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' ,I.- '\ :'" ~ \. ~ ~ \ " , ;', ',"';1' :1' , " ", " 111'1 r "/11''' 'I/,j,:" :AII :' "".1 " '/ , ' , . I', ", \, ,(, j , ,,1' II I!, \'1 " It ,I. I , , " ,', i " "I' , I't,,[( ,'1.:,'1: '.\, 't'l, , , " I' ,\ i :,11' t J, ,,'I ')'/ .!' J 1 ,;." '-!, ,I ' , ~"" :"I,i,l.' ", <' ,'f; "-.,' 'I~': l;'r~C I), j' 'I' , " ,/ I.' ,J1 " I' I.rll' ,: ,~ ,ji", " , " " , " , , It, 'J '" ! , I' '.. I,tj I'" " " I', ,". ': " .,' I' ",': ':",1 i<': ,,,t','~>: k, , " ',,'l ~' I" " ,'.1' ,I" I,' ..of. ," i,. ~ ,'" II" \ . ,I. , ,,',I )', ., " ,j,:" I;, I}' '.,1. . "I : ' "1," I"~ ,,".'1' \ It, I ') , :,\1 :'1 ,', '1' :!, '.11: ~' .' ,,' ! . : \ ,I ,.', , 1'" .',' ,11 i I " " .", ; , f' '.. " '.. ~,,~~~,y f)'; ~':j.'l\ ..,1, u.. COMMONWEAllll Of Pftlt-lSYlVAtllf\ OEtAR1MENT Of REVHHJt 0EP1160601 ~IAIlRIS811RJ, P^ 171180601 ="'~.-,,~ 'r,ttiiiiNi'i;,mr.I:AIHlm:-,nllriiIMl\l'""m;q- ffi ~ Cl ------...----- . I!! ~iS :z:~-' U..lll .. 0( Future Interelt Compromlso II0r dale. 01 dealh afte, 12.12.82) [ I 6, Decedenl Died Te.lol" [ I 7, Decedenl Malnlalned a living Tru'l (Auoch <cpy 01 Willi (Ailoch copy 01 'f ,u.l) .__h__ - . u", . "AiCcORRISPONOiNCiANi) 'CO-Nfi'o-ENOiii\L"TAX INFORMATION SHOULDii"iIIlICTID,TOa ~ ~ TI:f;~;.;-;:::~:,--;'~~::::~' --_n'---.--lM~:1:;I~'N:A~;~S~r. PC ~ i mtPllmH ""MBER .- . - 2331 Mnrkut Street ~_~___ I 712..1__ 763-1383 ...n' . Cnmp Hill. PA 17011 I. Real blole ISchod"lo AI ( 1) ..-------. 2, Slock. ond Bond. (Schodulo BI ( 21 ........ .,.----.--.--.- 3, Clo.oly Hold Slocl<iPCIIlno"hl" 1"lnro.1 ISchodulo q 1 3) _____:L.1B1l...U2....---.. ~, Mo'lgogel und Nolo. Roroiv"blo 15ehodulo 01 ( 4) ------.--.--- 5, Cosh, 8ank 001'0.111 & MilCollclneoul Porson,,1 Proporlyl 51 ..___..l....41L4.. 00 ISchedulo E} 6, Jalnlly Ownod P,oporlY ISchoelule II 7, T ran.lors (Scredulo GllSchoelulo II 8. 1'0101 Groll AlIol. 1101olllno. 1.71 9, funoral ~xpon.e., Aelmlnl.lr"live Co.lI, Mhcollan.au. ( 91 __._:!.,.4W 00 Expen." ISchudulo HI 10, Dobl., MorlgClge liohllllin., lio" (Seheelulo Ii (10) 5 R 1..illl II. Towl Doduclian. (IOlnllino. 9 & 101 12, Nol Valuo 01 E.IClle (II no 0 minulllno 111 13, Charlloblo and GovornrnllnlClI (\1)'1lI0,I\ ISchodulo Jl ____ 14,_ ~lo'_'{<>l:'o _~u~ioella T u' .1"11012 mlnul Un." '_~L_n_.__. \ !IV.llOO 1". IlI.YII ' . .,. ..,. c l ~I .;;;' 0(, ,,, if fO. DAtil O' DIATH Ani. 12/31/91 CHICK HE" . A lPOUIAL POVI.TY C.IDIT II CLAIMID 0 .-.-. .ILI NUM.I. /;,/ COUNTY CODf roDEN1'S COMPLilE AoolnS.--- INliE:RITANCE TAX RETURN RESIDENT DECEDENT (TO BE FILED IN DUPLICATE WITH REGISTER OF WILLS) Cf '-/ YEI\~ .30$ NUMBER Kitchen, Richnrd L. 5o"ciAl- SfCURII'l' tlUMUER 31,49 Walnut Street rAfC6fBlRlf'---- Cnolp IIi 11, PA 17011 . 06_/3~/I,~_ (~~'L Cumb'!..tJ.~t!.______--- SlIpplomenlol Rolurn [J 3, Romalnder Relurn (lor dole. 01 deolh prior 10 12.13.02) [) 5. federol E.lole Tox R,turn Required _ 8, Tolal Number 01 SClle Oepa.1I80,e. 198-34-7914 \D^H Of OEATH 12/28/93 [ I 2, I I ~u, Ixh [I d, Orlglnul Rohllll Unlll.d E.lolo z o ~ E ~ '" ( 61._______.____ ( 7) .._ 4,832.02 ( 8) (151___.J.9L.Q? (11)_- 401,1.00 -..-- (12) .19.1.D2..-----.. (131 __--un (14) _--7.9L.02..---n K ,06.. __---a.7...l.6----m-- z o ~ !5 .. " 8 ~ ... 15. Amount of line 14 toxoblo ul 6% f(110 Ilnclud. volue. from Schorlulo K a, Schorlulo M,I 16. Amount ('Illino \.1 ltlXllblo Cll lS% rolo (Indud. volue. Iro,o Sehoduln K or Sehorllllo M,) 17, Prlnclpollo, dllo IAeld IUdrom lino 15 unellronlllno 16.) 10, Crodits SpouH,1 p<'....orly Crodit Prior POYlllonls (18) ._________ (19) .- .-----_.- 47,46 120) ..-----.-..-.- (20A) _._____..._____ (200) __.______. --- .K ,15.. --------.----..-...-.... (16) (17) ____________._ DllCaunl Inlere.1 .1 + -.---- 19, II Ii no IB I. gro,,'or Ih'>II lillo 17, nn!>H Iho dillo,ollco on line 19. Thll I. Ihe OVERPAYMENT, 1I1.I~rP.fr.IJ:.r.lfIm,.lII;~1,1111111~iLJmmn...,,1TI..~Ttlpll...'..mlldl 20, IIl1n. 17 I. gro"lo' Ih"n Iln. 10, nnlor Iho dilloronco on line 20, Thl. II Iho TAX DUE, A. Enlsf Iho InIOlo" cmlho holClIlUl dllU on line 20A. o. Enlor 11,0 101,,1 nlll1lO 20 ",,,110A on IIno 200. Thl. II th. BALANCE DUE, Make C:heck Puyahlo 10' Rool.lo, 0' Will., A9..~I_ ___'.'___' un.. BE SURE TO ANSWER. ALL QUESTIONS ON REVERSI SIDI AND TO RICHICK MATH". ~;p~~~ill.~'-~rl~~;r-i~';y~-TcI~-d~;(,-,i;~;.l'h~lvo tl~(1min;I;I'lili\ r(;'I;;'I;,-j;Cf~dlnp accompanying tchedul81 and ,Ialemen", and'to the bes' 01 my knowledgo Clnd G;.T;;i; it i\ 'ruo, corrucl (Inti complnlo. I docl(lll} thul (Ill rlllll tulllln !1m hoon ropnrlo( 111 true markol value, Declaration of preparer olher than the penonal reprosolllnllv(I h b.~~I.~~ on nU ln~&nn.ol ~hich pi firm 11m !lilY ~,nnwl/ldIl'J, . -- -----..---~----------- ~IGN^t\~Rf )f~~1 ""pmlll61 0' f'lIfl(. "'''''' AllI'" " om-u-..-...... .' (.... . . '?~,'i.,.) .L~ - lH/ d/J"/'u:7 52. ~ ,) // ,-,---4/1 ~~.l- /~# l'Ot..I.II.'1 (PRtP^'" Olll~\~'^,~IIVI " ^u"m> ,,v,,,., "n_ --7.,-.-l1r ~7; r..-=-- o'.ff!-~"i' ...'.. ..' .' _u-tnct1!1fI1,'tl 1M pi c);,) ~') Vft r; /?<:# ft1(~!-l!:J,--.CLLtif- ' ! 4M~- _If/;.. ;jZYuP .9.'ll.~ ~ (OMMONWIA\IIt O. P1NNrVlVANIA INHIlIfANCI IAX..l IN IIIIDINI ~ICIDIN ESTATE OF SCHEDULE E CASH, BANK DEPOSITS AND MISCELLANEOUS PERSONAL PROPERTY L PleOIl Prlnl o,r Tl~ FILE NUMBER I ' I I . I I I 1 I I IIY.UOI... II ~11 . RlCllARD, , L...KI.'tCHJI.tL ....... .___...__...... .... _.. q ,.....".._______..,__~...._... tAli prapllly lalnlly,awned with Ihe RIOhl al SUIY"a/lhlp mu,1 be dllda..d an Schedule fJ - I ITEM D NUMBER ESCRIPTlON VALUE AT DATE OF DEATH 1. Dauphin Deposit Bank and Trust Company Checking Account 038341956 $1 , 244 .00 2. Miscellsneous peraonal property, clothing, ot.her small personal effects 200.00 I , ~ , I ., 'II, TOTAL (Alia enler on line 5. RecopllulollonL S 1.444.00 (AUa,h addltlanal ell" X II" ,I..." " mare .pa,e It n..ded,l " " ,I -, ," . . a. To invest and ro-invost the samo and oolloot tho Interost theroon! and to pay ao ho seo~ fit. 'and is nooossary, tho inoomo, and ao w,uoh of the . principal as may be nnoounry, to my nephew, Rioardo Duarte, for hio furthor formal edueotion whon he reaohon the age of enventeen (17) yenra. said in- oome or principal ie to he paid to my nephew, Rioardo Duarto, on a monthly bAsio until he hne oompleted hio formal oduoation. 1 f my nephew, Rionrdo Duarte, does not ohoose to further hio formal eduontion beyond high eohool, I direot that the income from the said Trust Fund shall bo paid to my nephew, Ricardo Duarto, until he reaohes the age of twenty-one years (2l.years), et which time the Trust ahnll terminete ene! the cel'pus thereof, to- gether with any aocrued inoome thereon, be paid to my said nephew, Ricardo Dunrte. 1 further direct that Charleo r.. Duncan, Jr., the aforenamed Truotee, shall not be required to file bond in any capocity in which he may oct. lTF~ 6, ^ll th& rest, residue and remainder of myostats, real, porsonal or mixed, wheroeoever the oame may be situate at' the time of my death, J give, dovise and bequeath to my mothor, Clara L. Kitchen, her heiro and aosigns forever. " ~..J,o-J, ~ (BrAt) ...2-' " .,.... j. : ,.If, , ""4'~' '1",1'1 '" ',\ ',<\"',/. 'f ".hl\: '"., I " i, / 5'"r!~()- I R!YolS47 ex AFP (10093* ClI"HlIHWUlTli Of PfltfSYlVAH1A IlEPARTHEHT Of Rfvt:NUE ILllUlJ Of IND1V100Al TA\CU DfPT. 110601 HARllIIIllRll. PA 17111-0601 NOTICE OF INHE~ITAHCE TAX AP~~AISEHENT, ALLOWANCE O~ OISALLOHANCE OF DEDUCTIONS, AND ASSESSHENT OF TAM ACN 101 (C) I ( ,I. l) I /~ 0(., DAT! 08-29-94 - FILl! NO. DATI! OF DI!ATH 12-28-93 COUNTY CUMBERLAND HOTE. TO INSU~E PROPE~ C~EUIT TD YOUR ACCOUNT, SUBHIT THE UPPER PORTION OF THIS FD~" HITH YOUR TAX PAVHEHT TO THE REGISTER OF HILLS. HAME CHECK PAVABLE TO "REaISTE~ DF HILLS, AaENT" REMIT PAYMENT TOI DAYID W REAGER ESQ REAGER a ALDER 2331 MARKET ST CAMP HILL PA 17011 REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 AlIOUl1t RI"I Uld -l CUT ALONG THIS LINI! ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ REv: i!'47" Bie -Ai: if-flii: m-- iicificni F - "iNti BRIT ANC! -YAir A"ppiiA- i SBifE'iii'"; -Ai.i:ciwAiic! - 'OR -" - --- - -" - - - - - -"- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF KITCHEN RICHARD L FILE NO. 21 94-0365 ACN 101 DATE 08-29-94 TAX RETURN HAS. (X I ACCEPTED AS FILED RESERYATION CONCERNING FUTURE INTEREST " SEE REYERSE APPRAISED YALUE OF RETURN BASED ONI O~IGINAL RETURN 1. Rill Eltltl ISchldull Al 2. Stcckl ond Bondi ISchldull al 5. Clollly Held Stock/Plrtnlrlhlp Intlrllt (Schodull CI 4. Hortalgll/Notl1 R..llvlbll (Schldul1 D) S. Cllh/aonk DlPOlltl/Hllc. Plrlonll Proplrty (Sohldull EI 6. Jointly OWnld Prcplrty (SChldull Fl 7, Tronlflrl (Schedull 01 I. Totol AlIOto ( I CHANaED 1",\.' (1) (2) (SI (41 (SI 161_ (7) .00 .00 3.388.0~ .00 1.444.00 .00 .00 III 4,832.02 APPROYED DI!DUCTIONS ~ND EXEMPTIONSI 9. Funorll E,plnIII/Ad"lnlltrltlvl COlt II Hllclllaneoul E.plnlll ISohldull HI 10. Dlbtl/Hcrtglgl Llobllltlll/Llonl ISchldull I) 11. Totll Dlductlonl 12. Hot Vllul cf TI. Rlturn IS. Chlrltobll/Govlrn"ontll alqulltl (Schldull JI 14. Hot VIluo cf Eltltl SubJIOt to TI. 191 1101_ 3,460,00 581.00 Illl 1121 USI _ 1141 4,041.00 791.02 .00 791.02 If an a.....Mont wa. i..u.d pr.vioU.1Y, lin.. 14, 15 and/or 16 and 17 will r.flect figur.. that includ. the total of ALL roturn. a......d to d.t.. ASSESSMENT OF TAXI --- IS. Aoount of Llnl 14 tl.obll It 6% rltl liS) 16. AlIOUnt of L1nl 14 to.obll It lS% rltl 1161 17, PrinciPII TI. aul TAX CREDITS I PAVHENT DATE NOT! I 791,02X.06" ,DO X.IS " (7) 4~ .00 47.46 RECEIPT H\JI1B~R DISCOUNT 1+) INTER~ST I-I AHOUNT PAID 04-20-94 885981 .00 47.46 TOTAL TAX CREDIT BALANCE OF TAX DUE INT!REST TOTAL DUE 47.46 .00 .00 ,DO · IF PAID AFTE~ DATE INDICATED, SEE REVERSE FD~ CALCULATION Dr- ADDITIONAL INTEREST. ( IF TOTAL OUE IS LESS THAN fl, HO PAVHENT 1S REQUIRED. IF TOTAL CUE IS REFLECTED AS A "CRtDIT" ICRI, YOU HAV BE DUE A REFUND. SEE REVE~SE SIDE DF THIS FDRH FOR INSTRUCTIDNS, I " REIERVATlOth ,E.t.t.. of dIo...,t. ctvlill on or blfor. DKlIINr 12, 1911 ... if MY future lntlr..t In tM ..t.t. 11 trlft.flrred In poI....lon or enJovlent to ell" . (0011Itlrll) btnIflol.rl.. nf the dKiOInt Ift.r the 'Mplratlon of IftY I.t.t, for llf. or for Vllr., thl C~llth hereby IMpr..,lv r...rvI. thl right to ."r.l.. end ,..... trln.f.r InheritinG. TI.I' It the ""ful Cl... . (aoll,terll) nt. on ,"y ruoh future Int.rut. P\JRPOSE Of' NOTICE I To fulfill the requlrHll'\t. Qf SNtlon 21tt0 of thl lnhlrltllKl tnd Eltlt_ TI. Aat, Aot ZZ of 1"1. 7Z P,S. hOUon mo. PAVtEHlI DetlCh thl top partlon of thlt HotlcI end .ubIllt with your PIVllllt to the A.,hter of WUII prlnt~ on the river.. IIcII. .-Mlk. eh<"" or ..... ordor pI.obll 10' REGISTER OF MILLI, ADENT AU PIVM4 t. reQllvlcl .hlll flr.t be ",plied to tny Interl,t which ..v be due with .,,~ r...lnd6r tppllld to thl t".. REFUND (CA)I A reflM of I 101. ortdlt, which 'III not requ..tld on thl Ta. A.turn, IIV be requelted bv oOllPI,tlng In "Appllc.tlon for A.fund of Pennlvlvanll tnherltlnG. Ind E.t.t. TI." (AEV~lJ1J). App1loltlon. .r. IVlllabl. It thl O'flcl of tM Atlltt,r of Willi, IM1V of thl ZS n,vtnUI Olltrlot Offlo.., or by o.Ulng thl ,,,"Ill 2"~hour ""Wlrlng .Irvlel nuablr. for forll orderlngt In Penn,vlvanll 1.'00~S6Z~ZOI0, out. Ida Penn.vlv,"11 and wIthin 10011 Hlrrl.burg .r'l (111) 111-1094, TDOI (111) 172-2252 (Hllrlnt I.,llrld Onlv). OIJECnOHtt Anv perty In Interllt not IIthflld with tho epprah...nt, l110NtnCl or dhlUowtnc. 0' dltduotlon., or .....'""t of t.M ((noludl,. dhc04M\t or Intlrllt) II .hown on thl. HotlUIU.t obJlGt within .lMtv (60J dlv, of rec.lpt of Ihlo Holle. bVl uwrlttln prot"t to the PA Dt9lrtllnt of A.Vlnue, SGlrd of Appt.lt, DEPT. 281021, tltrrhburg, PA 11121-1021, OR ~"Iluotlon to hlv' tht ,.tt,r deter_lnld at audit of IhtI 1000Ult of thl Plrlonal rlPrllentltlv., OR -~."..I to the Drph..,.' ClXJrt. AOIIIN IITRATlYI COlltlI:CTlllItS. FlGtUll ,rror. dl.aovlrld on thl, I.....-.nt ~ld be tddr.,.1d In wrltlnt tal PA OIp,rt-.nt of AIVIOUI, IurelU of Indlvldu.1 TIICI', ATlIIl ;lo.t AIIIII.."t A.vl... Unit, DEPT. 280601, Hlrrhburl, PA 11121.0601 Phone (717) 117-6505. ell ptge S of tne bookl,t "tn.tructlon. far lnhlrltano. TI~ Alturn for I A.,ldlnt Dlcedlntft (REY~1501) for In 'MPllnltlon of ,dllnl.trltlv.lv carrlOtfbl, ,rror.. IN1ERt!IT. If MV tlX due It plld within thrH (5) clllndtr .,th. _fter thl Mldtnt" dMth, . flv. Plro,"t (5~) dllCOUlt of thli tI. plld i, I11QWed. tnt.r..t I. ohlrged bltlnnlnt with fir.t d.v of delinquency, Jr nlnt (9) IOnthl end one (1) dey frOB the dati of duth, to thl dlt. 0' P'VHnt. TlMII which btcMl dll1nqwnt btfare J.nulrV 1, 1.U bur Int.rltt It Uti retl of .he (6~) percent ptr tnfM c,loulatld .t . dellv rltl of .000164. AU tI... wttloh bIG... d111~t on end Ifter JlnUlry 1, 1912 will belr Interllt at . rite which will vtrV frOB ulendlr Vllr to c.llndlr VI" '11th thlt rite ~td by the PA Otp.rt-.nt of A.venue. The eppllclbl. Int.rl.t r,t" for 191Z through 1994 .rll DIICOIIfl. !!!!: Inter..t Mlt. DillY Int.r..t Faot~r :!!!r tnterllt R'.!! Dill. 'ntlr..t FlOtor 1912 20X .OOO~U 1916 lOX .00027\ 19U IU .000151 1917 9X .0002\7 19M IU .000SOl 19""1991 1IX .00OSOI 1911 lSX .000n6 1991 9X .0002\7 1995-19CJ4 7X .000192 --lnterllt I. alloul,ted I' foll~'1 INTEREtT . BALANCE OF TAX UNPAID X NU"IER OF DAYS DELINqUENT X DAILY INTEREST FACTOR ....Ani Hotlo. I..UJd Ifttr thl tlM bloo", allnqu."t .,111 rlUlOt Il"I Interllt o.loulltlon to fif',," (15) dew. beyond the dlt. of the ......IInt. If plvaent I. ,Ide Ift.r thl Int.rl.t oo.put.tlon d.t. lhewn on thl Notlo., Mktltlonlll Intlrllt Wit be ollou1ltld. \ , I I 1'1 " \,';,I'! I , I .. I ' l "I , t. '. p , , I I" I , I ... \ r ..~ ~ ,. ,.. ".,._''''1 ....... ~ ~.......,....,.. ,-~.... " , , \ , \ , " , , ,:, , ,. '. , , " , " I ,. . 1'_' " " , " " " ,-,. .'.'.1 ,I, , I,' ..-'1 ." \. RIV.l~47 IX AFP (12.94* COHHONWEALTH Of PENMlVLYANTA DEPIIITII!NT Of Rt!YENUE IUREAU Of INDIYIDUAL TAXEI DEPT; Zl0601 HAARIIIURG, PA 17111-0601 ACN 101 NOTICE OF INHERITANCE TAX AppRAISEHENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSHENT OF TAK DATIl 09-12-95 FILl NO. DATI OF DIATH 12-28-93 COUilTY CUMBERLAND NOTE I TO INSURE pROPER CREDIT TO YOUR ACCOUNT, SUBHIT THe UppER PORTION OF THIS FORN WITH YOUR TAK pAYHENl TO THE REGISTER OF WILLS, HAKE CHECK pAYABLE TO "REGISTER OF WILLS, AGENT" REMIT PAYMENT TOI " DAVID W REAGER ESQ REAGER a ADLER 2331 MARKET ST CAMP HILL PA 17011 REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 , .t AlIOUIIt R..Uttld -II' Ii :So ..... RITAIN LOWIR PORTION POR YOUR RICORDS ~ , "'~ .~. '(I,' L\'.~::'.~_'_L ,; l...,~i'-"'-'-' . . .....ft............................._ .,.._'~~_......,...._.............. CUT ALONG THIS LINI l.wj~~i"'....".,.,...,.".,.,.- ,-...- -.-,-., ,:" ,.! ,II f\' / . ,".1\ . "I .;\',' . ~ ,; '" , ~,; ,~ " . ' 1 ,', {" I.. " ,I' ,~ r,..;. , 'j .' '-.4 , "I: ' , . ~ ~ I r, ~ ~ ~\, " ' ' 'If I , f .t '. \ j llf. " ) II ' r . j' ~ " 'j,i. ". i "~I ,I ); " ,. '" " " " 'L , " " I , ,. '., " I :' ", " ,j",' ;"j I' I 1\.' "'1 ;1 I! ",.i VI,;: , , . .~, " fl' , , ,. , , .'1, ',1,'1'; , , , , , ' L ,,' ii; 1 'I' , , "-. i' Ii " "....... J~~' . ...',~......__..-.-.......--..-A.J~ 4~J' L"-f-:'\,'" ,) ,-,r." , " -:' " f" '" J, 'h.: (. ' "f.",,' . .1._";-;....~.','.- . l ' ',' 'lr- ", ~,-. -."... ~, i"-" 'i.'''.' '. I , , . ", .1, , I ,I [ I' I I " i \ , I ) i .' 1 1 1 Ii!: 'I'll II,I! ',I. lI,\\! ('IIi' 'it ! ,. "I:" 1':\:' II ," :,'!/ , " I',' ,. ,. " l\~ 'i~ I, I, ~ ~ \ ..... ~ " ,. I ,\ " ,., .1' 'I, '. I , ", " '" 'I N :! , ~ ..,. , ... I ... t.l 0' ,.., '! ~ ... 0 nl ,- ui ~ i Q.C:~ :l~>. I lii8 ~ ~ I' '6'tlVl~ <~tl~ .:.(-' oIS ~ liP= 1il(U~:r i , o.oE... Co , mo",e \ ~~;:)a I ~ ' . ... .., ,.. '~.' .... '-" ., ,.... ~ . ", !:il '....:, 0';, ~J' " I... N ~') ~~\l ,>;1 1-, \" 'ir.1 -'..) 1':' r',,;, .... r&l I 81'1 ~I~ r.. ~ ~I~' i~i ,~'\: 'I" L':i ~;: ,..,I ,~ 'I) ".. '~ (t:: .::r: :r. 'l'!' , r ~ (I ~. i' 'm , , '" l 1:1\". ('; ll,\, '\ I ;1").' "~to t" , ',r' ,. " 1 " ',',,, .. ':"1 ....;.~: :::E' ....;.~: ::;:;' " .:~ 1,1110 'II~) ,\ ' ":I ! ' , ' - = - - - :: = : "":: - - =: - - - - - - - J - = - """ 'I' -:::' ,;,;):.' ,I '~,";:: ' '., 1,1, I, (" I I 'I,: " ,I' . , Il" ,. , " I "~I , , I " , i' " 0, , , , j', , " , .,'1 ,'-' ,. , , , , ,. ,.' l "I' ~ ','.r' . " . ";" \ I ....ll I , ' ", ,. ~, , I' '. I, I' ',' '. ",\,'" ,I' I I " '~,,' b' "',' ',t'&' , ' ! .' '" . . ,'f . I 'I " to,l ,- ,I ',~ . I' ,\ I , 'I~' ~ I' " , \4;' .01 " / " \ " .. '.~ '~""-'::~""',"",..:J~ra ~ _ ~".r""":'" '\ I ,-.. ......"'- , , . - .~ " REAGER & ADLER, PC ATTORNEYS AND COUNSELORS AT LAW 2111 MARKET STREET CAMP Hill, PENNSYLVANIA 11011.4642 711.763.1383 TlLEfAX 717-73011366 THEODOR~ A. ADLER'+ DAVID W, REAGER DEBRA A. DENISON THOMAS O,WILLlAMS SUSAN H, CONfAIR ' '., MONICA D, ZERCHER LORal Alllltanl , 'Alia ad'nlUed 10 D,C. Bar , , " REPLYTO: P,O, BOX 191 ~ARRISBURo. PA 11108.0791 september 18, 1995 , . Camp Hill , ' Register of Wills CUmberland County Courthouse Carlisle, PA 17013 RBI ISTATI O' RIOHARD IITOHIN NO. 21-'4-0365 Dear Sir or Madam: " " Enclosed please find a check in the amount of ,$4,30 representing the interest due to the Department of Revenue for the above-referenced account, ,., " " " 00 , ~ (~ ,Irl "):0 \11 " ,J (., .. " I.. (.. fi. I'" .' d ., !.., ) .{) , , :"'.1 '0 , , " " , ., ,) , (/" '1"1' " , ~r:' ,'-I f'd " (:(1 Thank you for your attention to this matter. ,. Very truly yours, /(j~u (I~ t., ~ {ll?(~ ',' Monica D, Zercher Legal Assistant ,!l" , . ", EnCllollur~ .,. " ,.' '" + Cerllfled al a Civil Trial Specialist by tbe National Board of Trial Advocacy, A Pennsylvania Supreme Court Accredited AKency p,f.., q],fl.:C i/ol, QJrr /-'/ ~/ /I' dol- I) <) REV-1547 IX AFP (12-94* C_AL TN OF PfNNSVLvAHIA DEPARllENI OF REYf:NUE IUREAU OF INDIviDUAL IAKEI DEPI. 211601 IIARIIIIIlJR1l, PA 171/1-0601 / t.j..),e) (; "5 C/ HOT ICE OF INHE~ITAHCE TAM APP~AISEHENT, ALLOWANCE O~ DISALLOWANCE DF DEDUCTIONS AND ASSESSHENT OF TAM ACN 101 DATI 09-12-95 FILl NO. DATI OF DEATH 12-28-93 COUNTY CUMBERLAND HOTE. TO INSU~E P~OPE~ C~EDIT TO VOU~ ACCOUNT, SUIHIT THE UPPE~ PO~TIDN OF THIS FO~H WITH YQU~ TAM PAYHENT TO THE ~EOISTE~ OF WILLS. HAKE CHECK PAYAILE TO "REOISTE~ OF WILLS, AOENT" , REMIT PAYMaNT TOl DAVID W REAGER ESQ REAGER a ADLER 2331 MARKET ST CAMP HILL PA 17011 REGISTER OF ~ILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 [ AlIOUIlt ~..ittod. CUT ALONG THIS LINE .... RETAIN LOIlER PORTION FOR YOUR RECORDS .... iiiv':ii'147-ix""AFP--n'F94Y"NoYici""oF-INHiiiifiiN-ci-'r"A'inipPRA-i8iifEjji'~"AtrOWAifci-o-li-mm_m"".... DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ISTATI OF KITCHEN RICHARD L FILE NO.21 94-0365 ACN 101 DATI 09-12'95 TAM RETURN WAS. I X) ACCEPTED AS FILED I) CHANOED RISIRVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ONI SUPPLEMENTAL RETURN NO. 01 1. Reel E.tete (Schedule Al (1).. 2, Stock. end lond. ISchedule I) (2) S. Cla.ely Held Stock/rertnerlhip Intere.t 16chedule C) IS) 4, Hortse,../Note. Receivable (Schedule D) (4) i. C..h/hnk Depalito/Hhc, Per.anel Prap.rty (Schedule E) Ii) 6. Jointly Owned Property ISchedule F) 16) 7, Tran.fer. (Sahedula 0) 17) I, Tatel Ae.et. .00 1.188.75 .00 .00 .00 .00 .00 II) 1,188,75 APPROVED DEDUCTIONS AND EXEMPTIONS I 9, FUllllre1 E.pen.../Ada, Cc.to/Hhc, E.pen... (Schedule H) (9) 10. Dabt./Hartsese Li.bilitie./Lien. ISchedule I) (10) 11. Tatel Deduction. 12. Net Velue of Te. Return 15. Cheritable/Oavern..ntel leque.t. ISchedule J) 14. Net Velue of E.tata Subjact to Ta. 90.00 .00 Ill) (2) US) (4) Qn no 1,098.75 .00' 1,889.77 If .n a..a....nt W.. 1..u.d pr.v1ou.Iy, 11n.. 14, 15 .nd/or 16, 17 .nd 18 will rl'f'l.llt figur.. th.t 1nclud. thll total o'P ill r.turn. .......d to dat.. ASSESSMENT OF TAXI li. Aaount of Line 14 at Spou.al rate Ili) 16. Aaount of Line 14 te.able at Lineal/Cla.. A rate (16) 17. Aaount of Lin. 14 ta.abl. at Call.t.r.l/Cl... I r.t. (17) 1" Principal Tax Due TAX CRIDITSl PAYHENT DATE 04-20'94 07-05-95 NOTlI .00. .00. 1, 8S9 . 77 .,06. .00.,15. Ill) .00 113,38 .00 113.38 RECEIPT HUHIER XA885981 AA047964 DISCOUNT INTEREST 1+) 1-) .00 4.22- AHOUNT PAID 47.46 65.92 INTEREST IS CHARGED FROM 07-06-95 TO 09-20-95 AT THE RATES AI'PLICARLE AS OUTLINED ON TIlE REVERSE SIDE OF THIS FORM TOTAL TAX CREDIT BALANCE OF TAX DUE INTlREST TOTAL DUE 109.16 4.22 .08 4.30 . IF PAID AFTE~ DATE INDICATED, SEE REVERSE FO~ CALCULATION DF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN 11, NO PAVHENT IS REquI~ED. IF TOTAL DUE IS REFLECTED AS A "~~EDIT" IC~), YOU KAV BE DUE A REFUND. SEE ~EvERSE SIDE DF THIS FORK FOR XNST~UCTIOHS.) 1;1 .\ \0 1,_." :. .:( ;"1, ' /.'\ r1 ~. ,., " '('1 ~,n " ",(' 0': '. 1'1 ;,J, .1) !", 00 RESERVATION I Eltlt.. of aclNntl dying on or before OloHbtr 12, 1982 ..... if InV futurl lntlr..t In the I.tlte 11 trln.f.rrld In pOlllldon or InJov,ant to Cll1, B (colllt1rIU blnlflollrl.. of the ac.dlnt .ft.r thellCplrlUon of IIW IItltl for l1fl or for YI.r., the C~llth h.rebY .xpr..IIY r...rve. the right to IPprlll. and 1'11" tran.f.r InheritInG, TIXI. It the l...ful el... B (coUltlrlU rlt. on MV IUCh future Intarut. ~Ellf' NOTICE I To fulfill thl r~lrl..ntl 0' Slctlon 2140 of the Inhtrltanol and Ettatl Tax Act, Aot Z2 of 1991. 12 P.S. Slctlon 2140. PAYHEHTI Detach the top porUon of thh NotlcI and .ubtlt with your PIYlHW'lt to thtl Atglttlr of NUll prlntld on the rtVlr.. IleM. ........ _ or 0001, ordor p..obl. 101 REGISTER OF NULS, AGENT All plyWII\h rlltO.lvtd 'hall flr.t b. applJld to Ifty Jnttrllt whtch IIY be eN. with MY r...lndtr IppHId to thtt tlUl, REFUND (tR) I A rlfund of I tlX crtdit, which wal not r~lttd on the Tax Atblrn, .ay ba rlque.ted by totIpllUng In "AppHcIUon for Alf\Wld of PennlYlvantl InhtrlhuclI and Eltltl Tax" (REY~13a), AppllcIUonl Irl avallabl. at thl OffiCI of the ROIhtlr of Wllh, any of the 2S R.vtoot Dhtrlct OffiCI', or by calling tM 'Plctll Z4-hour an'Wlrlng ..rvlc. OUIbtr. for foral ordtrlngl In Penn'Ylvanla 1-800-36Z-Z0S0, out'lde Penn'Ylvant. end within 100.1 Herrllburg ar'l (717) 717-8094, TOO. (11) nz-zzsz CHelring I.alr'd Only). OBJECTlONSI Any p.rty In Inttrut not IIthfted with the IIf:lf'rahtHnt, allowanc. or dlllllowanoe of dtduotlon., or ........"t of tax (Including dhc:~t or Jnttrut) .. lho... on thll Hotlc. lU.t obJ.ot within ,hctv (60) dlvl of rtc.lpt of thll Hotlc:. bYl uNrlthn protllt to the PA Oeplrtllnt of R.VIflUl, 10lrd of Appuh, D.pt. 2110Z1, Harrisburg, PA 171211-10ZI, OR Ullectlon to haVI the .aUe,. deter.in.d at IUdlt of the; account of thl ptr.onal rlprll.ntIUv., OR ~.IPPI.I to the Orphan., Court. ADltIN ISTRATlYE CORRt!CTlONS I Factull .rrorl dllcov.rld un thll au.....nt .hould bI addr....d In writing tOI PA Dlpartnnt of RIVIftUI, Bureau of Individual T8xu, ATTNI Po.t A........,t Review Unit, Dept, 280601, Hard.burg, PA 1712a~0601 Phonl (717) 7.,.6505, S.. Pili S of the bocHl;lIt "In.trucHon. for IF\h.rltenc. Tlx Alturn for. Rllldtnt Deotdlnt" (REV-ISO!) for 10 .xplanatlon of adllnl.trltlvllv correotabll Irrorl. OISCOUNT I INTERUT, If eny telC eN. 11 p.ld within three (l) eeltnd1r IIOnthl aft.r the deCtdlnt'l delth, a fl.... p.rcent U:O dhcount of the talt plld 11 aUOMId, Int.rllt I. chlroed begtnnlng with ftrlt day of dellnquencv, or nlnl (9) eonth. end one (1) dey frol thl d.t. of ..th, to thl dati of p.vant. TIMU which btc.. Otllnquent blfor. Jlf'lUlrv I, 19IZ bur Inttrllt It thl rlt. of .Ix (6~) plrcent plr ~ cllculat,d It a d.lly rltl of ,QOOI64, All tax.. Nhlch bIo... delinquent on end Ifter January 1, 198Z Mill bear Intlrl.t at . rlt. whtch will vary froe calendar Yllr to caltndlr Y.lr with th.t r.tl announced by the PA Dtplrtttnt of Alv.nue. The appllcebla Int.rl.t rata. for 198Z through 1995 arll '!m Int.rut Ratl Olllv Inter..t rector !!!r Int.rut Rate OallY Intlra.t Flotor 1912 20~ ,00ml 1917 9~ .000247 1915 16~ ,000451 1911-1991 III ,000501 19" IlX .000501 1992 9~ .000247 1915 U~ ,000556 1995-1994 r~ .000192 1916 IO~ .000274 1995 9~ .000247 ..tntlrllt II calculltld a. followlI INTEREST . BALANCE OF TAX UNPAID X NUnSER OF DAYS DELINQUENT X DAILY INTEREST FACTOR --Any HotlcI luUId .fttr the tax bllCoa.. d.lInquent NI11 rafllct en Jntlrut calculltlon to ,lft.tN1 nS) dlV' baVond thl dati of thl a.....nnt. If PIYHflt l'ladt aft.r the Inttrut coltpUtatlon date .hown on thl NotlcI, tddltlonll Inttrllt MIlt be calculated, "I" ., I , I ( : I' PAYIlENII oCr r~ .:, ", '\11 '.,1 "Ij-" '" .~ 'I I" DltlOh thl top portJon o' thlt MotJCI tnd .ubelt with vour PIVIMf't llde PIVWlll to thl n_ tnd Mdrt.. printed on the rlVlrlt .Ide, If Rt:IlDENT DECEMNT .... chock or IICMY ardor PIY..,I. tOI ~EQISTE~ OF WILLS I AQENT. If NUN'RESIDENT DECEMNT ..... choek or IICMY ardor PIY..,l. tal COHllONWEALTH OF PEHHSVLVAHIA. All PIVNi1te reollvld lhall be .,pUtd flrlt to any Intlrllt which ny bl duI with any rHllndlr IPPUtd to the tiM, REFUND (CA)I A rlfund of I tlM credit, which w.. not r'qullted on thl TIM A.tur", ~.y bl rlqu..ted by co.pl.tlnt In "AppllcIUon far Rlfund of Ptnnlylvenll Jnhtrltanc. and E,hte T.x" (I~EY-UlSJ, AppllcIUonl Irl IVIUtbll It the Offlc. of thl A..hter o' '11111, eny of thl 2S RIYInUI Dhtrlot OfficII or fro. ttMI Dlplrh.l"t', Z4~hour an'Nlrlng ..rvlc. ~rl for 'or.. orderl"'t In Ptnn.vlvlnl. 1-100-162-2050, outllde Penn'Ylvenl1 end within IOCI.I H.rrltburg erll (7171 111-aO", TOOt Ul1) 172-2252 (H..rlng llpllr'd only), RfPLV TO, DIICOUIlTI INTEREST I Oue.tlonl r"lrdlng .rrorl cont'lned on thll notice .hould bI Iddrl..1d tOt PA DIp.rt.."t of RIVenue, lur.eu of IncUvldutll Tlx.., AllNI POlt AII'II""\ R.vJ... Unit, Dlpt. 2'0601, Hlrrhburg, PA 1112"0601, phoN (717) 717'6Sn. If any tile due I. p.ld within thrH (SJ clllnder IIOnth. .fhr the r1l<ledent'. dflth, I flv. PIrClnt U:O dlte04A1t of thl tex Plld It IUowd. Intlr...t 11 ehargtd beginning vlth first dlv of deUl\qUInOY, or nlng (9) IIOI1thl and OM (1) dly frOll the d.t. 0' dtlth, to thl dlt. of PIV.."t. TIM" which beo... delinquent blfor. Janulr~ I, 1982 bllr Intlr..t at thl rlt. 0' ,1M (6X) perclnt per IMUIl c.leullttd .t . dllh rlt. of .000164, All tlMII which bee... dlllnquent on end .fter Jenulrv 1, 1911 viii bI.r Int.r..t at a r.t. vhlch vtll y.ry fr~ clltndlr y..r to Cllendar v..r vlth thlt rlt. InnOUnCId by thl PA c.p.rt.."t of RIYInUI, The Ippllclblt Int.rl.t rat.. for 1932 through 1995 Irl' V..r Int.r..t Rite DII!v Int.r..t Factor V..r Interllt Rat. D.UV Inter..t Fletor 1911 /Il .000541 1911 91 .000147 1911 161 .000411 I9Ia-l" I III .unol 1914 III .ooom 1"1 91 .000/47 \911 III ,0001S6 1 "Jo1994 71 .00019/ 1916 101 ,000174 1"1 91 .000147 "-Int.r..t I' c.lcullt.d .t follow'l INTEREST . SALANCE OF TAK UNPAID K NUNSElI OF DAYS DELIHQUENT X DAILY INTEREST FACTDR .~AnY Notlc. IlIued .fter the tn bKotMI' dllInClUtRt .,UI refleot an Inter..t a.loul.t1on to fift"" US) dlv, bevond the d.t. 0' the ........"t, If p.~t I. ,Ida .ftlr thl Int.r..t coaputatlon date lhown on thl Notlet, tcktltlan.l Interllt au.t be a.lcul.tld. / Y.;;OC'..1 C\'J~'~ INHERITANCE TAX RETURN ~\1II~ RESIDENT DECEDENT COMMONWEAl1HOfPlNNlYIVANIA (TO BE FILED IN DUPLICATE UEPARTMENT m IEVENUE IlAIRI5fJ/c\. ~~onb'.0601 WITH REGISTER OF WILLS) COUNTY CODE ormfN'I"S NAME IIAII. mIl. ANU MIOiilf'iNIlIAII . ImDlNrirtOMPlEl[ A15nIDr Kitchen. Richard I.. 3449 Walnut Street lOO;~S~~U;~: ;~~':C'-----' -'IUIA~I/::;~';' '-ID~t6~'31~;i;.:"-- c.,,~am~lI:~~~ ~a;~ 170 II . .__.__.. ....____..____. ...__,._,____._..____"..__._.__ ._.L..,,___.__. [I L Original Relurn 11\ 2. Supplomonlol Rolurn [I 3, LI 4, llmllod Ellole [] 40, fuluro Inloroll Comprolnllo In] 5, Ifor dolol of dOOlh ohor 12.12.B21 1.1 6, Docedenl Dlod TOllolo L I 7, Docodonl Molnlolnod 0 ll,lng Trull IAlloch copy of Will) (AUoch copy 01 Trull) ALL CORRlSPONDINCE AND CONfiDENTIAL TAX INfORMATION SHOULD BE DIRSCTID TOI 'NAME .. OM I MA I N AD IEII ,'f r-8't.-c. {L ' V(}V-' IEV.Il00 EX+ 112,111 fiLl NUMIIR + 19, II lino IB II groolor Ihan lino 17, enlor Iho dllloronco on lino 19. Thlllllho OVERPAYMENT. aD 20, II Ilno 17 II groalor Ihon lino IB, onlor Iho dlfforonco on lino 20, ThllII Iho TAX DUE. (201 . A. Enlor Ihe Inloro" an Iho bolonco duo on Ilno 20A, 120AI B. Enlor Iho 10101 ollino 20 and 20A on Ilno 20B, Thh II Iho BALANCE DUE. 120B) ,65,,92 . ....... Mak. C.h.ck ~".yabl.'''.!..R!~I.ltr a' WUI~, Al!"".... ._......_ .. . .BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND TO RECHECK MATH.. ' U~dor pon(ljiio~~fporjury, id~~I~;~-ha...~_;;;minod..'hl;_;;lu-;r;,'n-~I~dml,-rn~~rClnyin9 $Chocl~l;~-ond--;ln~monl', o';J1olho~j;y knowledgo andb;~~ II It true. corroel and complolo 1 doclmo Ihol all renl oUolo hm boon roporlee 01 Iruo markol valuo, Declcuollon of propmer olllor than Iho porlonal tepunenlallvo il bmed on 011 ir,formollon 01 whleh propuror hm any knowlodgo ~ IIGN~~UHI~' ~;-ih~I;rll"J;~U"N (AO~'y r / //,1 ~r".tU I. 1~~LIl 1~ P"'jI7,,,/AlI i . '(~':"-"" !i~N u,rcin.~,p,iRER OffeR flf&;mlM-r.'lvr~AOORl!r~ ~.~~-- n'-<"--"FfJf!~~h. ".il. O'''I!- ..L..L__ .~....Jl..LI}.!_'_,-_~:~_.':i (L (( 'l Z :-";L..L((( JJ.!...:-.i!..j.[LL!L~ etlL.[J_ ..II ~ !7t~ l!! ~~B 1500 ..... ...~ ... c( 21-94-0365 YEAR NUMBER ~ ~ o __8. Remalndor Return Ifor dol II of d,olh prior 10 12.13.821 fedora I Ellole Tax Rolurn Required Tolal Numbor of Sol, Dopalll Box.. ~~ =0 0% u2 m(~~~fZU~iR.~!l.!!~!i-~9.lI-~.r.~--..------- Renger & Adler. P.C. 2331 Market Street Camp Hill. PA 17011 717 _L...J 763-IJ83 z o ~ ! .. L R.al E1lale (Schedule AI ( 1) ,. __.~_. .n_.._.___ 2, Slack! and BondI (Schodulo B) ( 21 1., 1/Hl.cZ?__.. ..pO .; \ 3. ClolOly Held Slock/Parlne"hlp InlorolllSch,dul, CJ I 31._._...._......_____.: 4. Mortgages and Noles Receivable (Schedule D) ( A) ..______.____,' f:-. (U- S, COlh, Bank Depo.1I1 & Mlleolloneoul Po"onal Proporlyl 5) "....----.-.-.- I ISch,dule EI U I 6, Jointly Ownod Proporly ISch,dulo fl I 6) ...----.-.~--...- . :1 7. Transfe" (Schedule GJ (Schedulo LI ( 7) " ! "J . 8. T alai Grall A"ell Ilolollln.. 1-7) :,., , ( B) _ i".\ 9. funoral Expen..., Admlnlllrall.. Call., Mlleolloneoul I 9) ..__._lCLJlJ!___._ Expenlll ISchodulo H) 10. Debll, Morlgage liablllll.., ll.n. ISchedulo II II. T olal Doducllo", (Iolalllnol 9 & 10) 12, Nel Valu. a' Ellolelllne 8 mlnu.llne II) 13, Charlloble and Go,ornmonlal Boqu..lI 15chodulo J) 14. Nel Value Su.bleclla Tax IIIn',12 mlnulllno 13) 15. Amounl of line 141axable 016% ralo (Indud. ,olu.. from Schedule K or Sch.dulo M,) 16, Amounl of line 14 laxable 01 15% role Ilndud. valu.. from Schedule K or Schedulo M,) 17. Principal lax ~uelAdd lax from Ilno IS and from line 16.) 18, Crodlll Prior Paymonll Dlrcounl 90.QO , \(> l.11 . :U ,T)III ~ ) , ' 1.188.75 (10) (11) (12) (13) __._ ___ ( 14) _ ...!.. 098., 7 ~ (15) ____.!..Q2Jl_..li__x .06" ____MJl2__ (16) __.x.15- z o ~ !; ... ~ u ~ (17) _.....u..Ji..2L_ Inlounl (1 B) ...u.__............__..._....u,...._.. (191 .. _p__.m.__. ,._...._. Cllocl. 11010 if you cuo requo\,ing n rofund 01 your OIlOlpClVmIJnl. 65,92 ,It ..t.....un Il't 17011' ~j~ COMMONWfALlH 01 PlNNlYLVANIA INHIRIIANCf TAX mURN IUIOfNIOfCIOINT ESTATE Of Kitchen. Richard L. ITEM NUMBER A. Pun.ral Exp.nl.11 1. B. 1. 2. 3. 4. C. 1. 2, 3. 4. 5, 6. 7. 9. SCHEDULE H FUNERAL EXPENSES, ADMINISTRATIVE COSTS AND MISCELLANEOUS EXPENSES " , ._..~...... PI. 01. Prlnl or TVp. 21-94-0365 DESCRIPTION Admlnl'Irallv. COIIII Pellonol R.prtlentallve Commllllonl Social Security Number 01 Perlonal Reprtlentatlvtl Year Com million, paid AlIorney Fell Reager & Adler, P.C. - preparation of supplemental return only Famtly [xemptlon Claimant Relatlonlhlp Addrell of Claimant at decedenl', dealh Slreet Add,," City Probate FeOI Mlle.llan,oul Exp.nl.11 Inventory Filing fee for return' Stale _--:... Zip Code TOTAL (Alia onler on line 9, Recapitulatlonl $ (If mort Ipaee II need.d, Inltrl addltlonallhlt" of lam. 1111.) AMOUNT 65.00 10.00 15.00 90.00 COMMONWEALTH OF I'ENNSYLVANIA I. COUNTY OF CUMBERLAND J HI .'-- ---..-_}J:JL~F" '_I' .-~]~--_J.LC/)_"__1~__ b,'ng duly - '"1" 1..:-'------_ according 10 law, depolll and saYI ,th.t>h. _ ((" -XLllJ.~LCiIJ'3-r~-,-.(__._.___._...__.. of the Eltata of f, "/,.:,' I. ( , " lat. of --- ....,1/1: /) !" /, .. - - '... ... '-..._._.~_, Cumberl.nd County, P." d.o....d .nd thlt th, Ilhll I t db .j"I/,I"!'" /, /i"j ,'.i' th..,d rl,'II"'/II/(/'/~ w n I an nven ory ma e y ...- -.~.- -.c...-+..__,________m _.-' _. ., a , _' _. of tha entire '1Iat. of said deoedent, consisting of all the personal propdrty and r..l est at., .xo.pt r..1 estat. outsld. the Commonwealth of Pennsylvania, and Ihat the figures opposlt. each lI.m of the Inv.ntory r.present It's fair v.lue as of the date of decedont's dealh. i/I' I ,L . /' ( /-,r /r" /1 --- "--- II '-X/If', II end subscribed before me, \/;1 IlL l) 1:k:f-tJ NoI4!rlaISf'iHl J <:I101yl A, Clloldlno, NolDry Publlc Gamp HII~ Ooro, C;umLorlnlld GO\Illl\' \' Commission e.p11C3 July 20,1998 ~iiJU., ~t'MS\'NaIritl ksol~on 0i'MJ'" ,} Date of D..th ______:::::,.,1' D.y /. 192:.L- llt(1'2d(''//11. Addr... l.J .,- -) ') ') v.., Month INSTRUCTIONS I. An Inventory must b. flied within three mOllths after eppolntm.nt of perlon.1 r'present.tlvo. 2. A lupplement Inventory must bo filed withIn thIrty days of discovery of .ddltlon.1 'lIeh. 3. Addltlonalsheels may be etteoh.d as 10 pellona/ty or reelty 4. S.e Article IV, FiduciarIes Act of 1949. ~ I!! 1 ~ e ~ g G ~ f e w Cl C' ;!: oc: Q. .... U. ~ Q. I z u. .... ~ 0 ~ W 0 ~ oc: t > z o Q ~ - In ~ (3 ~ "" "II a ... e 1: 0 J '1 ... G e J ... /J j d it