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HomeMy WebLinkAbout94-00626 , "ft ~,"- . I' ' " ~"",tlr \ \", " "I': ,..,~, l ..,,(/1. i, ,; '111'0;,(, .. ' I ~\ if 'II ," .i.~l.' " "I:t~.I:;"fi\l..\1IYI:' ';,,' "',.~, .' ,. ':,. ,.,1, ,,, 1",\1 .. , , .. .. I' ". , ", , " .. " , " I, , " , 1.1\ ", , It . ," i " , I' ',' )l'! I,', "'1':,', :1""",1.. , , , ' " " " " ',."1 " , " " ,0: ." ,\. , " , " p, ''I' '" \" ,\ .,j, 'I t','" " " 'f .,..,:"llj'I'I' '. ,. " 1 " " .' " " .I \' , I "/' ,". , ; " " .",' " t" :;" '.. i ", ," " , " '.1' '\'. .. , .. " '. .. , , " ,.. '" , .' I' " . \' " .' " " I(,~\ . , .' ,fl'.' " " f.1\'" \ '" , I, " ,. .{ . " " '" .. , " , , ,.,1 I." .. , '" 'I' , ,I'''. .., II" , , p. 'I , ,I ,1\' ;:,,:. I f~ I,: I \' . 1 ~', " Ii" 'I ,f ',' , ,,\1, " 1'. ,I , I" " ,\:~I. .' L' 'I ' , I", L t,',', '.. ",' l\i1 ~I,I.' ' T. If'(l 'l.t ,I. 1 , . , , , " "', . .; t 1\' ,t ", '\ ." ,/1" ;1\ I, "I,', I;' ;~ 'J' " 'I',j;: " '" } ~ ,:' " " , . ,\ :'1", I :,,"',1, .' ",I," I ~ J ' ,I', , , " , ~ ' '/'\;: .../0,',\\ .1" ii',. .;d' ,'; I' I," ,f'" II) ,1;'1' .. (ii', , ::' 1(',.1' "",,II \ ,,"1 :" .,,/,..'1' "'" " '", '," \.. .,' , ''','', ".' I 'j' '.\'. .i I'. '<' (i'!I]' , 1:1"'; , " i\ I :;:A, ,l:,""" ", ,I"f\!, ",' ".,1,11 , I',' ,\.1'"',, :'\ '", H '/'1 ~I\ . J "lq, ,),'~: ',":,f.. : ',,: '1 1\,' ,I,'"", I' , , I, , " II', ' ~l ,\ f I,i,''' ..\ t ,'ll',hl ~ " I', '. l' '. ' I '~l 'I: '." {"J t,;'..J! 'I t 1,:,'/\/ ." ," " I~' .I:.: I' t ::,,;' "I I , d' l,"'I " ~ ... ,.. ,~. ", , ol.--.,_~_ ___. __ _ ~___ _"_ _"_ ..._ ..._...... ~_, "_...'. _, .. .,--~, ".,. ., .'. .---.. ..&_- ..-- -. .... --., --.--. -._. -- ,.--.. -.-- -'- .'..._-- RECEIVED FROMI I m AMOUNT IRWIN RO~ERa ESQ 60 W POMFRET Ell I ('i I .3. 1 77 ./to ---- CARLISLE PA17013 SSN eoa"36~153ee 1M I) - WARNER CLARA K E OF PAYMENT AR~ rupm 194 --- ~:~:ND REMARKS IRWIN, IRWIN & r-- . m TOTAL AMOUNT PAID . "'/1 RECEIVED ~';--I'--J '3. 1 77 . eo SG :J MCKNIGHT,~TrYS SEAL CHECK II 8508 REGISTE~ OF WILLS MARY C. LEWI I'lEGISTER OF ILl.S -y-:--,---:------- -- - --..... - -.- - - ---- -"'- - -- _. -- -- - ~-,--_..~ ' . .. ... '. ' . ,~ ,t . . .', I " ; [I I, 'I '\1 '! 'j ,- , .\ .' 'i'J ", , '.' I I '" \ ."' .' .._~"'- ..' '.~' .,.......-.-'; ................,u-q '~.4''''''q,!..~., . " . \ " v<5 L~ - 3 II '5 " /v L./ Ii ))Il- ,,{ REV-1547 EX AFP I08-94~ j CDHItONIIEAUIl Of PENNSYlVANIA ACN 101 DEPARTItENT Of REVENUE NOTICE OF INHERITANCE TAK BUREAU Of INDIVIDUAl lAKES APPRAISE"ENT, ALLOWANCE OR DISALLOWANCE ~~:~~~~;PA ~~~;;1 '._ IDl- ="=,;:"~~~:~:~~S~'~~~_'~~~::F~~~A~O ~~~~r~~~: 5,_~ DATE OF DEATH 07-05-94 COUNTY' CUMBERLAND _ NOTE, TO INSURE PROPER CREDIT TO YOUR ACCOUNT, SUB"IT THE UPPER PORTION OF TtlIS FOR" WITH YOUR TAK PAY"ENT TO TtlE REDISTER OF WILLS, "AKE CHECK PAYABLE TO "REGISTER OF WILLS, ADENT" REMIT PAYMENT TO: ROGER B IRWIN IRWIN ETAL 60 W POMFRET ST CARLISLE PA 17013 REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 ~nt ROftlttO:c:::j ~-~=~ ~ CUT ALONG THIS 'LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS .... R iV: iS47 - E iC" F ii- i 08:94 r - NOi'" icr.O' F - ytiH Eif if Ailcir i'"Ax - 'A-P'PRA"f SEiliNT ~ - -" [rciwAN-ci E - DR - - - - -- - - - - - - - - - -- DISAl.LOWANCE OF DEDUCTIONS ANIJ ASSESSMENT OF TAX ESTATE OF WARNER CLARA K FILE NO. 21 94-0626 ACN 101 DATE 01-16-95 TAK RETURN WAS, (X J ACCEPTED AS FILED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL 1. Rul Eltoto (Schodulo A I III 2. Stooka and Bondi (Schodulo BI 121 3. Clololy Hold Stook/Portnorlhlp Intorolt (Schodulo CI III 4, "ortgogoo/Notoa Rocolvoblo (Schodulo OJ (41 5, Coah/Bank Dopoaltl/"llo, Porlcnal Proporty (Schadulo EJ (51 6. Jointly Ownod Prcporty ISohadulo F) (6) 7. Tronlfora (Schodulo OJ (7) 8. Tctol Alaota I CHANDED .00 .00 .00 ,00 68,031,48 .00 .00 (81 68,031,48 APPROVED DEDUCTIONS AND EXEMPTIONS: 12,291.08 9, Funoral E.ponlol/Adft, Coatl/"llc, E.ponaoa (Scharlulo H) (9) 10. Dobh/"ortgogo Lhbilltlu/Lhna (Schodulo II 1101 .00 11. Totol Doduotlcna Ill) 12. Not Voluo of Ta. Roturn (12) 13. Chorltablo/Dovarnftontol Boqualta (Sohodulo J) (131 _ 14. Not Voluo of Elt.to Subjoct to TN' 114 I NOTEI If an aosessment was issued previoully, lines 14, 15 and/or 16, 17 and 18 will reflect figures that include the total of ~ returns as'essed to dati. ASSESSMENT OF TAX: IS. AMount of Llno 14 ot Spoul.l r.t. (151 16, AMount of Lln. 14 t..oblo .t Llnool/Cl.oa A rata (161 17, Aftount of Llno 14 t..oblo .t Coll.toraI/Cl.al B roto (171 18. Prlnclp.l To. Duo TAX CREDITS I PAY"ENT DATE 10-0~-94 l?,Ql nR 55,740.40 .00 55,740,40 .00 K,03. 55,740,4~ K ,06. .00K.15. 1181 .00 3,344.42 .00 3,344.42 RECEIPT NUHBER MM913042 DISCOUNT (' I INTEREST (-I 167.22 A"OUNT PAID 3,177.20 J TOTAL TAX CREDIT .-- ------ BALANCE OF TAX DUE ------------" INTEREST TOTAL DUE 3,344.42 .00 ,00 ,00 . IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. IF TOTAL DUE IS LESS THAN .1, NO PAY"ENT IS REqUIRED, IF TOTAL DUE IS REFLECTED AS A "CREDIT" ICRI, YOU "AY BE Due A REFUND. SEE REVERSE SIDE OF TIllS FOR" FOR INSTRUCTIONS. I , , ~~ t~ (w~ (r, () Ii 1'// i1 , I: (,; iii' i'i . , ,', I ~ I:', ,. .' ( " ~:, l~';' , " (J , ,. :, I,) -0 ~~II't' " -' iif () ;g~ 1.:. '" N REIERYATJOth eat.t.. of deoeHnt' dVlng on or blfor. 010'''' 12, 1'It .. If anv future lnhrllt In thl utet. 11 trln.flrred In po.....lon or .nJov.."t to el... a (ooll1ttraU bln,flahrl.. of thl dlCldtflt .ft,r thl IMP!r,Uan,of anv utlt, far 11'. or for v..rl, thl COIIOnw..lth htr.bv 'Mpr"llv ra..rv.. thl right to appr,I.. and ...... tran.t.r Inherltanc. TIM" It thl Ilwful el,.. . (colllt,ral) rata on any .uch futur. lnt.r..t. PURpose Of HOTJCEI To fulflll thl "qulr..,ntl of hctlon 2140 of thl tnh.rltlnca and Eltat. TaM Act, Aot 22 of 1991. 12 P.S. Sooll.. 2l~O, PAVHEHTI DltKh thl top portion 0' thh N(.lUcI and sub.1t with your' PIY,.nt to thl Rlght,r of WUII prlntaa on thl river.. ,Ida. "Hol,,'chlck or Ion" ordor .".bll lot REOISTER OF MILLS, AOENT All PI,.."t, rlc.avld shill flrtt b, Ippl1td to any Int.r..t which .IY bt dye with any ru..lndtr applltd to thl t'M, REFUND (CA)I A r.fund of . tlM or.dlt, which WI' not r,quelted on thl TIM Rtturn, "v bl r.quI.tld by oo.,II'ln; In "Appllcitlon for R.fund of Plon,vlvlnl, Inhtrltanc, and E,t,t, TIM" (REV-13IS), Applloltlonl Ir. Ivalllbl. It thlOfflcl of thl Rlal,ter of Wills, tny of thl 23 RIVlnUI Ol.trlot OffiCI., or by ollllng thl sPlcllt Z4"hour Inl...rl"" IIrvlel nuIltltr. for for.. ord,rlngl In PIMlylvanlt 1-800-362-2050, outtldl Penn,vllIlI'dt and within ID~.l H,rrhburg .r.. (717) 7&7'8094, TOOl (711) 17Z"U52 (lturlnA Jlpl.rld Onh), blJECTlONSl Any p.rtv in lntlr.,t not ..thfl,d with thl IPprals..,nt, allowancl or dhlllow.ncl of d"duotlonl, or a......tnt of t.. (Jnolu~lng dllcount or lnter..t) al Ihown on thl1 Notlc. IUlt obJ.ct within .IMty (601 day, of r,cllpt of this Notlcl bVI ..wrltt.n prot,.t to the PA O,p.rt~.nt of Rev.nu., Board of ApPIII., DEPT, 281021, H.rrllburg, PA 11126-10ll, OR .-.I.otlon to hlv, the .att.r det_r.ln.d at ludlt of the aocount 0' the p.rlon.1 r,pr..,ntatlv., OR ..app.al to the Orphan.. Court. ADlIIN ItT~ATlW COlItlfCTlOHS. Feotutl .rror, dllcoverld on thl, a......ent .hould b. Iddr....d In writing tOI PA O'Plrt-.nt of R'v,nu., lurllu n, Indlvldull Ta.lI, ATTNI POtt A.......nt R.vl.w Unlt, OEPT, 2110601, ttarrhburg, PA 17128-0601 Phon. (711) 7'7-6505. S.. pi" 3 of the bookl.t "Inttructlon. for Inhtrltanc. 11M R.turn for. Rllld.nt Olc.dlnt" (REY-lS01) 'or an 'Mpl.natlon 0' .d.lnl.tratlvely corr.etlbln .rror.. DISCOUHT. If any t,l dui i, plld within thr.. (5) cal.nd.r lonth. Ift.r thl dlcld.nt', dl.th, . 'Iv. p.rr.nt (SXJ dl.count of the tlM plld II allowed. IHIEREST' Interllt II ohlrg.d blglnnln, wlth flr.t day of dlllnqulncy, or nlnl (9) 1I0nth. and Oil' (1) day 'rim thl dlt' 0' d'lth, to the dltl 0' Ply..nt. TIM" whl~h b.o... dlllnqulnt blforl January 1, 1982 blar Intlr,.t at the rat. of 11M ('~1 parolnt p.r annul oalcul.tld .t n dally rete of .00016\. All taM" which b~O'11 d.llnqulnt on .nd Iftlr Janulry 1, 19a2 will b..r Int.r..t at I ratl which wttl vary frnl c.l.ndlr v..r to cal'ndar yllr with that rat. Innounold bv the PA OI~lrt'lnt of RIVlnul, Thl applioabl, Int.r..t rltl' for 1982 through 1995 arll !i '!' ;i I' ,I '!!!!: Interllt Altl Dilly Intlr.,t Flctor ~ Inter..t Rlt' Dilly Inter..t Factor 1912 20X .ooml 1911 9X .0002~1 I9n I6X .OO04!1 1911-1991 11% ,OOUOI 19I~ lIX ,OOO3Dl 1992 91. .0002~1 1915 llX ,000lS6 1993-1 99~ 11. .00019/ 1916 lOX .0002/' 1995 91- ,OO02~1 --Intlrllt 1. ollcuAet,d a. followlI INTEREBT . BALANCE OF TAX UNPAID X NU"BER OF DAYS OELINQUENT X DAILY INTEREST FACTOR --Anv Notlel I..u.d I,t.r thl tlM b,ool" dlllnqu.nt will rlfllot en Int.rl.t elloulltlon to flft.'n (IS) dlV' b.vond the dltl of th. ........nt. 11 pay..nt I. Ilde Iftlr the Interllt oOlputeUon dati .hcwn on the Notlel, addltlonll tntlr..t au.t bl olloul.tld. ," "'..1...,. PETITION J<'()J~ PIU>IIATE /lnd GRANT OJ<' LETTERS 21-94- ~~/.p No, To: /;',11111" (!/, CLI\H/\. K. \'IJ\RNER a/I/I kilo II'" al' Ilc~islcr of Wllis for Ihc , /).,,'('(/.1(''', ('011111)' of ClMBERI.J\ND III Ihc Sorlal S"l'lIrlty No,.?03-36.,5382 ('OIllIllOllwcillth of I'clIlI,)'11'1I11111 Thl' I'clltloll of Ihc IIl1dl'I\lgIICd rC'ltrrlflllly IcprcwllI' Ihlll: YOIII' pCllllollcr(\). who is/II fl' 1M )'l',II' of IIgl' 0' oldl'l IIl1lhc CXl'l'1I10r IlIlhc 111\1 will of Ihl' ahOl'c dcr,'dclIl, dalcd Novonmr ~5 ~0CKk ,p II1l111ed , ,19,92_ ('\llll' rl'1l'\'lIUI drl'Ullhlll1H\''I, ql, 1l'lHlI1dalluu. 1k'i1lh lIl' l'\l'l'lIhlf, CIl'.1 llerl'lIdclIl 1\'11' dOlllkikd III dClllh ill a.MIJERLlIND.. ' __ _ ('Ollllly, l'ellll'yll'lIl1ll1, wllh her.., 11111 flllllllyor prllll'iplIl rClldl'IIl'c III BOIN. JIlIOOVERST.""ClI/lLTPT .r.,.J.>A ..,nnn,n_, UQ1;\.I,JPRl'H MlDPLJ:.'rON'lOONSHIP, .. _" .. ,_ _00_,__ "n___..._..n___.'_____ (Ihl ,lrl'l'l, 111l11tlll'r lIlHlllllllldpalil,\') IkcClldclIl, Ihell . ,85 _ _ _ ycar, of IIge, dkd July.05 __, n_ ,,19,9,4_._, III,. .801N. Hl\l'K)VER 5'1'", ClIRLISLE, PA. NJRrlLMlDDImDN 'l'a'INSIJIP. ~--' becpllll follow" drrcdclIl did 1I011ll1lrry, wal 1101 dll'orccd IIl1d did 110' hal'e II child horll or IIdopled IIfler exerllllolllli' Ihc will ol'frrcd for proltillC; wa. 1I01Ih,' I'klllll of a killlll~ alld Will lIel'er IIdjlldlelllcd IIIl'OIIlPl'ICIII: .'" '_'m'_'Hm",_n"_'~'" IkrelldclIl al dl'lIlh oWlled propcrl)' wilh c"llllIaled l'ahlC\ ,II follow,: (II' dOlllidled III l'iI.) All pCl.'ollal proprrlY (If 1101 dOllllcikd IIII'll.) I'crlolllll propcrty III Pelllllyll'alllll (11'1101 dOlllieikd ill I'a.) I'er,olllll Plopcrtyill ('OIlIlIY ""ll1e of Icall'Ilatc III I'CIIII'yll'lIl1ll1 slllUlICd ii' follow,: n ____, " ,,,___._ $ _~J.,9Qj),9JL ___ $_..__.,._____.___, $ _nO_'n'_ :..___..n $ _ _ ___..m.."......___.._.__ --.--.- -,._-.._.,-,-.---..._----~---_._. - .---<.---._. ..__._..__._~._---_._--"*..._----_.,---~.---, WIIERIWORE, pClitloller(s) respcetflllly rcqllesl(s) thc probllle of Ihe IlIsl will IIl1d codiell(s) prelclllcd hcrewllh IIl1d Ihe ~n1111 or ICIICl\,.,~st~,I)J;,a,ry_.___... .u'_.__.__. lll',IUIJ1~'IlIlIl~'; lIdl1llnhlrillllll\ C,[,lI,: llllmlnl\IIOllitl/l d,b,Il.C.I,ll,) IherOIl. II ~,~m_ 3 . 60, .WestPanfret . Street fr~ .carlisle'nPA17013_ ~ 0 11 ", Vi . ._. :; J :: ~. ,...---- -- ......-.-........----.-.---.---,- --_._--~--- --.. --. ,-----,_._--_...._...-----.~----.__..._--~ OATH OF IJEJ{SONAL REPRESENTATIVE COMMONWEALTlI OI' I'ENNSYLV ANI:\ I. ml COUNTY OJo',ClMIlE!llJ.l!'lD.._ J . Thc pl'lltiolll"(s) all(1\""lIall1ed lIIeal(',1 01 afllrll1(') Ihilllhe '1lIlCll1enll in thc rore~oill~ pelllloll nre I rill' II lid ronccltolhe ltc, I or Ihl' kllowkdge al'd I",lid or pClilioller(s) lInd Ihalas pel'solllll represell' IUlil'c(s) or Ihe allOI'C derc'delll pelilion"r!s) will W~ld Irnly lIdll1ll1islcr Ihe cSllllc necording loinII'. S\\'(I('1I1O 01 nfllr.lllcd a."'1 Slllt'CrihCd~ (. If-,%,. '.-. '.(~)i -~-"-----"--. ,..,- .... bl'i'ore 11ll' Ihi'(j] 15TH .. dll} or Rogcy;,,,J;r\'{..n.__,..._. _....___,."._ '~' 41u:~l~ilUd~k~,i~. O';'7rltJ )~.,~_.::..~:::=~:.:~:~.~==::-=~ ~ ( MfjV C. LEWIS III'gil/'" '(/'0--- .."hn._ U. 2 / If - ;.),) l( - ,;J. " No. 21 - 94 - 626 Estate of C[IIRI\ K. WlIRNER I Deceased DECREE OF PROBATE AND GRANT OF LETTERS AND NOW JU.!- Y 21. 19_~, In consideration of the petlllon on the reverse side hereof, satisfactory proof hnving been presented before me, IT IS DECREED that the InstrulIlent(s) dnled N:Jvcmber 5, 1992 described lhereln be admllll:d to probnte nud flied of record as lhe Insl will of Cl.lIRA K.. WARNER and Lelters Testarrentary nre hereby urnnled to Roger B. Irwin 7lfr; {) i2 ' (3 Lh- 9 ( '<" Uut-o pu. .. m L.UO . Roslll" of Will. tft MARY C, LEWIS (j FEES Probnte, Leltcrs, Etc. ... . . . , ., $ Short Certiflcatcs(3 ) . . . . . . . . .. $ RCl\Ullclntlon .".,...,....." $ x-pages. $ JCP TOTAL '-..:. $ Flied .." ~,~~ Y. ~.1. t. , ) .9.~4 , , , . . . . , , , . . . , . 115,00 9,00 RcQer B. Irwin 06282 ATTORNEY (Sup. CI. 1.0. No.) 60 W. PomfretSt., carlisle, P~170l3 ADDRESS b.UU 5.eO 135.00 1717) 249-2353 PHONIJ Ch ': I 1 " " CJ , , I , , \I , ,-. '"I , , . , "II.: I ; ", " U., ,,:. -) 0(,) Called attorney on 7-21-94. WARNItW: II Ifj ILI.I:GAI. TO AI.Tl'1l HIIH ('Ill'\' Oil TO [IlJl'IICATL II\' PIHHOSTAI (lit l'IIOJ()(irlAI'11. COMMONWI'A,:rll Of f1fNNSVl.VANIA OF.MIITMI'NT OF III:AI.1t1 VIrAl. III:COII09 LOCAL REGISTRAR'S CERTIFICATION OF DEATH CERT. NO, 2231985 ..~~_(;f ~l.._/1 tj,q~1'-, ~ ~~.. ,u~ "I ~.,r..Il' Ill\llllll Name of Decedent u__:_., --- ~ . {L~ ,{ IUeLtl1.L.__._ '----7f--m-.-'--~-- Sex +n,~__.~,soclal s~'~'urlty No, .465. .3L, .0j'k:~ ~uto of Doath':5._~'rf.<1..~q.!1.!i-~_ DateoIBlrth..J~jq}I-NPft", ~ Blrthplm:o IUntt.~'1 U(L,~ --.--,_-.----------.-~.- Place of Death ___,_,(!...1"",A",~""", ~~!- ~/Jd j/fJr/.L"", ,~_~, II" . ~' /I '. __,~~l'.l)OD~lv~nL(!, <, 0": ~~, Race .~~ ,,~_ ,Ocouputlon -J./A (.UUu.~ Arll10d Forcos? (Yes or No) .Iu..--..--~-----.- , Docodont's ." j. ,11 'J /J Marital Status ~af'-d Mailing Addross ~'l;L,1J.!J){ ':Pu...rv:;)!(.U.'ilL1. d{t{~r:jtL-!J(}'J~, Inlormant __~~u!Jld~4fi'i<J..). ..~... . Funoral [)lrochH. (!.eyJi..I4.-td4-'~~~~_.d"~".~'_.'---- ~~~e~a~n:S~~11~~~~~t .. f!.. j~ iL/<J 't:t.4f- ~u.llw.l1J'n~/~J1l'- 'ijl.d"'.J,>4I'I)L.u."._,___._~. --l[ : I nlerval Between Part I: Immediate Couse : Onset and Death i!.JLu' 1 't.' .... : (a) ___ ku..Jl~-'-d (LLU11~_ _ ..m____'_~d~d~,," --~--,~----------- , (h) _._._____~._~__~_,_,_.._~"'_,~_._.~_~_ "~_.-.-_,, '. ,..,.-__._______~__~____: ,-~-~,--. 1 I I __.___._._.,.____..__ .__..___....__. ....._ ... ,.--..-.-----.-......----.-1---- , , 1 .___._..,~_______..___._..______._..____~_____._1_ (c)__ (d) Part.ll: Other Slgnlfloant Conditions ..,__.__.__.____u_.... ..._._.,..,_____.._..__.___._____._____ Manner of Death: Natural 0 Aocldent 0 Suicide 0 Doscrlbo how Injury ooourred: Homicide Pending Investigation Could not be Dotorrnlnod [] [] [] /1" , Name and Title of Certlflor,Ii.LJ14'y~I~ fK..1J,',_...-~,,,_..~~_,____._..,,~___..___,__,_~__"__.- Address _~______,~__. ___'Vi./!;LW~.i: ,/ld.t., .(J,L IJt.}1C?~___~ ,~..~___~___~~~_~~~~~:r~"er , ~~~~ This Is to cortlfy that tho Informotlon 11Oro [Jlvon IS corroctly oopled lrom an original cortlflcato 01 death duly flied wllh 010 as Locol HO[Jlslrnr. Tho orl[/Inol cortlfloate Villi bo forwarded to the State Vital Records Office for pormanont IlIln[/, _2 / ~ (q~t-~u-- .., . 1l~1..~eht~hfL"'''!f1'I'I'III'U .) ,,,,< Vi." tl 1!€ 6 -1-"'" a.l.-L . lU.k,,__(L!:J'I.f.__._~___. ,//II;'fjj;;=''':i':''''''"/~n(&fl.J, ""'P?i~ a ""'" ," ,,'1, -+ r {"'" Il.""""rd.,,,t 8' if ' 11<.,-\; ~ ACKNOWLEDGEMENT ~ AFFIDAVI1 WE, CLARA K. WARNER, BETZI A. MORRISON and KATHLEEN M. KENNEY, the testatrix and witnesses respectively, whose names are signed to the foregoing instrument, being first duly sworn, do hereby declare to the undersigned authority that the testatrix signed and executed the instrument as her Last Will and that she had signed willingly, and that she executed it as her free and voluntary act for the purpose herein expressed, and that each of the witnesses, In the presence and hearing of the testatrix, signed the Will as a witness and that to the best of their knowledge the testatrix was, at that time, eighteen years of age or older, of sound mind and under no constraint or undue influence. COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND 5S: Subscribed, sworn to and acknowledged before me by CLARA K. WARNER, testatrix, and subscribed and sworn to before me by BETZl A. MORRISON and KATHLEEN M. KENNEY, witnesses, this , ~ ~ day of November, 1992. ('7/Lo _ '1, ~t,- tJ..~.1 F\oalIr B, Irwin, Notll1Y NlIc Ca~~ lloto. 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" ~~ ' " " .' .' j' . . :, " .. <lIf', Estate of: Date of Death: County: INVENTORY CLARA K I/ARNER July 5, 1994 ClJMBERI.AND ,," 'I,' Cash: ..~................................._.................................. , , . I I '':':':'::-., ..... :..... .-. ~....:t!- -1:., -" - '.. r-....:......_-,,.. ~...... 1-"'..."\r~I,~..,lt-" ',- '.',. . - ,. -._t.,., \.. .""'" . i , .,~r_ . " '-r-,. ,:._, i'e".. " "" r,iL '. ,- H_"_~'"" _. '" ') . ", ',.'1 ':')',I!t")"-~i "it'" -H';;, C',', ' 1 CORESTATES HAMILTON BANK . ACCT 31358256 OPENED IN THE DECEDENT' S NAME ALONE DATE OF DEATH BALANCE 2 CORESTATE HAMILTON BANK ACCT 6239072 OPENED IN THE DECEDENT'S NAME ALONE, DATE OF DEATH BALANCE 3 ' CORESTATES HAMILTON BANK . ACar 1523645 OPENED IN THE DECEDENT' S NAME ALONE, DATE OF DEATH BALANCE 4. CASH ON HAND AS OF DATE OF DEATH 5 CHIlRCH OF GOD HOME PATI~ REFUND 6 FORETHOUGHT LIFE INSURANCE CO CONTRACT # 0001888990 PREPAID FUNERAL POLICY Subtotal ", Total Inventory ,', " , , " ';1' '" ,\1 " i:, ~ (/1 1-, V,l 1." ..,( " "~q:' ,'; .... , ~', ; ,I t'j, \0" 1 I{ I " ','I " 'i-.~, 1"1 ".' , .' '" j':, (\,,/' n:' " " , , t' "I.: , ..:.. :::1', UU " " " ',j' P\' I' ,I "1, '" ,1'1,_, , ' " -'--""1'" '" " --','1.", , f , _._ I ~o,629.82 22,000.00 19,796.74 75,68 294.74 5,234.50 .................. 68,031.48 68,031.48 I" " ,I; '" ." ,.' .. , ' " 'I, " REV. 1100 EX o(l1-Vl) . CO~.~m:tMNWIf %!%ll,\~ANIA HARRlSR5~t,V~~ha ,0601 I SOCIAL SECURITYNUMBEA 203.36 - 5382 ~ X 1. o'lIglool Aelum ~ I ~ 0 4. LIrrJ1,d E.,ale ~ l ~ []:I 6, Deoed,nl Died To Sial' ~ (Atlach copy of Will) ~OR OATESO' OEATHA'TER I!lll/IICHECK HERF. FASPOUSAl 0 OVERTYCREOIT IS CLAIMED ' FILE NUMBER 21-94-626 YEAR DATE OF BIRTH 1.2/27/1906 Coun Supplemental Aelum 801 NORTH HANOVER STREr~ CARI.ISI.E, I'A 17013 CUMIlERLAND INHERITANCE TAX RETURN RESIDENT DECEDENT (TO BE FILED IN DUPLICATE WITH REGISTER OF WILLS COUNTY CODE DECEDENT'S NAME (lAST, FlnST ,AtlO MtDOlE INITIAll DECEDCNT'S COI.4PI.F.TE ADDRESS IIARNER CLARA K NU~BER 05. 3, AelT\lilnda, Aelu,n (to, dales 01 de.th prior 10 12-13-821 F.d.,,1 E.I4I. TIX A.lu", A.qull8d 6, Tot.1 Numbor 01 S,le D.posh Bo,es D 4.. FulUla Inler.sl Compromisu (tor d,tes of dealh .her 12,12-82) o 7. Docedenl Malnl.ln.d. Living Tru'l IAttach. copy of Tru,11 ~ C ~ + ~ o N T ~ C o M ~ f N )L{; CO~PLETE ~AJLINO ADDRESS (1) (2) (3) (4) (5) IRIIIN, MCKNIGHT & HUGHES 60 IIEST POMFRET STREET CARLISLE PA 17013 None None None None 68 ,031. 48 C P ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO, NA~E ROGER B. IRIIIN , ~ TELEPHONE NU~BER ~ 717-2/,9.2353 1. Roal E.lale(Sch.dule A) 2. Slock. and Sand. (Schedule S) 3. Closely Held Slock/Partnershlp Inlero.t (Schedule C) 4, Mortgages .nd Noto, AacelvablelSchedula D) 5. Ca,h, Sank D.posh' & Mi"ell"18ou, Personal Property (Scltodul6 E) 6. Jointly Owned Property (Schedule F) 7, T,en,fe" (Sch.dulo G) (Schedule L) 8. Total Gro" A"el' (tolalline, 1.7) B. Funeral E'penses. Adminl.lraU,e COSl', Miscellaneous E'pen,e, (Schodulo H) 10. Dobts. Mortgago Liabilllio" Lien, (Sch.dul. II 11, TOlal Deducl;on, (Iolalllno, 9 & 10) 12, Nel Valu. 01 E,lalo Oino 8 minu, IIno 11) 13. Cha,ilablo and GovammenlalSoque.t, ISchedulo J) 14. Nol V.lue Subjoct 10 Ta, (line 12 minu, lino 13) 15, Amounl 01 line 14 la,ablo a16'1o rale IInclud. valuo, from Schodulo K 0' Schedul. M,) Ie. Amounl ollin. 14 'a,ablo a115'1o 'ale IInclude valuas f'~m Sch.dulo K 0' Sch.dulo M) 17, P'lncipalla' duo (Add la' from lin. 15 and from line 16.) 18, C,odilS/Sp Povony P,lor Paym.nlS Dlscounl Inlo,o,t 0.00. 0.00 + 167.22 0.00 19, II line 18 i, groatorlh.n lino 17. enlorlho dlherence on line 19, Thl, Is tho OVERPAYMENT. [IJ 0 ICh.ck h." II you "" "quilting. "fund of your ov.rPlym.nl.1 20. II line 171, groalor Ih.n line 18, enle, Iho d,horenco on lino 20 Thi' I' 1he TAX DUE, A. Enlo} Ihe inlore'l on Ih. balanco dUB on line 20A, B. Enler Ihelolal of Iino 20 and 20A on lin. 20S Thl, I' Ih. BALANCE DUE. M.ko Ch.ck PI able I., R.glsl.r 01 Will.. Agonl ~ .. BE SURE TO ANSWER ALL QUESTIONS ON PAGE 2 AND TO RECHECK MATH <Ii <lI Undlf ptrv.JUu of po/IUry, I dect",o lhlll ha~e examIned lhtl 'lIIUln, Including Iccomplnylng lChtdulo, and Illltlmenls,.nd 10 the bell of my knowltdge .nd blU.I, II II llue, coulcllnd complete d"cll,elhllll1,uleslllt has beentlporl.d 111'uo IN/kilt value. OI<:II.I.Uoo 01 plfp.llt' other thin lho pel!lOnal ,.present.lIvelll biNd on .U Infofmll!onof which prlp'r., hlllll)' knowledgo, SlaNATURE OF PERSON RE'PONSIBLE FOR FILINa RE1UR~ ADDRESS (e) (7) None None (e) (B) 12 ,291. 08 (10) None (15) (11) (12) (13) (14)- x ,05 = 55 ,740,40 (Ie) 0.00 X,15= (17) (18) (IB) (20) ( 20A) ( 20B) L it.... .ROGER. R.. IRWIN.............. __ __..._.. __.. ___ ___. 60 liESI' POMFRET STREET CiiRLiiiLE: .'pi>:. .ijoY:i.'....... -.. ...,.. - _..-...... :) ER DWER TH~N REPRESENT AliVE ADDRESS IRIIIN, MCKNIGHT & HUGHES (,ci .WEST' PCiMFRE'I;' STREET" -......,..... -. -....... CARli S'I:E ','"Pil"'i joY:i......., ........... -,..,..,.. , le<:eSoflw"',lnc 68 , 031. 48 12 ,291. 08 55,740.40 NonB 55,740.40 3,344.42 0.00 3,3/14.42 167,22 0,00 3,177.20 0.00 3 ,177 . 20 DATE 10-05-94 DATE 10-05-94 FOfm 1500 (ROY, 11,111 REV, 1101 EX + (HII SCHEDULE E CASH, BANK DEPOSITS AND MISCELLANEOUS PERSONAL PROPERTY PIe.se Print or T . fiLE NUMBER 21.94.626 COMmm~o/~MhYANIA ISTATII Of CLARA K WARNER SS# 203-36-5382 07/05/1994 Inll -own.d with RI hI 01 Survlvoflhl mu.l be die cloud on Sch.dul. F) DESCRIPTION VALUE AT DATE OF DEATH 20,629,82 CORESTATES HAMILTON BANK . ACCT 31358256 OPENED IN THE DECEDENT'S NAME ALONE DATE OF DEATH BALANCE 2 CORESTATE HAMILTON BANK ACCT 6239072 OPENF~ IN THE DECEDENT'S NAME ALONE. DATE OF DEATH BALANCE 22,000.00 3 CORESTATES HAMILTON BANK - ACCT 1523645 OPENED IN THE DECEDENT'S NAME ALONE, DATE OF DEATH BALANCE 19,796.74 4 CASH ON HAND AS OF DATE OF DEATH 75.68 5 CHURCH OF GOD HOME PATIENT REFUND 294.74 6 FORETHOUGHT LIFE INSURANCE CO CONTRACT # 0001888990 PREPAID FUNERAL POLICY 5,234,50 , " TOTAL (Also .nlll on line 5. R.c. hulallonl (At1ach .ddhlonal8 1/2' x 11'ehe.1I W mortlp.ca II nlldad.) Copyl19hl (e) ,n, 101m 1011",,," only Coni" PIoco SOn",,", I"" . 68 031. 48 p"",, 1100 ..hId..I(...., 1017) .'1",'11 'I