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'.- ,,"',!-, "',".. ,,': '" ".'..A;.I)Mo.M-............___~.t...,..Iwt"MWw~M1Il_~V'tWlJrt1(Mf-~~.~I' 'I . , 1 " , ' l~l~L.~,.i_.~..... I. If l'" " \I ", I, -L ,\ "(1.1 " " ,I ,', Ri,V"rlod.OltldJ 01 'I:"" . .,\1 Wills I, " , " , , ,. , " JUN 2B ,I"~ (I " 1,.\ l:,' '95 " " OI~;I':' I Curnl)\;' I ,i ill r, I".' .\It I' ,r.'(, , " .:I'i",IJ/I'.' ,. ".,-',,' , " I!"~ I, 1>' " 'd " 'i ; ,i [", " " "I' , , " ii, '~"_":'_"_'."-:"rl_"_j'_""'\"I"I"" f'!1<lJ<'I9fIl.1~-I'Wil''''''~I~~-'':'';'h-:''''''''''''''''''-~'f'''' , 'iitr"l!l....,::.::;wr.~-.-... ;il , " 'tli.Il", , ' , ""'rT: \ -,.-: I ~ {h~" ' I 'f' ' ' I'" , j" I I, . "11 \' 'II """ ':' ,,' , ", I" "', "Ill!'" ~ij I, , ,:' " " ,:':' '.'! {~: ,it \iil I, \\ 'I" !" ",,' "' ','" I:"~ I', ". ~j,~' , " , ~'rd ,. i' I ir ,'t., ~. " '1 ' ," ',' "\", ",r " i ' J" . ; ~ \ _,A -''''I'' . : 'I, " ,I ','l" f ",I. ~ ," ,,"" "",',!: ":'~,'.'t':1 :""j" >.< "I /, 101 j. I" j If" f- '" "I I' ..;' .! ,~, /, II "F. ,. 'I. .J; ,'~ \' ~ ", , ,I: " (" , ,. " ", ' :". 1/,1' '" '" " , " .-,' f " ,', " , , I' ,J ,,_1., \' ", " , , , I," 'i' , ., " " '. j'i" I, .( ,d .m'_'", ",i,' '.. 'I I',. f '.~'f"" "1,~.:: ,~ ..,....... . ."R. :;r."", ~.i"i -"'/1 '~I' -"~..~j7,~"-'-:--~.- ",'). ~!b" \ II I' "!"jC '.,p' 'I" , ,,,Jdl,\'.T'ifdl ............ .. ..,,-..-- , m""4 ~- 4tlU , " . ,J .. ! " , " ';, " , t.'...... '\ ,.' '\ I I, I,,' I' ! ~ I, " , . . ( It f, Ji , V' I , ,J PETITION I,'OR PROBATE and GRANT 01<' LETTERS t.:llalc of -.-mIfIfIlt Il_J,t1'!:!!'.J?_____u No, ,__..d21::-:._CJ Jt~__to I,;)..J IIl.m kl/owl/ 11.1 __,__, ___+,___.. .,..._____...__..______.m To: . m_...____._ Rcglstcr of Wills I~'r I~C -=---===_-_-=:::~._:...-..I-...- .....----, f)c('cu.I('d, COUlllY of _ C MB RLAND III thc SOc/1I1 Se('l/rill' No, ._.._..._7L_-"Lt.,.._=--'U:::!:1.~ Commollwculth of I'cullsylvunlu Thc pctltlon of Ihc ulldcrslgllcd rcspcctfully rcprcscllts Ihut: Your pClltloucr(s), who Is/urc IR ycars of ugc pr oldcr ullthc CXCCUI.,!2~____ nUll1cd luthc lust will olthc ahol'c dcccdcnt, (1I1I1'd __.___"-'<:'''_'i.,_2__L'?~__________, 19_ uud codlcll(s) dutcd _+._____________+___..__________. (~liIlC rl:1C\'1l1l1 drl.:\I/Il~IlIllCC~t c,~, rCllulldnlioll, denlh (If ~'.,(cclllnr, CII.:.) Dcccndcnt wus domlcilcd ut dcuth In _~v '''./..E>t' '-II IV 1)___ COllnty, I'cnnsylvunlu, with h~_ lust fumlly or prlncipul rcsldcncc ut _'Z...'1..Q..'/_i1tti'!:L1LL....s.l:..c._____ -..c.#V..--f-Il-!:-'='--r-/~fj-----.-----. (Ii'll meCl, Illllllhl'r lIlld 1I111I1dpalll~'1 Dccendcnt, thCII-.--l7-1 ,years of ur\tcd _,_J....f..y____ b ut________.._~_~.L '.'--. _ ._______ Exccpt as follows, deccdclII did 1I0tmurry, wus not dlvorccd IIl1d did 1I0t huve u child born or adoplcd uftcr cxecutioll of thc will offercd for probutc; was not the victim of II killing IInd WIIS ncvcr adjudlcatcd Incompetcnt: __...________.______....___.______________ Decendr.nt lit death owncd propcrty with cstimatcd vulues as follows: (If domlcilcd in I'a,) All pcrsonul propcrty (If 1I0t domlcilcd in I'a,) I'crsollul property iu I'cnnsyll'ullill (If 1I0t domiciled in I'u,) I'crsollul propcrty in Coullty Vulue of rCIII estlltc ill Pcnllsylvuniu sltuuted us follows: ________. 9- , 1 92.Y._, u;v tf"....o..;"j $ $ $ $ 111"-'-"'''- WHEREFORE, pctltloner(s) respectfully requc"J(~l thc p,tpbutc of the lust will and codlcll(s) prcscntcd hcrcwlth und till' grunt of ICllcrs TESTAMEN I ARY theron, (tC'ilal11cllllHY; lIdminlslrllliUlIl',t,ll.: lldl11lnl~lrntlol\ d,b,n,e,I,8,) ~ 5 '0- 6" ",'6" c "0,9 ~'il "'.. ll'~ ~ 0 ! Iii , ")~7&J,o' )t, _ cdv 11- '1t;r:-- _~ 1./ v ,-\- OATH 01<' PERSONAL REPRESENTATIVE COMMONWEAL.TH OJII)I<:NNSYLV ANIA } sa COUNT\' OF CUMBERLAND The pctltloncr(s) nhovc.nul11cd swcur(s) or ufflrm(s) thlltthe stulelllcnts In thc forcgolng pctltlon arc trnc unu corrcclto thc hcst of thc knowlcdgc unu bellcf of pctltioner(s) unu thutus pcrsonal rcprcscn. tutlvc(s) of the IIhove deccdcnt petltloncr(s) will wcllllnd trllly IIdmlnlstcr the cstatc according to law, Swmn to ,~r lIf1nnl.Cd..,And sllhsclihed t ..ti_'21..,lli~ .-J. <I,>:;""'I1:Z!a ~ helorc l11e tl~IS 13tH ellllY ell ,;0' 'IP, - JUL Y -- --- - 94 . h___ ----.. " ~tMf;;'tQ~i,.~~:(4~~~~!'f I }$=.- ----- ! IIJ - C)~ 3 - I othorwiso, shall bo paid out of the principal of my residuary estate. as a part of the expenso of the admlnistrution of my ostate. ITBM IV: 1 allthorize und empewer my personal ropresentive und/or saill Trustoo to compromiso, udjllst, relouso and dischargo , . In such mannoI' us my personal roprosontativo may deom proper, all debts and claims owod by or to me 01' my Estato; to soIl, lease or exchl1'1go ut publil.: e'f pd vate sulo of In such munner, at such pril.:es, and upon such terms of credit or otherwl se, as my personal represontative of suld Truutee may doom propor, ull or any purt of my property, reul or personal; to oxcuto, ucknowledge und deliver instruments of convoyance, including deeds in fee simple; to borrow money for the purpose of puying estate, inheritance or other taxes which aro required to be puid to secure any such loan by pledge or mortgage, of all or any part of my property and to ex cute the necessary instruments to curry out such powers; to distribute my estate in kind or purtly in money or partiy in killd, and to 'determin", the fair value lit which any property so distributed in kind shall be received by the distributees; to conduct any business in which I have an interest at the time of my decease, for such period as my personul representutive may deem proper, powor to borrow money and pledge ussets of tho business and the power to do all other acts that I, in my lifetime could havo done, to delegate such power to any partner, managor or employoCJ without liabi li ty for any loss occurring thorein and to orgunizo a corporation to carryon said business as capital to such corporation and accept stock in the corporation in 1 ieu thereof and hold such stock for the uses of this my Will, and to voto sald stock er soil the same , as to my porsonal rosprosentativo may soom bosti to 'rotain all stocks, assots, bonds and invostmonts owned by me without being confined to what is knolm as legal investments; to execute any eptions to purchase, te apply for stocks, bonds or other investments, to purchase or othenvi se acquire' real estato and to oxecuto tho sarno powers thoreover as hereinbefore provided, to retain indofinitely any part of my assets, renl or personal, which is or may become unproductivo or to make sale theroofi to pay carryi ngcharges and expenses of the property (Jut of other principal or income of my estate; to invest and reinvest in all forms of property lvi thout rostrict ion to investments autbori zod for Pennsylvania fiduciaries, as they deem proper, without regard to the principle of diversification or risk; to excerlse any law-given option to troat, administrative expenses either as income tax or as estato tax deductions, without regard to whether the oxpensos were paid from principal or income. 1110 powers hereia conferred shall be te my named personal representative and sllid Trustee and all successors thereto and shall be in addition and not in limitation of other pO\~ers con ferred on said fiduciaries. Any and all payment of payments of any sum or sums whether in cash or in kind and whether for princi pal or income. payable te any beneflciary sha 11 be made upon the solo roceipt of the respective benofJ ciary to whom the paymont is mado, and freo from anticipation, alienation, assignment, attachment, and pledgo and freo from control by the crecli tors of any such beneficiary, All shares of princ! pal and income heroby given shall bo freo from anticipation, assignment, plodgo or obi i.gatlon of tho benef.lciarios " .. e.. I CERTIFICATION OF NOTICE UNDER RULE 5.6(a) Name of Decedent I !1J/JIC n/11 J, ;.}\"(' I ) , Date of Deathl -Iv. L.y (" 19 'i1 Will No. 1 'lei ~ CJ(l &./2- Admin. No. '2.i -'}l( To the Register! " I, t, VII .. " ___4 I certify that notice of beneficial Intoront ruqulred hy Rule 5.6(a) of the Orphans' Court 'Hules waR HIH.'voll on Ol' mailod to the following beneficiaries of the above-C:llpUonOlI oRtllta Cln ? -2. ",4' Y' I Name .J/Qt:'.../r () ;./r,,, I) Adstrosll. 111,- I'll .J I Y i'~_.C'_~J!.~II~jL}.!:I~,1~1~___._ Oil/IV;! L J1,1".t'~1', /7";;, ,J.I ~) /J""(".:!!.~_.I1'J.k!t;rl~'!.~____ ..--..-.-...---------.,--..-- Notice has now been given to all persona ontitlod thol~(lto under Rule 5.6 (a) except __,____....._ Datel Sio r ~ IMt" , Y / (;~/I "I, (, , I , '. V \ ...L...-1L) ( U. 'lAJ { S gnature Name C'''V''''t~ II/f,M'tllr Addrf'J8BJ.j ~ ) I1lr.:11 tJ("(', ;j'1" ."u 1;'I"~l j r).... / Telephone.~7.l M 7 . J. V I t.- , Cllpac J.ty I_-=::::personal Representati va CounBel for personal representative _' .... ...~ __c....,.....,.. . " ~, IN]. . II '( ~~'If.ldA . .\~d,. ,. , .,f'IJ,1.. COMMONWEAltH OF PENNSYlVANIA OEPARTMENT Of REVENUE om, 280601 HARRISBURG, PA l1U8.0601 A , / '-/ -,,:.(:; 3 - / INHERITANCE TAX RETURN RESIDENT DECEDENT (TO BE FILED IN DUPLlCArE WITH REGISTER OF WILLSI . REV./lOO IX. 1",911 , W 0- l<~l:l lrl"~ x~-' U..1ll .. c( 10- lilifi ~ Q o Z uo .. (II) ___ti.3)fL-:::-..___ (12) L2L2_S:'-'_-:_______ (13) ___________,______ r 7 /J.-,S,-', - ____..,___Jl~__:::=:====:c_,_____ ,_,.::_ - .:C':,:":__.. 'S'2..z.'"7 . .s-ZL o M , ( I~UMbER .. __..... ., _ _. .. H _......u., .-----.------..---.--- f(urnuifldtlf Rfl!ll/JI !for dOlos of d(t(11h p(tvl III 12.13.82) fedoral hldlo lll~ Rolurn RequilOd Talul Numbef of Sofa L>opoiil 8oll,ft. -. - ... .".. .-------.- .,.......--...----.--. ... ..----...-.-----.- !Z w 51 ~ Q l:I?D ntJ~ E URlTV NUMB:41- r;: D~~~ IOA~~,:f "~~--- Original Relurn 0 2, Supplemenlal R.I"n /l1€.c: /+ 1;7;.) _ ~_O_U_~'!__ C.y_.~_(3_ I ; 3. ! J 5 'd UI 'U:U - C11 t\'1 () " 0 ". "'TI, ".' \" , o tAL 17 (YT. 04, Llmil.d E'lale ::~J ::n .....4 C:J -t~)K:S, . ~~ r1, - fJ 40. Fulure Inlolosl Compromiso Iler dOl.,' of d..lh oh.r \2,12,021 06, Deced.nl Died T.,lal. 0 7, D."d.n1 Malnlain.d. Livlno Tru'l (Allach copy of Will) IAllach copy of TIUII) ALL'.CORRESPONDENCE AND CONPIDENTIAL TAXINPORMATION SHOULD 8E DIRECTED TO, M OMPUTE MAlltNG ADDRESS ,___ 0, 'o,VNiL..h EPHONE NUM8ER . IV) f.lM f7Ts ')../ '$ ') t<}-eCc;J"vl'I ~D In,;.c If" p4, !7" n-- 1171 (10) (191 s- 2. ,~ 7,r'O 20_ If IIn. 17 II greater Ihan line 10, .nl.r Ihe differ.n" an IIn. 20, Thh is Ih. TAX DUE, 1201 A, Enl., Ihe inler." on Ih. balance duo on lin. 20A, POAI B, Enl., Ih.1a1al ollln. 20 and 20A on IIn. 20B, Thl, II III. BALANCE DUE, 120111 Mak. Ch.ck Pavabl. tal R.gl,t..., WillI, Ag.n'___ ,_,___ .._.,__, ,_ , , '. ..IlUURJ TO ANSWIRALL QUESTIONS ON RIVERSE iIDfANDTO-iifHECK-MAYH..-----mu --.--- Under pnnahltl of perlury, I d.dare that I hav. uamln.d thh r.lurn, Including accompanying Ichedulel and Ilallmenll, and 10 the belt of my knowledge and belief, It h true, corr.cI and ("mpl.I". I dedar. that 011 Ital tltale ha. blten reporled allrul mark'l value. Dodofalion of proparer olhor lhan Ihe peflonulrOproltnlollvo Is baled on alllnlormallon of which prepare' hOI any knowl.dQ" I:N~nERSON REI/ONI".! fOR PIIINO REtURN ADDRESS -'------------,--------------.----...,-----., C>AWu-'.-----------.. miNA ffl~A~~Ma!~tfiVE ADlim~~ 3_ 7 1'It2C'''_~1__ .eQ...___/!I.g~Jjf!L oft _~~.:-:ct~ .L."-!1 ') -'2..1./ I V _h__ .__.__ -.---.----.--.-----,.-.-. ..- z o ;:: :3 E .. ~ '" 1. Real E"ale ISch.dul. A) ( I) 2, Slack! and Bond, (Sch.dul. BI I 21 _ _ .-9.-(" G:. 3> /, 3, Clalely Held Slock/Parln.rshlp Inlore" ISch.dul. CJ I 3) ___..________ _ _ _ _,__,,_______._ __' 4, Morlgag., and Not., Rec.lvabl. ISchedule D) I 4) _________.______ 7-/'" - 5, Ca,h, Bank Depolitl & Mhc.llan.oul Personal Proper1y( 5) ___,____~~_,____ ISch.dule E) 6, Joinlly Own.d Properly (Sch.dul. F) I 61 _...______ ',_______________ 7, Transf.rs ISch.dul. G)ISch.dul. II I 71 ___.. _", 8, T 0101 Gro.. A..." IlolalllnOl 1 ,71 I (;, ': ff _ 9. Funeral Expenles, Administrative CoslI, MhctJ-Ianeoul ( 9) ____m,_ ____ _ ~__.__'--.. Exp.nlel (Sch.dule HI , 10, Deb,., Marlgage liabUiti." ll.n, (Sch.dul. II) (10) 11. T 0101 D.ducllon. ('alalllnel 9 & 10) 12, Nel Value of Eslale IlIn. 8 mlnullln. 11) 13, Charitabl. and Gav.rnm.n1al Bequos" (Schedul. JI 14, Nel Valu. Subl.Cllo Tax I"ne 12 mlnulline_13) 15, Amounl of Ii"" 14 la,abl. 01 6% role (Inelude valuei1rom Schedule K or Sch.dul. M,I 16, Amounl of IIn. 14 la,abl. 01 15% ral. (Include value, from Schedule K or Schedul. M,I 17, Principal lax du.IAdd lax from lin. 15 and from Iln. 16,) 18, Credit. Spaulal Pov.rly Cr.dit ~rlor Poym.nl' DilCounl In'.r." ___________ + _m__________ +_____,____..__ --- __,____,_..___ 19, If Iln. 10 i, grealer 1han line 17, .nler Ih. dlfferenco on lin. 19, Thh io 1h. OVERPAYMENT, 1410 00 c: n:;" :y',~ 81 , ,,1 1151 _ -$: 7 Il-S-~ x .06 :; z o ;:: g ~ U S 1161_______ x ,15 = Check litHe jf you (UO rC(IUo~ling (I refund of your O\lcr,H1vmonf. $}.."),7,nl UV.UO.UtIJ.lll' w SCHEDULE E CASH, BANK DEPOSITS AND MISCEI.LANEOUS PERSONAL PROPERTY C04,\lawIAH~1 ~~ t'n~,\I~ANIA . 1~1,~/N1 DIC1DINI ESTAT~ OF 111 Ate rJI A J It f. t?.J) IAII plOp.rly lolntly-own.d wllh tho Right of Suruluollhlp mu.t b. dl..lo..d on S.h.dul. PI ITEM NUMBER DESCRIPTION / pN C- (3lwlf ,. 'I " ,;', , , " "f, , ,"1 ,. " 'I' " " , ". " " " " " " , " ,. " , , , I.', " ., , , , , ,. ' ;; ; PI.ol. Prlnl or Typ. FilE NUMQER "I" " '" " " ,. ". , , , " or- -..------- VALUE AT DATE OF DEATH 2.152- - , " I. (, , ., ,\1' , , " " ,I"~ TOTAL (Aho .nt.r un IIn. 5, R.ca.e!!~L S_.2.:.UI::.L,=_. (Allach addlllanal 8\1" )( 1\" th..II'i, mot. .pac. II needod,) UV.UlIlJlt 17.1.) UTATI O~ /I1~~rffn ITEM NUMBER [teD SCHEDULE H FUNERAL EXPENSES, ADMINISTRATIVE COSTS AND MISCELLANEOUS EXPENSES PI.all Print or.!If. . .-.;J.;; -1LI NUMBI.R__ ___..___. ..___ , " * COMMONWIALTH 0' 'INNIILVANIA INHIIITANCI TAX AlTUIN 1II1DINT DICIDINT DESCRIPTION AMOUNT. A, Punllal bp.nll" 1. II. II / .3 'I ,-, ~ : B, 1, Admlnl.t,atlv. COlt.1 Personal Reprllentallve Commlulonl Social Security Number of Pe"onol ~eprelentallvel Year Commlulonl paid 2, Allorney feel 3, Family Exempllan Claimant Addreu of Claimant at decedent'l death Slreet Addreu Relatlonlhlp City Stale Zip Code 4, Probate Feel C, ' Mlle.llan.ou. Exp.n.." 1. A- /)r E.~ 7t St! !t14,vT A . I-U.S, 2, P,S"7'/4(;.'l.. f'{f'.e.. 3, Df.I4.T'fJ C(ra.~, 4, Co"'ftT fe.~ 5, C,t.<..e'r ret:. 6, 7. 8, '6}. -, .i~1 - Z. 1', - 5''"1. - (, ~-, - TOTAL lAlla enler an line 9, Recopltul~lIonl $ . (If more .pacel. n"d.d, lnlllt additional .h,," of lam. 1111,) --- UY,U1llhll,111 , '* COMMONWIAITH or "NNlnVAN,.4 INHIIIIANCI lAIC ."liIN ftUIOINT DIClDINI SCHEDULE J BENEFICIARIES ISTATI 0' fiLE NUMBER h1fJR17ff;. J fk~j) '" ITEM NUMBER NAME AND ADDRESS Of BENEfiCIARY RELATIONSHIP AMOUNT OR SHARE Of ESlATE A, Ta.abl. R.quIIIII ._--_._._~._--._. .._--~.._..__.~-- 1. ~c.k /-I(~O IIS-rJ 30 s'r c~tliC.f- .I /II1el?l?l :rr~ 21 ~ 7 IMCCJ-VtJ fi!~ ttlE.c../f SaN ...!.o,8 ...s-O ~# z.-. (.PNI'JIt. O/4v.ar/l"i"t, " " , , ITEM NUMBIR NAME AND ADDRESS Of BENEfiCIARY, AMOUNT OR SHARE Of EST ATE, B, 'Charllabl. and Gov.rnm.nlal B.qU.'11I 1. TOTAL CHARITABLE AND GOVeRNMeNTAL BeQUeSTS (AI.a .nl., an IIn. 13, R.capllulallan) --r-_____. IIf more .pact II n..d.d, In..rt addltlonollh"ll of lam. ,lit) s -----.....-.~._....- -- ,I I / .,(V.1547 IX AFP (12.94* V'~~,,"OHlIEALl1I Of PENNSVLVANIA DEPAA1NENl Of AEVENUE IUREAU OF INDIVIDUAL lAMES DEP!. 110601 HARRlSIURO, PA 111ll-0601 1iflff-6rtIt'1m'-- -='=='J.OOm J ~=~.- FiLE NO. OAT! OF DEATH 07-06-94 CDUNTY CUMBERLAND NOTE I TO INSURE PROPER CREOIT TO YOUR ACCOUNT, SUBHIT THE UPPER PORTIOH Of THIS fORH WITH YOUR TAM PAYHENT TO THE REOlS TER Of WILLS. HAKE CHECK PAYABLE TO "REOISTER Of WILLS, AOENT" REMIT PAYMENT TO: I t./ - ,.) ,ij.. / ~o\l NOTICE Of INIIERITANCE TAM APPRAISEHENT, ALLOWANCE OR OISALLOWANCE OF DEDUCTIDNS AND ASSCSSHENT OF TAM ACN 101 DATE 06-26-95 ~ REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISL~(llA 17013 " < \ (.. \ . ~ , " ) I:: , " ~nr-~'.Itt~d CUT ALOND THIS LINE ~ RP.TAIN LOWER PORTION FOR YOUR RECORDS ..... '~: il! V: isi;j - ii[ -AFP - -f 1'2-;94 "i-iloYi oE"ii F" i:"NHEifi f AifC'E - TAX - ifti pilif i SEHiilr, OM At UiWANC'E' cili" - - - - .... - -... -- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT or TAX MARTHA J flILE NO. 21 94-0612 ACN -(,101 .' CONNIE L MERRITTS 2137 ARCONA RD MECHANICS BURG PA 17055 1 ESTATt. OF HERD TAM RETURN WAS I I X) ACCEPTED AS FILED I ) CHANOEO DATI! ,06-26-95 , r" RiiiRVATION CONCERNIND FUTURE INTEREST . SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Rul E.bto ISch.dulo A) 11) 2, Stock. ond Bond. (Schodulo B) (2) S. ClolOly Hold stccklPortnor.hlp Inbrut ISchodulo C) IS) 4. Hortgogo./Noto. Rocolvoblo ISchodulo D) (4) S, Co.h/Bonk Dopc.lt./HI.c, Porlcnol Prcporty ISchodulo E) IS) 6. Jclntly O.nod Prcport~ ISchodulo f J (6) 7. Tron.for. ISchodul. 0) (7) 8, Tctol A..ot. ,00 86,631,00 ,00 ,00 2.132,00 ,00 ,00 (8) 88 , 16l.:.Q.! APPROVED DEDUCTIONS AND EXEMPTIONS: 1.638.00 9. funorol E.pon.o./Ad., Co.t./HI.c, E.pon.o. (Schodulo H) (9) 10, DObh/Hcrlgogo L1obllltlo./Llon. (Schodulo I) liD) .00 11. Totol D.ducHcno (11) 12. Not V.luo of To. Roturn 112) IS, Ch.rlt.blo/Gov.rn..nt.l Boquo.t. ISch.dulo J) liS) 14. N.t Volu. of E.toto Subj.ct to T.. 114) NOTE: If 8n 81.811m8nt W81 illued previoUIly, linel 14/ lS andlor 16, 17 and 18 will ref18ct figurel th8t include the tct81 of Abh r8turnl alle.led to date. A8SESSMENT OF TAX: IS. A.ount of Lln. 14 .t Spou..l r.to liS) 16, AMcunt of Lln. 14 t...bl. .t Llno.I/C1... A r.to (16) 17. AMount cf Llno 14 t...blo .t Ccll.t.r.l/Clo.. B r.to (17) 18. Prlnolp.l T.. Duo 1 .~38 no 81,125,00 ,00 81,125.00 TAX CREDITS: PAYHENT DATE 04-10-95 ,00 M ,03. 81.125.00 M ,06,- '~M ,15, 118) ,00 5,221,50 ,00 5.221,50 RECEIPT NUHBER AA023020 DISCOUNT I') INTEREST (-) 5.16- AHOUNT PAID 5,221~50 INTEREST IS CHARGED FROM 04-11-95 TO 01-04-95 AT THE RATES APPLICABLE AS OUTLINED ON THE REVERSE SIDE OF THIS FORM TOTAL TAX CREDIT BALANCE OF TAX DUE -- - INTEREST TOTAL DUE 5,222.3(, 5.16 ,11 ~,Z1 · IF PAID AfTER OATE INDICATED, SEE REVERse fOR CALCULATION OF ADDITIONAL INTEREST, If TOTAL DUE IS I.ESS THAN H. NO PAYHENT IS REQUIRED, If TOTAL DUE IS REFLECTED AS A "CREDIT" ICRI, YOU HAY BE DUE A REFUND, SEE REVERSE SIDE OF THIS FDRH FOR INSTRUCTIONS.) , 0\ ...., <.( >'1' \';1 , , '1 ~'l rL .'- " ,+-. ',; . ... f"') ,;~ ;~ , ./ .)11' 11\ ,\llJ' i:~8 u: - J, PAVlEHTI Dotooh tho top portion of thlt Nollo. .nd ....It with .our p.....t _ P.....I. to tho .... ond Ilddr... ~rSntld on thl rIYlr.. .Ide. If RUIDt:NT DECEDENT ..... ehook er 1IOnO, areNr pay...l. to. REGISTER OF HILLS, AGENT. If HOH-REIlDt:HT DECEDENT ..... eho.'k er 1IOnO. .rdor P.....II 'e, COltlOHHEALTH OF PENNSYLVANIA. All PIYMl1t1I',c.lved ,hall be .,lIed flr.t to ...v Int.ru' which "Y b, dut with any r...lndtr .,lIed to thl 'IXt REFUND eCA)1 A nflRl of I tl)( credit, which Nil not r.qUlltlld on the rllC R,turn, "V be rtquelted by eotIPltUng Irt "Applloetlon for Refund 0' P....,.vlv.,l. Inhlr1t1n01 end Etbto Tax" (REV"UU), AppUOltJonl erl 8YIIUlbl. It tha OfficI of tM Reghhr of Wlll1, "Y of thl U RIVtnUI 0llt"'ot Offlctl or fr~ the Depart.."", 2~"hour Inlwerlnt ..rvlel ~r. for for.. orderlngl In P'~lyly.,l. 1-800-362-2050, out.lde Pennlylvlnt, and wIthin 1...1 Herrlobor. .r.. 11111 1'1-1094, TOOl (111) 172-22J2 lHoarl.. lop.lrod onl." REPLY TOI au..tlon. r".rdlna .rror. contllned on thh notlc. should be Iddr...~ tOI PA Ceplrt.."t of AIVtn4Je, IurllKl of Individual T.~.., ATTHI POlt A....~t R.vl~ unit, Dept. 260601, Hlrrl.burl, PA 17121-0601, phone (1111 1I1-650S. OISCOUNTI If any taM clue II paid within thr.. (5) calendar Hntht .ft.r the decedent'. dt.th, . flv. percent (S:U dhcOl.I1t of the t.~ plld I. allowed, INTEREST I Interllt It chlrged tAtlmlne with flrtt dlw of dellllqUlMv, or nlM (,) IIOnth. .. OM (1) elIy 'r~ the dati of delth, to the dtt. of PIIYMnt. Taxll which MoIM dellnquent before Jenulry 1, 1912 bear Int.rllt .t thl r.t. of IlK (6~) percent per ~ cllculttld It I dilly r.t. of ,000164. All tIM" Nhleh ble... delinquent on end 4ft'r JlllUlry 1, 1912 wUI b..r Int.rllt It I rltl which will vlry frOll c.lllndlr v..r to e.ltnd1r V'lr with thlt r.t. tnnounctd bv the PA o.p.rt-.nt of R.vtnUl. The epp\lclbl. Inter..t r.t.. (or 19.2 through 1995 arll V..r tntlrnt R.t. D.lly Intlrl,t Feetor V..r Intlr..t Rlt, 0.110 Int.r..t FlOtor 1912 lOX ,OOOSI. 1911 9X .000241 1915 m .0001st 1911-1"1 I\X .000l01 19M m .000l01 1"2 9X ,000241 1981 UX .000116 19".1994 IX .000192 1916 lOX ,000211 19" 9X .000241 "'Int.rllt I. c,loul.tld " fallOtl.1 INTEREST . IALANL'B OF TA~ UIfl'AID ~ HUHIER OF DAYS OELIHQUEHT ~ DAILY INTEIEIT PACTO. ....Any Hotlo. I,,,. .ft.r the tlM beooIMI. dlUncpJltnt wUl rlll"t en Intlrllt Gllcultltlon to flft,," UI) deVI beyond thl dlt, of thll .........,t. If PIVMnt II Mdt Ift.r the Int.rllt *'PUt.tlon dltl thoNn on thl Notlc., Iddltl~l Int.r.lt .u.t be c.loul.tld. t~' t Ikc,'i' (,1 /{.,'. : I" I j j. d STATUS R~~Q~T UNDER RULE 6.12 )1j1/~J l-k if. /) '~Xj ""N 10 r.3 :~, 1 Name of Decedent I Date of Deathl Jlt L'f '" 1'19tf elL", ".irl CUnJ/ . '), PA Will No. ,;J../ 1"-1 - o G., 1 L Admin. No. .' Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the follow.ing with respect to completion of the administration of the above-captioned estatel 1. State whether administration of the estate is completel Yes_ v_ NO__n_._ 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete 1_.._________________ 3. If the answer to No. 1 is Yes, state the following I a. Did the personal representative file a final account with the Court? Yes j..-- No b. The soparate Orphnns' C(Jllrt No. (If any) (or the personal representatIve's account JSI c. Did the personal representative state an account informally to the parties In interest? Yes. V_ No d. Copies of receipts, releases, joinders and approvals of formal or informal accounts may be filed with the Cerk of the Orphans' Court and may be attached to this report. Datel f-S'-q.r- _-f/I---r'-n~' ,-:( ..:}Vlc~l/Jvr.(.. Sighature7 v ./ U,tlN /€.. L /l1 U",", b-:s Name (Please type or print) .)..13 7 I'llfro,..!/') ('D /)teclf ~ Address (MAH ami! AM3) (7 /7) ~ en .2...1/ I ~_ Tel. No, Capac lty I (/' Peraonal Representative Counsel for personal representative