , . , .. �r'itawtssss; a�d that to tbe best of o!d,�c ]cao�rl � " � " ' � . �` . , � att� tl'�t ' .. � ,' .'j'!s't�t'�1tr tl�i' �1�i'�i O� !U�!� . . '; ., . • . , �s �, a'Q�♦ �'� �� -�� ,.. ��_� �� . . ao .c�stSa�.t�'t O= ua�e '�-1�@. , . �itaess : ` .. , . .. , f , , . �itaess . � . . , ,_ . _ : , , . _ :. � S�ora or affir� to amd � ° , � . . , . snbscribed befor,e. se b� , . . - � • -� `anc� . . _ . �illia� L _ . �].er , , . , x�. _ � ts�esses, th�.s � c3ay of . . 2007. , t �o l.ic � � �O�MNION���VSYtVi4N�q .lODY t�pl,pRt�tG, �p�� �IY � • ���+rty �1'3.��9 Page 6 of 6 _ _ �. � _ ___ _ _ _ - - Nov. 26. 2013 8:37AM No. 0431 P. 2 penns�l��� � sIJREAt10fG0[1.6CI10�N3& DEPARTMENT dF i�11�11�E 7�c1PwY�!8�tv�C�S !0 gOdt Zdl6�i �.►x��r�,�iu.�ns� NOTICE OF(,�YE1CDrJ''E1'N''.�IER1T141V'CE TA.Y'RL?'Cr�11�' �w-�a�n,►�r���� Date: 11/2 2/�013 Ls#ate of: • wI�HOLA� MELWICK MELNICK CHERVL D 5��= 2A0�26-8897 52 CENTER DR Dste of Dest�: 11-16-2012 CAMP HILL PA 17011-7611 Fil�Number: 2113-0757 � �Departa�o;ent records indicatc�ou are resprn�sible far t�ie settlement of 1�c�at�identi���abo�r�or f�at you re�present the responsible pail.y. The�state is in d�lin�uent stat�,s�ti��inh�ritan�e tax ret�rn � became del�nc�uent within nine months of the deced�nt'�death,but has�et tn be fi1ed. - P�eas�file the tax~retur�i and remit paym�nt of any tax due within 15 days of the date of this�notic��vith thc . �R�rgis�r:�of�N'i11s idcutif�'ied below. __ . �- 4 :: . �. �f t"�is esta�"�was c�pened for thepurpose of.filzng`�.'�awsuit,please prov�d�`�e'cc�u�et term a�i dackct �' ;, . �u�riber�o��e-p*oceeding in�vriting to�t�s i�f�ce. , k �,- . . � :. �. ,. .� .:� �. . . � -- �� � �� . ���. .� �� ��� � ... � � � � . . ; � � , �. . �;..,� �k� �- . :We e�+�u� e ..ou.tp ta,1�,c~th�:opportunYty to address yotu 1�x dellnnquc . ���!ou�to c����� g �- .. � . , account in�y be-referit�d tv a collection agency anad.�a�dit�onal fees�ixp to� .��'t�ie:..:�..�s :,� - will be add.ed to�he liability. , , If the requested�re�rii w�s filed recent�Y>please disreg�rd this notice. Dir�ct an�.questions regardi�g this n.otice to: � . - - . . ._. .. .. ._. .. . -- .. .. _ .. .._ . . . �arrisburg Call Center �'T�RNS SI-�OULI��E��,� 717-783-3000 AN'l�PA��I�TS MAnE AT 1-$04-447-3020(Services for t�cpa�reers �3E REGIS�'ER OF W�.�,S with sp�cial hearing at�d/or speaking needs) � L�STED BEL�W: REGISTER OF WILLS 1 COURTHOUSE SQUAR� CARLISLE PA 17013 a o M.- � WN�� . O�.N� m � _r .,;t~ �,.. � 1}Y .r p n , . ,y� � �p��p . .� . I � �� �. �oN . � �� c�� o° � �� cn u' � � �.O�� , '� d� ` �M J ��NN11 0 NO< �,, O O� r.. . . . . � �°° C:.1 CJ'� � � -. � � � � ' O � � � �z- .G`��. G�3 V 1.�.. L�.. p,,,. � t,? � `v� � � � ' •�-'•`. � O , � � � � � J ,,� �" � � ,[� �... r"`� J Q � b�A �'"d � pq c,,, �c O � O M � � W a- W � � �--+ � M +� `~� � c� � � � a � r� � � ..,�`""-'� � � ; � � � � � - ��., � .� V � �'' � V o `� a a� � °� �''' � �' •C �, � O n . I � ~ O � ~ � '~ � � i �j � VUV � { � r, I a? � •� - a� �; � .:..:: i �- ::< ::..:: , _ _ _. - =�: I'� �-' I ... ,. 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