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HomeMy WebLinkAbout88-0230 v PETITION FOR PROBATE and GRANT �I�' LETTERS Ma.rgaret E. Nailor No. �-���`�r- � `� 3� Estate of To: also known as Register of Wills for the Deceased. County of r',�horl anr� in the Social Security No. 1 AR-'�f1�.17� � Commonwealth of Pennsylvania The petition of the undersigned respectfully represents that: named Your petitioner(s), who is/are 18 years of age or older an the execut 19_$�___ in the last will of the above decedent,dated Feb���x�l�.. � and codicil(s) dated ---- (state relevant circumstances,e.g. renunciation,death of executor,etcJ Decedent w�as domiciled at death in C`�anhPrl an�l .__C'ounty, Pennsylvania, with h Pr __last family or principal residence at �� 1�arP R�r�P�'h^ni��h„_rg, PPrm?._,_ T�l�ZTPY Cr,r;no Tr�7m��„n� --�._ (list street,number,Twp.or Boro.) Decedent, thcn SD--)'ears of age, died Mar�h 17� __ , 19$�$--, at r�r�; i o P (Cr,,,th ' ---- ' Except as follows,decedent did not marry,was not aivorcea ana u�ci not ha.ve a child born or adopted after execution of the will offered for probate; was not the victim of a l;zl!ing and was never adjudicated incompetent: �+` Decedent at death ow�ned property with estimated values as follows: $ � nnn 00 (If domiciled'in Pa.) All personal property ----�-�--- (If not domiciled in Pa.) Personal property in Pennsylvania $ (If not domiciled in Pa.) Personal property in County $ Value of real estate in Pennsylvania situated as follows: ---' WHEREFORE, petitioner(s) respectfully req TESTAMENTARY of trie last will and codicil(s) presented herewith and the grant of letters (testamentary;administration c,.t.a.; administration d.b.n.c.t.a.) theron. � U C y _�_.._ 't7 y l. ' xy � '�!�!lY -- C -- O �'« MArha ���ira Parm_a__� i�n�5 _. �n p - N w ? � _'___. � C 00 � OATH OF PERSONAL REPRESEN'�ATIVE COMMONWEALTH OF PENNSYLVANIA � ss COUNTY OF C:UMBERLAND The petitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing petition are true and correct to the best of the knowledge and belief of petitioner(s) axxd that as personal represen- tative(s) of the above decedent petitioner(s) will well and truly administ�r��� estate according to law. � Sworn to or affirmd and subscribed �~�� �• before me this �5 T H day o f — �-- � A M CH 19�$.�.� ---- � � ' ' --__ 1 Register — � MA� C. LEln� ° , .. .�;� � ___._._ . ,r,.. _ I � � �.14�' ___._ `7 ��l -� i lc� a... ...,.,._�.,�.� : No. 21 - sa - 23o Estate of MARGARET E. NAILOR , Deceased DECREE OF PROBATE AND GRANT OF LETTERS MARCH 25 , 19 AND NOW 8 S , in consideration of the petition on the reverse side hereof, satisfactory proof having been presented before me, IT IS DECREED that the instrument(s) dated FEBRUARY 12 , 19 8 7 described therein be admitted to probate and filed of record as the last will of MARGARET E. NAILOR and Letters TESTAMENTARY ' are hereby granted to M�IYNARD L, NAILOR WILL BOOK #106 � � PAGE 6 9 3 ETC. Register of Wil MARY C. LEWIS FEES Probate, Letters, Etc. .. . . . . . . . $ 25 . 00 � c�� �qL���G„� Short Certificates(2) . . . . . .. . . . $ 4. �� ATTORNEY(Sup. Ct. I.D. No.) Renunciation . $ X-P age s . . . . . . . . . . .. . .. --�-�p- $ ADDRESS TOTAL $ 33. 00 Filed . . . . . . . . . .P�ARC:�. .�5 ,. .�.9.$�. . . . . PHONE ;....,_ -- -: .: =.�. 6_7.i_. -- _ {�.�,-,! _" �v_... O.^ ��� • � (: Mailed letters to attorney on 3-25-88 . �_ �'.��'� LAST WILL AND TESTAMENT OF MARGARET_�E`._ NAILOR I , MARGARET E. NAILOR, of the Township of Silver Spring, County of Cumberland and State of Pennsylvania, being of sound and disposing mind, memory and understanding, do make, publish and declare this my Last Wil1 and Tesl�ament. lo I direct the payment of all my ju.st debts and funeral expenses as soon after my decease as the same can conveniently be done. 2. I give and bequeath the proceeds c�f my IRA Account and my Certificate of Deposit which I have tlxrough Farmers Trust Company, of Carlisle, Pennsylvania, to my i�ur children, to wit, DONALD R, NAILOP., DENNIS E. NAILOR, DEBRA K. SHIELDS , and KAREN Eo NAILOF., snare and share alike, per stirpes . 3e I give, devise and bequeath all the rest, residue and remainder of my estate, real , personal and mixed, whatsoever and wheresoever the same may be situate, ta �ny husband, NIAYNARD La NAILOR, absolutely and unconditionally. 4. In the event that r:iy husband, 1�"�NARD L. NAILOR, -1- ' '.� should predecease me, or should he die a� about the same time as I do, such as in an accident common t� bc�th of us , then in such event, I give, devise and bequeath my c�ntire estate, real, personal and mixed, whatsoever and wheresoever situate, to My four (4) children, to wit, DONALD R. NAILOR, DENNIS E. NAILOR, DEBRA Ko SHIELDS , and KAREN E. NAILOR, shar� and share alike, per stirpes. 5 . LASTLY, I nominate, constitute and appoint my hus- band, MAYNARD L. NAILOR, Executor of this, my Last G�ill and Testament, and in the eveizt that my said. husband should prede- cease me, or should he be unable to serve in. such capacity for any reason, then I nominate, constitute a.n�l appoint my son, DENNIS E. NAILOR, and my daughter, DEBRA K, SHIELDS , Co-Execu- tors of this , my Last Will and Testament. IN WITNESS ��THEREOF, I have h.ereiaxzto set my hand and seal this �� ��'�- day of February, ��. Do 1987 • `'� j �,�, -:�' `��-��c���L_. (SEAL) �Iar aret E.�Nailor �' ,� -2- Signed, sealed, published and declared by the above- named MARGARET E. iQAILOR, as and for her L�st Will and Testament, in the presence of us , who , at her request an� in her presence, and in the presence of each other , have hereunto subscribed our names as witnesseso �` /, �_;�-f t �, r ,� ..� �..__�, . _�s:,. f . � . . ,.._ ,.., y� .�, .�� . . C � �';' i �' ' ii�.y i�r` i. � �..�u "�f'"`�' f / -3- , ��R� ��.1�P.'�i_� 21 - 88 - 230 REGISTER OF WILLS OF CUMBERLAND _ COUNTY OATH OF SUBSCRIBING WITNE�+S J. Robert Stauffer and Mary S. Robi��sor:! , codicil (each) a subscribing witness to the will presented herewith, (each) being duly qualified according to they were present and saw law, depose(s) and say(s) that --- Maraaret E. Nailor ---- ' the testat ri_�____, sign the same and that th�y _ _signed as a witness at the request of testatr;x in h�_ presence and (in the�'esence of each oth.er) (in the presenee of the '� / other subscribing witness(es)). � ,�t--- Sworn to or affirmed and subscribed before Li , ����I ,,�' 1< 25TH aay of � (Name) me this �RCH � 19�_ �arket Square �3]_c��r, echanicsburg, Pa. 1705; (Adaress) � G1N ,:' ' Re ister =--���'-'`''r:`��`'s� g i� (Name) 9 E. Maplewooc� l�,a��s. ,. Mechanicsbur�, Pa. 1705; ('Ad'dress) REGISTER OF WILLS OF _ COUNTY OATH OF NON-SUBSCRIBING WI'I'r1ESS , (eaclt};.a„subscriber hereto, (each) being duly qualified according to lav�✓, depose(s) and say(s) that ' - ,_ _ familiar with the signature of ,-- � codicil testat of (one `o�`'�he subscribing witnesses to) the will presented herewith and codicil ��� believes the signature on the will is in the handwriting of that � testat believes the signature of the will prg�,ented herewith and that — codicil �� ��� � believes the signature on the w' is in the handwriting o^f'�,�` --- to the best of nowledge and belief. ,. . Sworn to or affi ed and subscribed before -- me this day of (;'Vame) 19 --- (�ddress) Register --- � �'Name) (rlddress) .'q� 3 . � .,..._. . ,,._� , ,., � �` ; ,,. _ � '�����.. � 1 ,� _ ;-�,�� _ 7 FILE NUMBER REV-1500 EX+ �2-e>> INHERITANCE TAX RETURN ���°� RESIDENT DECEDENT ❑Q COMMONWEALTH OF�PENNSYLVANIA (TO BE FILED IN DUPLICATE 21'�Uv"2�o DEPARTMENTOFREVENUE W�TH REGISTER OF WILLS) POST OFFICE BOX 6327 (:Oi.�NTY CODE YEAR NUMBER HARRISBURG,PA 17105-8327 "���� -----"�- DECEDENT'S NAME(LAST,FIRST,AND MIDDLE INITIAL) DECEDEN�b"S Cl�i�4PLETE ADDRESS Z NAILOR, Mar�aret E. ��U Bare Road W N[e;r:haniesburg, Pa. 17055 � DATE OF DEATH DATE OF BIRTH �++ SOCIAL SECURITY NUMBER � 198�30-1712 3�1?/88 �! �' � � co���Y _C;tz:r,nberland _ ❑ 2. Su lemental Return ❑ 3. Remainder Return Q � 1. Original Return PP (for dates of death prior to 12-13-82) � ❑ 4a. Future Interest Compromise 5. Federal Estate Tax V au ❑ 4. Limited Estate Return Re uired =00 (for dates of death after 12-12-82} O 9 u am ❑ 7. Decedent Maintained a Living Trust _8. Total Number of Safe Deposit Boxes � b. Decedent Died Testate Qttach co of Trust Q (Attach copy of Will) ( PY ) ALL GQRC���PL�ND�l�10E 11NE)�+�'FNFtt'�ENTIA�.'CA�C 1l�FQR1�1A'�#Qlti�S�tC�t�l,t�B� �16tE�.�'EA 7Ci: ' _ _ COMPLETE MAILING ADDRES'�. Vf 7 NAME; � c J . Rob�r� StauPfer, Atty. Market 5����re Blc�g. � � Z M�chan:�.cs��izrg, � 1�55 � O TELEPHONE NUMBER _ v a - 717 ?bb-9673 -_---_ - �},��c;__ 1. Real Estate (Schedule A) � �� - -� �u9.Q��.1 _ 2. Stocks and Bonds (Schedule B) ( 2) --- -- _, ��1.�l,1 - 3. Closely Held StocklPartnership Interest ($chedule C) ( 3) --- - C.).Cl(..) 4. Mortgages and Notes Receivable (Schedule D) ( 4) --- ---- a. 5. Cash, Bank Deposits&Miscellaneous Personal Property( 5) ��"�-"�'+�-��- Z (Schedule E) O s;�.O�)- Q 6. Jointly Owned Property (Schedule F) � 6) �^� V M��',�1 � 7. Transfers ($chedule G) (Schedule L) � �) ( 8� �f,.�89��� r Q8. Total Gross Assets (total lines 1-7) � 1��3«t�Cl W 9. Funeral Expenses, Administrative Costs, Miscellaneous ( 9) � -- - oe Expenses ($chedule H) - {a���'.� 10. Debts, Mortgage Liabilities, Liens (Schedule I) (1�) 7,188 00 (�1) �-- 1 1. Total Deductions (total lines 9 & 10) 0�o0 (12) - 12. Net Value of Estate (line 8 minus line 1 1) O�o0 13. Charitable and Governmental Bequests (Schedule 1) (13) - 14. Net Value Subject to Tax (line 12 minus line 13) _..-_____ (14) �•�� ( � x .06 = Os00 15. Amount of line 14 taxable at b% rate 15 ------- (Include values from Schedule K or Schedule M.) O•o0 16. Amount of line 14 taxable at 15% rate (16) __-X .15 = - (Include values from Schedule K or Schedule M.) O�oo Z (17) O 17. Principal tax due(Add tax from line 15 and from line 16.) ~' Interest r18. Credits Prior Payments Discount ( ) Q�QQ _ - - - + _ ---- � a - � __0�___ p 19. If line 18 is greater than line 17, enter the difference on line 19. This is the OVERPAXNkENT. (19) V �� . . . . . - -• . . • . . . - • ���� X -- � 20. If line 17 is greater than line 18, enter the difference on line 20. This is the TAX DI�E. (20) O•o0 (20A) - - A.Enter the interest on the balance due on line 20A. Q a OQ B. Enter the total of line 20 and 20A on line 20B. This is the BALANCE DUE. (20B) -" Make Check Payable to: Register of Wills, Agent __ . ' �I►�8�S[►��"E1�l�:t+l$W��t Ai,l.t�U�S�'1�1���N R��R���Il)� Ait1��'� �E�FEECIG MAt7H-4M�I�w Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and str�tements,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 h any knowledge. ------ DATe .�- SI U OF PERSON R ON BL ILIN TURN ADDRESS 30 Bare Road i,7055 ��� � � � ��� � , ` �,�, ;, Mechanicsburg, I��a� - � , �T; DATE SI A E �9REPARER TH �AN SENTATIVE ADDRE55 R�aY+�et g,ual'e ra�=• �,7�55 ��j���� � Mechanicsburg, �'a.__ ' �_ �, ; . ..1 ,i.,,.u rn�r • .. PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING A �HECK MARK(�j 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 intere'st or ......... �r . ........................................................... . d. r�ceive the promise for life of either payments, benefits or care? ....................... Ij 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 � occu�rred after December 12, 1982, did decedent transfer property within one year of . death without receiving adequate consideration2 � � . ................................................. ✓� 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. � RE�-,S�BEx� �Z2�, � SCHEDULE E ' ���� I CASH, BANK DEPOSfTS AND ''I I MISCELLANEOUS COMMONWEALTH OF PENNSYLVANVA pERSONAI PROPERTY � PI@QS@ Pfltlt or Type INHERITANCE TAX RETURN _____ _ - RESIDENT DECEDENT FILF NUMBER ESTATE OF 21—�5-230 MARGARET E. NAILOR (All property jointly-owned with the Right of Survivorship must be disdosed on Schedule F) _ ________�___ VALUE AT ITEM DE3CRIPTION DATE OF DEATH NUMBER — ---- l� Certificate of Deposit No. A68781 issued �0�'-3��7 � 1,967.62 by Farmers Trust Company, Carlisle, Penra�y]_�Arania. 11l�.61} Interest accrued to 3�17�88• g �,°�#;Yi 2. IRA Account No. 8050056 opened 4/23/ 4. Z�8o8�13 Farmers Trust Company, Carlisle, Pennsyl.����a1 i.a. TOTAL (Also enter on line_"i, Recapituiation) $ 4�890•39 (Attach additional 8Yz" x 11" sheets if more space is needed.) ,.., ��.,...0�-mr � RE�,S„ EX� (8-86) SCHEDULE H �-�'�a FUNERAL EXPENSES, ,��._�r� GOMMONWEALTH OF PENNSYLVANIA ADMINISTRATIVE COSTS AND INHERITANCE TAX RETURN MISCELLANEOUS EXPENSES please Print or Type RESIDENT DECEDENT FILE NUMBER ESTATE OF 21�,88_•23� MARGARET E. NAILOR � ITEM DESCRIPTION AMOUNT N U MBER ------- q, Funeral Expenses: �. Ewix�g Brothers Funeral Home, �]3O SOU'��1 F:[,�nover 5treet, Carlisle , Pennsylvania, Funer<��1. �:jxpenses . $ �.,975•00 g, Administrative Costs: �, Personal Representative Commissions — — Social Security Number of Personal Representative: ---- Year Commissions paid 2. Attorney Fees J. Robert Stauffer, Esq. , attc,rn�,�� s fee. 175.00 3, Family Exemption Claimant Mavnard L. N&�–Y' Relationship �u��b���-'� 2�000•00 Address of Claimant at decedent's death Street Address 30 Bare Road _____ City Mechanicsburg, State Pa• Zip Code 17fl55 4. Probate fees Register of Wills of Cumberla�~kd C. ounty, Pennsylvania, Letters Testam��atax�y. 33•00 C, Miscellaneous Expenses: �. Register of Wills, filing Tnsolvent Per�r�";;,�lvaxiia 5 ,00 Inheritance Tax Return. TOTAL (Also enter on line 9, Recapitulation) $ 7�188.00 (If more space is needed, insert additional sheets of same size) r ir_,,..,.0�riai � � � I REV-1513 EX+ (8-86) ,�,,;��5_•'� SCHEDU�E J I " "�'� BENEFICIARIES I COMMOHERTA`NCEOTAXE ETURNAN�A RESIDENT DECE�ENT '"'"'-' I'N��.E NUMBER ESTATE OF MARGARET E.NAILOR �1�8���3� AMOUNT OR ITEM �2LI.l'�TIONSHIP SHARE OF ESTATE NAME AND ADDRESS OF BENEFICIARY � NUMBER ;------ A. Taxable Bequestr. I �,����, One-fourth share �. Donald R. Nailor of Certificate of R . D. 4 Deposit and IRA Carl.isle, Pa. 17013 Account. 2. Dennis E. Nailor S�:r� One-fourth share 1175 Boiling Springs Road of Certificate of Deposit and IRA M�chanicsbur�, Pa. 17055 Aecount. � Debra K. Shields I Da��F�hter One-fourth share � q Terry Drive of Certifiaate of I Deposit and IRA Carlisle, Pa. 17013 Account. �, Karen E. Nailor � Da.�,;�ght�r One-fourth share � q20 Emily' Drive � of Certifi.cate of i Deposit and IRA Mechanicsbur�, Pa. 1705� Account. � Maynard L. Nailor I h:u��band Entire reaiduary � 30 Bare Road �� Estate. Mechan icsburg, Pa. 17055 II I10TE: Decedent� s � Estate is In- ' solvent. There is no net Estate __�___ to ' s � . AMOUNT OR ITEM NAME AND ADDRESS OF BENEFIClARY SHARE OF ESTATE NUMBER ------ B. Charitable and Governmental Bequests: 1. TOTAL CHARITABLE AND GOVERNMENTAL BEQUESTS (Also enter on Iir�L 113, kecapitulation) $ (If more space is needed, insert additional sheets uf s��me size) ��, ,,....,u.r.nll , R.EGISTE A OF WILLS OF CUMBEftLAND COUNTY � REPORT OF STATUS OF ADMINISTRATION (For Resident Decedents Dying After July 1, 1984) �` :;�:; ; ESTATE NO. 2i-88-230 •O�"� lii'i ,'i i .� Name of Decedent: MARGARET E. NAILOR ��„„�oc�ial Security Account No.: 198-3�"1712 Date of Death: Niarch 17, 1988 Name of Personai Representative(s): Maynard I,» Nailor Capacity Executor 7[ _ Administrator c.t.a. (check one) Administrator Administrator d.b.n. Is the administration of the estate complete? Yes �. No If "yes", how was the administration ended? (check one) By court accounting — By account stated to parties in interest Did the parties release the personal representative? Other (explain) Estate is insolvent. F'��rsonal representative is paYinR balance of obli�ations of c���t��3dent' s estate from his personal funds . Total amount paid to date to creditors and for funeral and $ l� � �9�•39 administrative expense Total value of distributions to date to beneficiaries $ 0.00 If administration is not complete, estimated value of assets � 0.00 still in administration NOTE: This status report is due no later than the due date far filing the Pennsylvania Inheritance Tax Return or, if no Inheritance Tag Return is required. nine (9) months after the date of death; if the administration of the estate has not been concluded, a summary report shall be filed annually thereafter until the administration is complete. I certify under penalty of perjury that the foregoing information is correct to the best of my knowledge, information and belief. ;, � q / % Date: ''Y'�� � q � 19_a� /,�� � ,�,. ��,� �� �l, _ � , Personal Representative , A�k.�7G�lC7f4G7C34�� This report must be sgned by the pecsonal representative. or one of them when more than one, or by counsel for the estate. , � ....,., �� ,...u�,-n�r� . �., REV-1547 EX (12-87) �` COMMONWEALTH OP PENNSYLVANIA ,���` d�� NOTICE OF INHERITANCE TAX DEPARTMENT oF ReveNue .."�c��, �� �' APPRAISEMENT, ALLOWANCE OR DISALLOWANCE ACN 101 ` BUREAU oF INDIVIDUAL TAXES �S`'t� � . � pF DEDUCTIONS, AND ASSESSMENT OF TAX � P.o. aox esz� DATE 0 -16-88 HARRISBURG, PA 17105-8327 ESTATE OF NAILOR MARGARET E FI�E N0. 21 88-0230 DATE OF DEATH 03-17-88 COUNTY CUMBERLAND NOTE: TO INSURE PROPER CREDIT TO YOUR ACCOUNT, SUBMIT THE UPPER PORTION OF THIS NOTICE WITH YOUR TAX PAYMENT TO THE REGISTER OF WILLS. MAKE CHECK PAYABLE TO "REGISTER OF WILLS, AGENT". REMIT PAYMENT T0: J ROBERT STAUFFER ATTY REGISTER OF WILLS MARKET SQUARE BLDG CUMBERLAND CO COURT HOUSE MECHANICSBURG PA 17055 CARLISLE, PA 17013 Amount Remitted CUT ALONG THIS LINE � RETAIN LOWER PORTION FOR YOUR RECORDS_� _ _ _ _ _ _ _ _ _ _ _ _ _ . - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - REV-1547 EX (12-87) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF NAILOR MARGARET E FILE N0.21 88-0230 ACN 101 DATE 05-16-88 TAX RETURN WAS: (X ) ACCEPTED AS FILED ( ) CHANGED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE � � APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN " �'T' c- ':'. '°�c--; 1. Real Estate (Schedule A) ( 1)___ .04 , =_ _ ' _ 2. Stocks and Bonds lSchedule B) ( 2) .00:° . - 3. Closely Held StocklPartnership Interest (Schedule C) ( 3) .00_ _ �.- 4. Mortgages/Notes Receivable (Schedule D) ( 4)_. _ .00 - 5. Cash/Bank Deposits/Misc. Personal Property lSchedule E) ( 5)_.. 4,890.39 - 6. Jointly Owned Property (Schedule F) ( 6) ___ .00 - 7. Transfers lSchedule G) ( 7) _ .00 8. Total Assets ( 8) 4,890.39 APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Administrative Costs/Miscellaneous � 9� '7,188.00 Expenses (Schedule H) .00 10. DebtslMortgage Liabilities/Liens (Schedule I) (10) 1 1. Total Deductions (1 1? 7,188.00 12. fJet Value of Tax Return (12) 2,297.61- 13. Charitable/Governmental Bequests (Schedule J) (13) .00 14. Net Value of Estate Subject to Tax (14) .00 NOTE: If an assessment was issued previously, lines 14, 15 and/or 16 and 17 witl reflect figures that include the total of ALL returns assessed to date. ASSESSMENT OF TAX: 15. Amount of line 14 taxable at 6% rate (15)_ .00 X.06= .00 16. Amount of line 14 taxable at 15% rate (16)_ .00 X.15= .00 (17) .00 17. Principal Tax Due TAX CREDITS: PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST (-) _ TOTAL TAX CREDIT .00 BALANCE OF TAX DUE .00 INTEREST .00 * IF PAID AFTER THIS DATE SEE REVERSE FOR CALCULAT�ON TOTAL DUE .00 OF ADDITIONAL INTEREST (IF BALANCE DUE IS LESS THAN S 1 OR IS REFLECTED AS A CREDIT" (CR), NO PAYMENT IS REQUIRED)