HomeMy WebLinkAbout94-00253
PETITION FOR PRODA TE and GRANT OF LETTERS
Estate of 0 r\(\r..J1JQ..h \r, (\ c, LL__ No. c2/ -9'-1-;;(53
also known as -----'lIDllLJ.I\RI ONSK 1 To:
Register of Wills for the
_ _---.I Deceq;ed. County of (' I I I'll het 1(\ n c) in the
Social SeclIrlty No. J!~lLL=-..'ik D / Commonwealth of Pennsylvania
The petition of the undersigned respectfully represents thllt:
Your petltloner(s), who IS/lire 18 YCllrs of IIge pr older An the execLuL1l'>...
in the last will of the IIbove ~J~e~ent, dated l:l (\::;
IInd codicil(s) dated . 4L.-
named
__,19...RL
(stille relevant circumstllllces, e,g. rellunclatlon, dCUlh or executor. cIC.)
Oecendent was domiciled nt denth i~ 01 t \'n \x 'r 1(\ "rl _ CountYj Pennsylvania, with
1Lf---L-- last fllmily or prlJl.clPIII resilience at I J. L:JL:lli. '" \ \ (" " h cI
r"l,\1 'J) (' ~(l __ I OllIe',' r- (/~ ~-I k ~(ll'cl 11 () (\ r"h ()
I
(list street, IlUmbCI llnd llIunclpalllY)
Oec,Rqdent, thcn YC,ars of nge" 11~~(_AlLl.\.lLL ,19 q ,-I ,
IIt_C-1:L - L:J1.:.ullL' 0(1rll\le .
Except as foilows, 'cedent did not marry, WIIS not dlvo;ced nnd did not have II child born or adopted
after execution of the will offered for probate; WIIS not the victim of a kliling and was never adjudicated
lucompetent :
Oecendent at death owned property with estimated values as follows:
(If domiciled in Pa.) Ail 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 Pennsylvllnia
situated as follows: ---1:-, 0 f) C,
$ I DO) () DC, .J,(,
$
$
$
WHEREFORE, petitloner(s) respectfulI~ :e;\I~tl~s~ t't~~ rob ate of the last will and codleil(s)
presented herewith IInd the grant of ICllers . .' ..' 111' I I
(testamentary; atJmlnhlrnllon c.l.a.j administration d.b,n,c,t.II.,)
theron.
-
.
1l
5
'to_
'~ .
..-g
'tI,g
ij.~
7..
"0'.
;0
!
Iii
j'l(/ 1 /I() / (I.(}, (I{ J-(/(j
'6:-2 'rJCl:,h I r:.n1col) (III p
1:4tb-BJ::..Ld\:.(e b2. CJ 'i:\ S d3-
OA TH OF PERSONAL REPRESENTATIVE
COMMONWEALTH OF PENNSnVANIA }' 88
COUNTY OF CUMBERLAND
- -
The pelitloner(s) IIbove-named swellr(s) or IIffirm(s) that the stlltements in the foregoing petition are
true and correct to the best of the knowledge and belief of petitioner(s) and that as personal represen-
tative(s) of the IIbove decedent petitioner(s) will well and truly admiaister the estate according to law.
Sworn 10 or IIffirl1l~%T~nd SUbscribed.~' ~L~J.!..L/" (' 1: (/ (H' U ~
before me this ----wmC'l1::=- ~~y 01 ::l
iAA----/+(.(,L-. ~~-,(""\(I L~ d:. ~
I~_~....!......"t-() !'-tLYi-I/!lL1:M ~ ~
MA Y C/. LEWIS . Register U ~
1"1- ) 0.9 ~ '}
No. ~1 . 9~ . ?53
Kstllte of _ ANNA M. .1ARI ONSK I a Ik I a , Deceased
ANNA JA[lLONSK I
In:CR.;I~ 01<' PROBATE AND GRANT OF LETTERS
ANI> NOW ._........ _.__ MA~CH 15. _ 19~, In consideration of the petition on
the reverie llde hereuf, llltllfllctory proof hllvlng been presented IJefore me,
. IT IS (>IlCRI!I!I> thulthe InstrulIlent(s) dllted__. OECEMBER B, 19B7
de,lerlbed therein be IIdllllttcd to probate Ilnd filed of record liS the IlIst will of
_.__.._.____.._._.__......._ ANNA M. IJABLONSK I a/k fa ANNA JABLONSK I
Ilod l.eUCT! ._~._.____--.-l.ESIAMf.ti:rAR V
lire hereby Mrlllllcd tu..._ KAREN L. CLEAVEIl
FEES
I'robate, Lellers, file, ... . . . . .. $---200....00
Short Certlflenles(~) ... .-. . . .., L--2..'OO
" llelUll1elatlon .."..,......." $.
X-I'ages b.UU
JCP -- $ ~"OO
TOTAL._$ ~17.00
Flied ." .M~RC.H .16"" 199.4..". , . . . . . . . . .
MARY C. LEWIS
ATTORNUY (Sup. Ct. 1.0. No.)
ADDRESS
PHONE
,
"
",
~~ \[.\ ::0
:\1 n"
"'~' (\1 (1
{f r'., ,
,It; "'I' :"
, La',
~~I , I
..... ..
lit "
I ,"
, Ci ~ ' ;~ . ~.,
.~ !}j' ,
"';-' . ,
:TI' , /-:'J !:,,,
" )~~4 ,
,r.. "
'Called Executrix on 3-16.94.'
"
,
.....
"
'It ~~, ~IUllV of ~oh. ~tlIUn
I, ANNA JABLONSKI, currently residing in the Borough of
lIigh Bridge, County of Hunterdon and State of New Jersey, being' of
sound and disposing mind und memory, do make, publish, pronounce and
declare this to be my Last Will and Testament, hereby revoking all
former Wills and Codicils heretofore made by me.
FIRST: I direct that all my just debts, my funeral ex-
penses, the expenses of my last illness and the costs of administer-
ing my estate be paid as soon as practicable after my death.
SECOND: I appoint my daughter, KAREN L. CLEAVER, of 82
Washington Ave., High Bridge, New Jersey to be Executrix of this my
Last Will and Testament, and I vest my said Executrix with full
power and authority to sell, transfer and convey any property, real
or personal, which I may own at the time of my death, at such time
. and price and upon such terms and conditions (including credit) as
she may determine, and to do every other act and thing necessary or
appropriate for the complete administration of my estate.
My Executrix shall not be required to furnish any
bond or other security in any jurisdiction, or if a bond be re-
quired, she shall not be required to furnish any sureties thereon.
THIRD: In the event that my daughter, Karen I,.Cleaver,
shall not survive me, or shall be unable or unwilling to qualify as
Executrix, or shall die before the completion of my estate, then
and in that event I appoint my son, PAUL GOLAS, of R.D. #1, Box 621,
Oxford, New Jersey 07863 as Executor of this my Last will and Testa-
ment, he to serve with the sams powers and privileges as heretofore
granted to my daughter, he to serve without bond.
FOURTH: All the residue of my estate, real or personal,
and all property over which I have the power of appointment, I
devise, bequeath and appoint absolutely and in fee to my children,
"
'-
2
PAUL GOLAS, R.O. #1/ Box 621/ Oxford, N.J. 07863, MARIANNE PELOQUIN,
492 Belmont, East.on/ Penna. 18042, KATnLEEN APGAR, 17 Robins Drive,
Carlisle, Penna. 17013, KAREN L. CT,ElIVER, 82 Washington Ave. / nigh
Bridge/ N.J. 088291 ROYDEN C. BARTO/ 3 Fine Road, High Bridge/ New
Jersey 08829 and CAROL, ANN BARTO/ 1 Fine Road, nigh Bridge, New
Jersey 08829/ equally, share and share alike.
FIFTH: In the event that any of my children shall not
survive me, then I give, devise and bequeath his or her share of the
residue of my estate to his or her children surviving, equally, share
and share alike. In the event that he or she shall not leave any
children surviving then I direct that his or her share shall be
divided among my surviving children, equally, share and share alike.
SIXTH: The use of the words devise and bequeath in this
my Last W:\.ll and Testament shall not be deemed to be a limitation of
the power of sale hereinabove given to my Executrix, or Executor, as
the case may be.
IN WITNES~)1HEREOF, I have hereunto
this 1-1laay of &'Cl,I.',)/vo<.--- , A.D., One
set my hand and seal
Thousand Nine Hundred
and Eighty-seven.
A~ABLO~K~~~'~1 .
(L.S. )
Signed, sealed, published and declared by the Testatrix,
ANNA JABLONSKI, as and for her Last Will and Testament/ in our
presenoe and sight, and wet at her request/ and in her presence and
sight, and in the presence and sight of each other, all three being
present at the same time, have hereto subscribed our names as
witnesses.
"Z/k~h1 ~.Alll'- .'.
,
,
fflu( 'J (Jft(.)
)
41
REV.1500 (X.. II 1.fjll
Ill-N~-' 7
~'I:\ V INHERITANCE TAX RETURN
1\. IT!;!' RESIDENT DECEDENT
COMMONWEAlTll Of PENNSYIVAH", (TO BE FILED IN DUPLICATE
DEPARTMENT 0' REVENUE
IlARAlSfJiri. ~~\'i\lS0601 WITH REGISTER OF WILLS) COUNIY CODE VEAR. NUMBER
ffi . ,) (:-1'" , ,,'( ',/<,' ~ tDrlHI111~~, -- . "--J. )ECfO::~;': COM,';!,". ~~~~;S~,"II)r' I' U ...... ..
~ IOW.rsrCURiT'lNUMstR'.----- A!of15fAItC' IDAllOiRIRI';' q. 1.\I\i'II~)lr', I.II "/."'?'
b )/IJ-Io "(1/0.,07 J-I'.'lo( ~) (" J't" COO", l'L\/"f"~IHr\fll\
__..."._ _________.____.....______"..."..".... . "L"".._".."....._.___.___.....__._...__
~ W 1. O,lglnal Roturn 1.1 2, Supplom.nlal ROlu,n [ J 3. Rsmalnd" ~olurn
l'Iiil...e(g (far dOl" of dsalh prior 10 12.13.92)
III [] A. lImil.d ElIato .I Aa, Fuluro Inl"o,' Camproml,. [ I 5, Fod"al EllUlo T..
152.. Ifar dOlo, af doalh alt" 12.12.02) Rolurn Roqulrod
:: III W 6. Docodonl O;od To,'a'o [J 7, Docodonl Malnlalnod a living Tru'l _ 9, T olal Numbor af Solo D.palit 9axe.
<II (Allach copy al Willi .. IAllachcaet~f..~~~IL". ......_.....__ .__,_
ALL COIUSI'ONDINCI AND CONPlDINTIAL TAl( IN'OAMATION SHOULD BI DIIICTlD TOI '---,
I l; N M '''r-,;mmMAliiNOAliliillS-
l:llll I~I\ ~ (<""..\ L. C) rt,vIH'_ 8 V IJ/I )11 Iltl(, lUll /I vtf'
~ ~ fIIDiiON!NUMIEk 1~3~-~-:~;~~----'--' -... ;//(;1( &'I',(~r IlJ. t? ~&,':')9
"_,,___._ ...1_ ~/ () '61. 6 J ~ ..,~~_~._~=O._...n'.__'~~=~=..R()_, ___ - ,
I. Real Ellalo (Schodul. Al ( 11.0..
2. Slockl and Rund. ISchodulo 9) I 21 ...'L..
3. Clo.oly Hold Stock/Partnorshlp Inl"o"ISchedulo C) I 3) __. . u___ .._ no . .J~......
A. Mortgago. and Nal" Rocolvablo (Sch.dulo 01 141-.0. ..,..___.Q......
5. Ca.h, Bank Dopo,'" & MllCollanooul Porsonal Proporlyl 5) I ao, &01-1. 'I.'i__...__,
(Sch.d<llo E)
6. Jolnlly Ownod Propo,'y (Schedulo FI
7. T ralllfo" (Schodul. GI (Schodulo l)
9. To'al Groll~S1.11 (lolallinOl 1.7)
9. Funeral Expense., Admin;stratlve COlli, Mllcellaneou\ I 91
Expon... (Schodul. HI
10. Dobll, Mortgago Llabllitio., lI.1lI (S,h.dulo II (101 _______.. .._..__....9._.___....
11. T 0101 O.ductlolll IlolalllnOl 9 & 101
12. Not Valuo of E.lalollino 9 mlnu.lino II)
13. Charltablo and Gavornmontal Roquoll. ISchodulo J)
14, N,o' Valuo SubjOCllo Tax llino 12 mlnul lino 13)
15. Amaunl of lino 141axablo at 6% ralo
(Includo valuo. f,am Schodulo K or Schodulo M,I
16. Amaunt 01 lino 14 laxablo at 15% rolo
(Incluao valuo. f,am Schodulo K or Sch.dulo M,)
17. Prlndpal tax duo (Add lax from lino 15 and fram lino 16,1
19. Crodlll Spou,al Pavorty Crodit Prior Paymonll Oileounl Inloro.l
........____.. + _.____... +3{&l~,,:J3 - _..___
19. IIllno 19 II groa.o, Ihan lino 17, enlor ,ho dlll"onco on line 19. Thlll,'ho OVERPAYMENT.
aD
20, IIlino 171. groal" Ihan lino 19, onl" ,ho dlfforonco an Ilno 20. Thil Illho TAX DUE. 120)_. ,J C,<).;.l..>..LJ...__
A. Enlor tho Inl"o.' on Iho balanco duo an Ilno 20A. 120A) ..._____._.___.__u_...._.___
9. Enlor Iho lalal of Ilno 20 and 20A on lino 209, ThllI. Iho BALANCE DUE. 1209) ___.0___" .._____..._
Make ChICk Poyabl. tOI Rlgllt.. a' Will., Aglnt.. ,.. . ..... ...._nu___._..... ...."...__.________.
. . SlIUIS TO ANSWII ALLQUESTlONS 'oifiivlASISlDI AN'ii TO "CHICK MATH""
Under pel"!olllll of perlury, I decler.thall hay. uomlned thlt relurn, IncludIng uccompanying lcho'dul", and Ilalemanh, and 10 the bell of my knowledge and heilef,
lilt Irue, correct and compl.le. I declare Ihat all ,.ollllall hOI bun reporled allrU8 markel value, Oeclarallon of proparer olher lhan the penanal r.pr...nlatlvl II
baled on allln'ormallon of which proparer hOI any knowl.dge.
liONATUAEaf PEkSOH kfIPONSlBrmiI "IIHO WUIN AOOAm----..---- . .. u_ . 'n ---- ..------..f,~:, ,fiT'" Diift------
tj6};6f(f~tJ;~~;~h~~A( IR('iirfttm~1-uJ.Ct.~JJW9Jcn .. Cl".C. ...111 J 1\15 ILc1g.<:_!)J.... -- bA~/L:20.~L-
'OR DATIl 0' PlATH AmR 12/31/91 CHICK HIli
" A l'OUIAL -
POVIRTV ClIPIT II CLAIMIP LJ
.....-------..-'--......----7....-----'..-----
'Ill NUMBIR ) 'II'.. , ) ,J .:' ';',:(
,.-)
z
o
3
E
~
( 61
( 71..
oJ
.'
I..)
(.
n)]~ C ..~L__
( 9) j~O I 6>0--1 . qq.
{l51L
(II) .~ZL~.{J 0..88....
{l2)_~:;t'&J-!1-{. Lt.
(l3) __...._..._._..____._~..
_..__..____J.1.~.:J:J.1i3 ~~..Jl.==
"I,u,3'H..ILx .06" _..7 3 7D ._105..____
(161
...x ,15"
(J
z
o
~
S
...
~
o
u
~
{l71
.... 1070. L15...__
.....3.~~'..Lii~__._.__
C"('[~ Ilt'l(' If you C11I' rf:qUt...11I1H U re'und 01 your OVN'IUVnlt'nl.
(19) .
{I 91 n' .____...._.._____...._
." '... ,""~'-".~ ~.-\- '-"-~-.. j... "
ISTATI OF
0Af3U)/J '5 I( I
ITIM
NUMBIR
A.
"I
IIV.UlI0+11.1I1
1.
B,
1.
2.
3.
4.
C.
1.
2.
3.
4.
5.
6.
7.
a.
.~._. -
~Jl,~
....~
COMMONW!AllH Of rlNNIYlVANIA
lNH!!llANC! lAX R!lURN
mlD!Nl D!C!D!Nl
SCHEDULE H
FUNERAL EXPENSES,
ADMINISTRATIVE COSTS AND
MISCEllANEOUS EXPENSES
f)1.J0A
DESCRIPTION
funeral Ixp.nl.11 rn r~:fY\oll' I>L -s-c;,e..h.l'.E .~-(,,;J) -
,/ {lA-RU5'I/: .cl/-'!t:nftJlfr
e^f'LI~c.e' f'."J.~, ':> /I ('A.f'TlJ.;:.
) " -rr~J{""/{!AL
\......_ 'r I(', 1l'11i'.v('~.s,rs
{l I (!(!'I"./ fj(:
Jr-, !(Pr--t:
~'j 1114J ~~t";.'""
,J.~ ,'1.,1 (//;c-I!{JII/PL;E/))/S'ri_ /601:> (~oS"1
!f1&!/4)/ZIO(fe; L-I,;Vi,c:.. I, " OlC. ~-AAlI(r 1n,lvllL',-cL'''i
I, " ~v'i"T"I>I"Ii/ ii. 7?l1"'''JI'::
Admlnlllratlv. COIIlI ,,' I, (1;/1 rn.l~ 7. 1/"i(,.I';,;{
I j " r t'.n,'-...Iclt'."i
Personal Reprtlentallve Cammllllanl ,2u? -).:? ,- '-/03'{,
Saclal Security Number of Perianal Reprelentallve:
Veor Commllllanl paid I'? 9 (
Attorney Feel
Family Exempllon
Claimant
Addr... of Claimant at decedent'l death
Street Addr...
City
Relatlonlhlp
State
Zip Code
Probate Fe..
Mllc.llan,oul Ixp.nlt..
/.,
O/'." 'L' J-l(.2.Y NoT7~E"S
1) t:' IC! r,/ c',z Jl n ft ~ II U::
f{RrUtJ t!l 01 va.? 701 VFi.- (3)~ lP~ @ ..l't II Q .;;l't
<5 T7-l(TIPS
(II [~ I i! /.; L
ry"c"<,:-/l-' s-(r~
t,)(CCUfrll<' Noll(!~ (,Thr:. Sen{II] ei)
Pel- SO(\Ct.! TO. x (c" "c(~J L, TIHA)lll)\ CL)
\<'t'')\.dc( \,U I 1\
d C;.:; 5' 3
AMOUNT
~~I (J~
1:(.' ,~.
) 5-, 00
/t.JO,()O
16,,(,(,
'SOda
..;> 5"".1J0
SO,dO
"'0.<>0
b 5""0" '" 0
--~--.--
0,0
C,a
If? 00
Id:? ,00
.!). 5"~ 98
/ / Go
.20 (p . C\Cl
J.f 7 ' 01
q. ~o
~ 17 00
TOTAL (Alia enter on line 9. Recapitulatlonl S 7 7 Ie 0 . <3 'is
(II molt Ipac. II nttd.d, Inl.rt additional Ihttll of lam' Ill'.)
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMIERLAND
}
HI
._. ._------------.---_...-_.._.-. -_.._-_._--_._._--_.._--_..._.._-------_._--_.._--~--_..-..---"....
being duly _________ according tc law I dopo... and 'a;(1 that h~ -;-,--------. -----
_._ _..__._..__._ ____no cf the Estate of .lLniliLJa.h.l.Dr.L~LJ . .
late of )..o.lJJec[r(L()k h)f( L Tu.\(\~h P _ .- ----.- __on' Cumberland County, Po., deoea~~ :f~ that the
within II an Inventory made by JhCfDbCttCl.\ I f!( ____u___.____, the Iald~ -r 1)(
of the entire Oltete of laid decedent, consisting of all the porsonal prop'drty and real uh'o, except roal uhte ouhlde
th. Commonwealth of Pennlylvanla, and that the figures oppollte each It.m of tho Inyontory reprelont It'l fair value
as of tho date of dooedent', d.ath.
and subscribed bofore me,
. 19
_harrcLLflc.o..u c r-
eo..u!., . Admlnltt",.,
_S'.;;twn.wh-w.skJl.u.e
lllB-b-ELde-co ) 0 ~ 8,Yl
Add""
Oat. of Death __ (\ l_________---D .3
DIY Month
q-d
Yu,
INSTRUCTIONS
I. An Inventory must be fHod within three months aiter appointment of personal r.pr...ntatlve,
2. A lupplement Inventory mUlt be flied within thirty daYI of discovery of addltlonallll'ts.
3. Additional Ih.oh may be attaohed as to perlonalty or realty
4. S.e Artlol. IV, Flduolarles Act of 1949.
~ ~ i
~ ;
Do rn II.
~ .
~ w 0 Q III r
i!: g: -I U. ,,; :
u. -I ~ 0 Do . ~
W o ~ = 4 t
~
o Q :J
- ~ ~ c.'l
0 ~
Z Do '"0
c
J ... ..
"i:
0 ..8
1 ....
II e J
..
.. d if
....
,1"'",."" 'X ." {".9'*
e_ALlH OF PINNSYLVANIA
DfPARlHENr OF RIVENVE
IUREA~ OF INDIVIDUAL TAMES
DfPT. 210601
HARRISBURG, PA 17121-0601
/q~
(C)
ACN 101
HOTICE OF INHERITANCE TAM
APPRAISEHENT, ALLOWANCE OR OISALLOWANCE
OF DEDUCTIONS, AND ASSESSHENT OF TAM
DAT! 09-13-94
DATI OF DEATH 03-07-94 ~~b~T~O' CUMBERLANO
NOTE I TO INSURE PROPER CREDIT TO YOUR ACCDUNT, SUBHIT THE UPPER PORTION OF nlls FOR" WITH YOUR TAM
PAYHENT TO THE REGISTER OF WILLS. HAKE CHECK PAYABLE TO "REGISTER OF WILLS, AGENT"
REMIT PAVMENT TOI
KAREN L CLEAVER
82 WASHINGTON AVE
HIGH BRIDGE NJ 08B29
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
l
AMount RIMlttld
CUT ALONG THI8 LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ....
iii'lj: ii'47'iirAFii"ilif:93Y-iliificiuot1uiNHiiiii'ANci' i'-Ax' 'A' PPRA"isiHiilr;.,\L.i:OWAifci.iiri.................
DI8ALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ISTAT! OF JABLONSKI ANNA M FILE NO. 21 94-0253 ACN 101 DATE 09-13-94
If an a.....m.nt wa. i..u.d pr.viou.ly. lin.. 14. lS and/or 16 and 17 will
r.fllot figur.. thot inolude the total of ALL return. .......d to dat..
ASSE88MENT OF TAXI -
U. Aoount of Llne14 toHobll It 6% rltl USI 122,844.11 K.06' 7,370.65
16. Aoount of Linl 14 toHlbll It 16% rltl U61 .00 K.1S . .00
17. Prlnolpe1 ToH DUI (171 7,370.65
TAX CREDIT81
PAYHENT
DATE
TAM RETURH WAS. t X I ACCEPTED AS FILED
RESERVATION CONCERNING FUTURE INTEREST . SEE REVERSE
APPRAI8ED VALUE OF RETURN BASED aNI ORIGINAL RETURN
1. RId Eatlte (Sohldull Al U 1
2. Stook. ond BondI (Sohldu11 BI 121
5. C10,"1y Hl1d Stook/Plrtnlr.hlp Intlrl.t ISchodu1o CI 151
4. HortUlUI./Notl' Rlallvob11 (Sohldu11 01 141
5. CI.h/Bonk Depo.lt./HI.c. P.r.onl1 ProPlrty (Sohedu1e EI 151
6. Jalntly Ownld ProPlrty ISoh.dull FI (61
7. Trln.f.r. tSchldu1. 01 (71.
B. Toto1 Alllto
APPROVED DEDUCTION8 AND EXEMPTIONS.
9. Funorl1 EHPln.I./Ad.lnl.trltlvl Co.t.1
HholUlnooul EHPln.u (Sohldull HI (91
10. Dlbto/HortUlge LloblUUu/Llln. ISohedu1e II UOI
11. Toh1 DlducUon.
12. Not Vl1ue of TI. Rlturn
15. Ch.r Itlbll/OovlrnMnto1 Blquuto t Schedule .n
14. NIt Vdue of E.toto Subjlct to To.
NOTEI
RECEIPT
NUHBER
DISCOUNT (+J
INTEREST 1- I
05-12-94
368.53
886069
I CHANOED
.00
,no
,00
.00
130.604. 99
,00
.00
18I
130,604.99
7 , 760.88
.00
lUI
U21
U51
U41
7,760.88
122,844.11
.00
122,844.11
AHOUNT PAID
7,002.12
TOTAL TAX CREDIT
BALANCE OF TAX DUI
INTEREST
TOTAL DUE
7,370.65
.00
.00
.00
. IF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
IF TOTAL DUE IS LESS THAN .1, NO PAYHENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" ICR1, YOU HAY BE DUE
A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS. I
\'
"
" "
"
,
"
"
Rt:I!RYATIOHI E.tlt" of dlelantl dying on or bllar. D.ce.b.r 12, 1912 h if any future Int.r..t In thl ..tat. 11 tran.f.rred
In,po.....lan or tnJoy..nt to Cl,.. I (oollet~r.l) blneflollrl,. ~f' the d.qadlnt Ift.r tht 'Mplr,tlon 0' .ny ..t.te for
Ilf, or for y..r., the Co..onw.,lth her.by 'Mpr...iy r...rv., the right to appral,. .nd I..t.. trln.f.r Inheritlnce TIM"
It thl lewful Cl'.. a (oal1It,ral) rlt. on any .uch future Inttr,.t.
PURPOSE OF
NOTICE I To fulfUl th, requlr...nh of StcUon 2140 0' the Inharltlnc. Ind Elt"t, T'M Aot, Act 2Z 0' 1991. 72 P,S.
Soatlan mo.
PAVHENTI Dtt~h thl top portl~ of thl. Notlc. end .ubllt with your pay..nt to the R,gl.t,r of Will. prlntld en the r.v,r" .Id'.
--""k" check or lanlV ardlr PIVlbl1 tel REOISTER OF HILLS, AOENT .
All p.y..nt. reollV'd .hlll flr.t b, applltd to any Int.r..t which ..y b. due with .ny r...lnd.r .p~llld to thl tiM,
R!fUHD (CR)1 A rlfund of . tlM arldlt, which WI' not rlqu.,t.d onthl TIM R.turn, .IY b. r.qu'lted bv cOlplttlng an "Appllo.tlon
for A.fund of Plnn.ylyanl. Inherltlnc. and E.tat. TaM" (AEY-Ull)' Application. are aVllhbl, at th.O'flc.
of thl R.gl,t.r of Will., any of the 23 RIV.nua Ol.trlot Off Ie.., or by ollllng ,ha .p.ctal 24-hour
an.warlng III'VIOI nuab.r. 'or 'or.. ordering I In P.nn'Ylvanla 1-800-362-2050, outlJd. P'M'Ylvanl, .nd
within 10011 Hlrrhburg ar" (117) 717-1094, TOOl (717) 772-2252 Oluring Irtpalred OnlY),
OBJECT IONS I Anv p.rty In Intar..t not ..tl.fl.d with tha appral....nt, ellow.no. or dl.allowlnc. of deduotlon., or ........nt
of t.M (Including rthcount or Int.re.t) II .hown on thh HoUel IU.t obJ.ot within .lMb (60) dlY' of rec.lpt of
thlt Hotlc. bYI
--wrltt," prote.t to the PA Dlpartaont 0' Alv.nu., Board 0' Appeal., DEPT, 2810Z1, Harrllburg, PA 17121-1021, OR
.-.Itotlon to have the .attlr dlt.r'ln.d at audit of the aocount of thl ptrlonal r.pr...nt.tlva, OR
--apPI,1 to thl Orphan.- Court.
ADIIIN
IIlRAlIVE
CORRtiCTlOHt.
F.otual .rrar. dl.aov.r.d on thl. ........nt .hould ba .ddr....d In writing tal PA D'Plrt..nt of R.venu.,
Bureau of IndJvldull TaM", ATTHI Po.t A.......nt A.v1,,,, Unit, DEPT. 280601, Harrl.burg, PA 17121-0601
Phone (717) 717~'SOS. S.. p.g. S 0' the booklet "In.truotlon. 'or Inherltanc. TIM R.turn 'or. R..Jdtnt
Dlced'nt" (RE~-1501) 'or an .Mplln.tlon of "dtJnl.tratlv.IY eorr.otlbl. .rror..
OIICOUHT.
If MY tlM due It Plld within thrll (3) 0.1100., aonthl aft.,. thl dlo.dlnt'. d..th, . flv" perc.nt (Sin dhaMt of
thl tlM p.ld II IUowld. '
INTEREIT.
Int.r..t It charg.d b.glnnlng with flret d.y of dlllnquenoy, or nln.(9) .onth. and ant (1) dav fro. the dati of
d.ath, to tha dete of p'Y"nt, TIM" ",hlch blOlM dlllllqulnt baforl Janu.ry 1, 1912 bltr Inttlrllt at the rat. of
,1M (6Xl Ptrctnt par InnUl o,loul.tld at . d.lly rat. of .000164. All taM" which bloa.. dtllnquent on and aft.,
January 1, 1912 will blar Int.r..t at a rat. which will vary 'rol o.l.ndlr Ylar to oal.nd.r vaar with thtt r.t.
lMnounotG bv the PA D~partMnt of R.v.nue. Thl appllcabla Intlra.t r.t.. for 1982 through 1994 .r'l
Vllr tnter..t R.ta Dally tnt.r..t F.ctor !!!r Intlr..t Rata Dally Interut F.otor
-
I9I! !OX .000541 1916 lOX .ooom
191. 16X .0004.1 1917 9X .0001\7
1914 11X .00DlOI 1911-1991 IlX . DOOm
1915 I'X .000556 1992 9X .ooom
1991-1994 7X .00m!
."Int.,ut It calout.ttd II 'oUn",,,
IHTEREST . BALANCE OF TAX UNPAID X NU"IER OF DAYa DELINQUENT X DAlLV INTEREST FACTOR
..Anv Hotlc. l'lued .ft.r tha tlM b.oOll. dtllhquent will ,.fllot In Int.ra.t a.loutatloR to fifteen Clll q.VI
blVond thl dati 0' thl ........"t. If pay""t It .1. Ift.r thl Int""t aotpUtttlon d.ta .hown on thl
Notlol, IOcUtlon,1 Inter..t lIU,t b. c.lcullt-a.
, '
"., '.-,1
~
6
[)'-'
\: :'
" '.:1
, ,
~TATUS ~POR~~DER RULE 6.11
N." of Il.".d..,,- a.~"" . \ o.b )0" ski
() ~ O_l~
will NO.~..1n3
,
NO'~~-
Date of Deaths
Admin.
pursuant to Rule 6.12 of the Supreme court orphans'
Co.,t R"'" , ,.po,t the fo"ow..g w.th"'P.ot to oo.".t.o, .f
the administration of the above_captioned estates
,. st.te wheth" a.,...,t,.t'o, of the e,t,t. ., oomp,.te,
Yes._- NO_v' -
2. If the anBwer iB No, Btate when the personal
"P,.,..t.t'V' ,..,o,'b'y-bf,..ve, th,t the ..,.."t,.t'o. w", b.
completeS_O II '1.J) \ ~~-- --
3. If th' ..,we' t. N.. , .' Ie', ,t.t. the fo".w..g'
a. Did the personal representative file a final
account with the court? Yes No
--
b. The separate orphans' court No. (if any) for
the personal representatiVe's account iSI
c. Did the personal representatiVe state an
.ooo..t ..fo'~'" '0 th' pa".e. .. ,.t.,e,t' Ie' No
d. Copies of receipts, releases, joinders and
.p"ov." of fo,m.1 ., ..fO"" .ooo..t. m', b' f.l.d w.th the
C", of the O,ph'"< coO,t "d ~I b. ..."hed to thl' "po'"
DateS~
.i1f.lAPA0lrjJpf1J~iL
SignatJure
J1arf'r'I L. CJ.efllJ er
Name (Please type or print)
UaW(H~h- - ~ t1..veli\aV\~r'--lIle.uJ
Ad ress ~ Il!l.-Ut
i O\O<is1 (or, 9,. 1s'3,")~
Tel. No.
capacity' ~ personal RepresentatiVe
counsel for personal
representative
(MAli s rmf! AM3)
STATUS REPORT UNDER RULE 6.12
Name of Decedentl-.O npn. M .10 .bl()n~;b
Date of Death:~~
Will No,-2l:~ 153 Admin. No.
Pursuant to Rule 6.12 of the Supreme Court orphans'
Court Rules, I report the following with respect to completion of
the administration of the above-captioned estate:
1. State whether administration of the estate is complete:
Yes../ No__
2. If the answer is No, state when the personal
representat.ive reasonably believes that the adrninist.ratJ.on will be
complete:
3. If the answer to No.1 is Yes, state the following:
d. Did the personal representative file a final
account with the Court? Yes~_ No
b, The separate Orphans' Court No. (if any) for
the personal representative's account iSI
c, Did the personal representative state an
account informally to the parties in interest? Yes ,~ __ No
d. Copies of recei.pts, releases, joinders and
approvals of formal or informal accounts may be filed with the
Ce~k of the Orphans' Court and may be attached to this report.
I
\
,
I
(
Vd ",~,~ I: ":!")'IIUna
pnc" . ~ 1'010
'I1()ILP~t ()j),pr;uJtA.J
Signature
J~{J( (~(j l fie 0.\/ e(
Name (Please type or print)
'ii':) Wr1"h \n(~dnl\ () II e
Address H l(J \" f3 (Id G e ill 018J.(1
15.Qh'J (o:S K .-'j \-) 'i-
Tel. No.
Capacity: ~__personal Representative
Counsel for personal
representative
I,
I
Date:~(p
LV: llV E l AV~I 96.
911!1/\ ',II.ii iiltJ
10 ()', I', I I . ~I.IO~10tJ
(MAH:rmf/AM3)
,
I PO"
"
i
!