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FAMILY SETTLEMENT AND FINAL RELEASE
IN
ESTATE OF I,EROY H. BRINTON, DECF:ASED
FILE *: 21-1994-0727
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'9'j ^PH 27 I'):I\,~
KNOW ALL MEN BY THESE PRESENTS, that WHEREAS, LEROY H.
C/u,. Lilt
BRINTON, late of Car lisle, Cumberland County, etlJJi18ylvan~~t1'1\
deceased, died intestate on May 2, 1994; and,
WHEREAS, following the filing of a renunciation by Donald
Brinton on August 19, 1994, Letters of Administration were granted
to Donna (Brinton) Mi 11 er and Diane Brinton on August 19, 1994,
hereinafter called "personal representative" I and,
WHEREAS, the personal representative has gathered the assets
of the estate of the said decedent and the assats consist of both
real property and personal property, to a total value of
$29,253.76, as set forth in Exhibit A, which la a statement of
account of the said personal representative, and which is attached
hereto and made a part hereof, and marked Exhibit Ai and,
WHEREAS, the debts and deductions, including the payment of
inheritance tax in the said estate, amount to $10,494.65, leaving
a balance for distribution of $16,756.93, also as set forth in the
statement of account of the said personal representative, which is
attached hereto and marked Exhibit Ai and,
WHEREAS, the balance for distribution as shown in the said
statement marked Exhibit A has been partially reduced to cash and
has been distributed as herein indicated in accordance with the
laws of intestacy of the Commonwealth of Pennsylvaniai and,
WHEREAS, certain items of personal property have been
distributed to the heirs, as set forth in the Table and Schedule of
Distribution, which is attached hereto and marked as "Exhibit B";
and,
WHmREAS, the heirs have been given the opportunity to take any
of the items of personal property of the decedent which heretofore
had been held in storage, and the heirs have in fact taken and
claimed such of these items as they desired, and the remaining
items were sold at auction and the proceeds have been included in
the "Assets" section of Exhibit A, under "7. Household Furniture";
and,
NOW, THEREFORE, KNOW YE, that we, DONNA (BRINTON) MILLER,
DIANE BRINTON AND DONALD BRINTON, being all of the childr.en and
thus the heirs of the said decedent, do hereby each of us,
acknowledge that we have this day had and received from the
aforesaid personal representative, in full satisfaction and payment
of all sum or sums of money, as to which are entitled pursuant to
the laws of intestacy of the Commonwealth of Pennsylvania, t.he
amounts due us under said laws of intestacy which amounts we have
received this day, and which amounts are in the amount set opposite
our respective names in the table and schedule of distribution in
said statement attached hereto and marked Exhibit B;
AND, each of us does hereby stipulate that in order to avoid
the expenses and time involved in filing of a formal account and
schedule of distribution, we each agree that no account is
necessary and we do hereby agree that we do consent to distI'ibutlon
being made without the filing of an account and schedule of
distribution, the same to be with the same force and effect as if
they had been filed and confirmed by the Orphans' Court Division of
the Court of Common Pleas, Cumberland County Branch.
THEREFORE, we and each of us, do hereby remise, releaso
quitclaim and forever discharge the eaid personal representative,
DONNA (BRINTON) MILLER and DIANE BRINTON heirs, executors, and
administrators and assigns of and from the said estate and from all
actions, suits, payments, accounts, reckonings, claims and demands
whatsoever for or by reason thereof, or for any other usa, matter,
cause or thing whatsoever, touching upon the estate of the said
decedent, and each of us do further. hereby covenant and agree that
should any liability come due to the estate of the said decedent
after the signing of this agreement, we and each of us do hereby
covenant and agree with each other and the aforesaid personal
representative, that we will contribute pro-rata, our share of the
estate to satisfy any and all claims, demands, suits, or causes of
action which may be successfully prosecuted against the said estate
or the aforesaid personal representative after the signing, sealing
and delivery of this Family Settlement Agreement and Final Release.
IN WITNESS WHEREOF, we have hereunto set our hands and seals
n)fl'{~
this ~l, -- day of April, 1995.
.11 (\ o1Ml~l LJLYl~ ((!Iit !/(iYI) )~!/;;~
DONNA(BRINTON)"MILL R
Oil ~oJCUVlCU\), J) '. /.
,01 l' }U fi;\ I\D)" J
(j__ DIAN BRINTON
" "}
. 1 I " ~ ,.' .
qnflt'(1U'1IlW ~dL" / ","~
DONALD BRI N
./
(SEAL)
(SEAL)
(SEAL)
III, ,nu.... 9
,(R!V:Il~EXt 117881 INHERITANCE TAX RETURN
. ~~;j~ RESIDENT DECEDENT
COMMONWEAatlmpWNlYIVANIA (TO BE FILED IN DUPLICATE
DEPARTMENT Of REVENUE
HARRISfJ:,U~Onlu 060' WITH REGISTEM OF WILLS) COUNTY CODE YEAR
O'C~~~'~;~I~':^S'L'~'~~~O~~OL' IN",^lI~.-~~--.-~~I(l'~~;r's~~~~~" ~~~ STR E ET
scicihLS'CU'"VtlUMBER .. ID^""""^'" I(lATE'" '''''' CAR1,ISLE, PENNSYLVANIA 17013
178-16-6042 05/02/94 03/30/23 c","' CUNI3ERLAND
. .. . . .1. . ~
I~ 1. Original Relurn I I 2. Supplemenlal Relu,n I I 3.
I I 4. limlled ellale I 140. fulure Inlerell Comp,omi.e I 15.
(for dOlo. of deolh olte, 12.12.82)
I I 6. Decod.n' Diod TO.lolo II 7. Docod.nl Moinlolnod 0 living Tru'l
(Alloth copy 01 Will) IAltoch copy of Tru,')
AIf cOilliISPOND'NCE-AND-cOijfiil'NTiALTAXINFORMATioN SHOU-LD 81DiiiECriil TO,-..---.----..--------.
.---------!..-_..-
-NAME - .-.----------..----'~-,-----.._.-.~._-----_.--.--..".-.,-.-.--- cOMPLffE~\AllING ADDRESS
C/.
(It(
PILI NUMBIR
1994-727
NUMBER
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:00
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Romaindor Roturn
Ifor dolOl 01 doolh prior 10 12.13.821
Fede,ol ellole To.
Re'urn Required
Tolol Number of Salo Depo.II 80.n.
1
_8.
~ffi
"'0
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82
~IICH,\EL A. SCIlERER, ESQUIRE
nLfPt{ON"f NljMstli
O'BRIEN, BARIC & SCHERER
17 WEST SOUTH STREET
CARLISLE, PENNSYLVANIA
. L?17.1
249-6873
17013
I ._.~_ .
23,270.00
NONE
NONE
NONE
5,698.23
1,978.31
NONE
1. Real e,'ale (Schodulo A) I II
2. Slack. and BOlld. ISchedul. B) I 21
3. Clo.ely Held S'ock/Parlnollhip In,ore.' ISchodulo C) (31
4. Motlgage. and Nole. Rocolvoble (Schedule 01 I 41
5. COIh, 80nk Dopo.II' & MIlCellonoou. POllonol Proporlyl 51
(Schedule E)
6. Jolnlly Ownod Properly ISchedule F)
7. Tronllell (Schodulo G) (Schodule LI
8. Tala/ Grall AIlOI. (10101 line. 1.71
9. Funeral Expensos, Adminlslralivo Cosh, MhclJllanaous ( 9)
e'penle. ISchedule H)
10. Debls, Morlgag. liobllltie., lie" ISchedulo II
11. T 0101 DedUCllo" Ilo'alllne, 9 & 10)
12. NOI Vo/ue 01 Ellole (line 8 mlnu.llne 11)
13. Chorllable ond Govornmenlal Boque.1s ISchodulo JI
.. 14.__N_ol Valu_e SubjecI 10 Ta'.1llnol2 minu.lln. _13)
15. Amount of lino 14 toxoblo 016% ralo
(Include value. Irom Schedule K 0' Schodule M.)
16. Amounl of llno 141axablo 01 1.5010 role
(Include VOIUOl Irom Schedul. K or Schedule M.I
17. P,lndpollo, duo (Add 10. from lin. 15 and ',om line 16.)
1 a. Crodits Prior raymonls Discounl
n _ __ n"H_~_", _._ ___n__._
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11,032.44
NONE
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11,032.44
'BO" ..._
19,914.21
NONE
1 9 , 914.2 1.
0'_'_ ..______.._. ___~______
1,194.85
111)
112) .
113)
Jl~L
x .06"
_U___ . .. ___________._.__.___...._._._
19 I 914.21
1151
116)
.X .15 "
z
o
~
S
~
o
u
g
1,194.85
1171
Inlorosl
+
19. II line 18 i. grenlo' Ihan line 17, onlor Ihe difference on lino 19. Th"" Ihe OVERPAYMENT,
al -J R!t:r.I!lII.U,.I.TI'I'.U('."hllf'IIllolj.l.-r.JI'Ti"I'Tllr.!ay.l'JIJ..l.:.IT",UIIUTIi'iT'lilll
NONE
118)
119)
20. II line 17" 91001er Ihon IIno 18. onle, ,he dilforonce on IIno 20. This i"he TAX DUE. 1201
A. Enlor Iho inloroSl on Iho ualanco duo on 11no iDA. 12CJA)
8. Enler ,he 10'01 of Ii no 20 "nd 20A on IlfI" 20B. Thi. i. Iho BALANCE DUE, (208) 1, 194 .85
Make Check Payablo to, Regl,t.r of Willi, Ageot _.. __.
. ....-. .SE siiiiE TO Atiswii-ii AiLQLJESTiClNS.ON iEVEilsESIDE AND TciRECHECK MATlI.-....------
lJ~rl;r .i;;~~"iOl-of 1'0;jury,I,I;c1I1'o ii,~i.lh",o "n~;;;;;d IhiJ rnlu',n, inciudinq accompllnylng lCh;cI~I.. ~;,f;,,,i'-';;~-;I;:-;,,;(I,-"-jj,-~b;;;;-;'Tmy kn'-;1~9'- ond-hnlj;~
,I II I"e, cOllocl "nd COmplol. I docl",o Ih," "II ,.111 0"1110 h," b"." '.po,'ocl "'lru. m",kol ,01110. Oodllralion 01 p,oporo, olho, Ihon Ih. p,"onol ,ep,o,ollloll,o iJ
hOlod on 011 informalion of which prororor hell ony knowlo~on.
l1'''''''''' OF P~'~Q',' 't~P?Ns:'g:'?I~;L'J' r~ET~~I.' ('~~'J'ESS i I., \ 1'-, j hi I , 1'" ,", 'I.Apl.!" ,_\(, (.;('
(j, /I1/1!l ,II! /IiJU. ..)\1) (U ~y!( 1(,1'/ I. ((" 1\';.1. 1,<. 11(1_,',
,M;Mtf.1 OfP,~MaR Ortl(hll'X~'^"V' '- .h,,,ESS ,..
--~~/f..'&_.. -_.nu_ _I to_#:. _$o-'.a._.~f. --1_.1.11.!:./1:r ~r-1.C1__ _._____
1,194.85
bATr ...... .. n..
:7/;/1<;"
DAfY /
1'31,tf'S
. ~
!IV.1l011X. 111.151
~ SCHEDULE A
COMMONWIALlH O. 'INNlYLVANIA j REAL ESTATE l
INHI!"AN~I lAX !IlU!N .
==....==_=~~~N,,~~I.~,!!lc"N_l_~.-~.,",.,,~._..~-,.-,-_,,,,,.~,,, ,_."__,_._=.-"",,==~,,.-=. ,,,,,_~...==..,_,,==~=,~,,,~.,.~=.====--.,
ISfATI OP PILI NUM8ER 1994 727
LEROY H. BRINTON _
___.__._..__u_.___. __ __._ _.__+.__, _ _.__. u..... _._. .. _ .._ _,___ ._n_ ._m_ ,_n._,. _....,..__......._._...... . ... ____ _.. u.._. .'_._____' __ ____._.__
(P,op..lY lolntly.ownld with Rlghto' Su,vlvollhlp mUlt bl dl..lo..~ on Schldull PI All 11.1 ..totl Ihould bl ..portld.I 'ai, morklt ualul
which II dlflnld.. thl p,llI.t which prop"Iy would bl uch.ngld b.lwoon a willing buy.. and. willing ..II.., nlllhll blln~ complllld
10 buy., ..II, both h.ulng II..onabll knowlldgl 0' th. ..lluant 'acll.
-.-.--.---.1'"---..----..---..--........ . ..- ---..---....-.,- ....... ..-.. ..--.---....---..---..----- -.-.---.-.....------..-
NulTMEMaER OESCRIPTlON VALUE AT DATE
Of OEATH
-------.---------.----...-.-.--- - ....
I. SINGLE FAMILY RESIDENCE
169 EAST NORTH STREET
CARLISLE, PENNSYLVANIA
CUMBERLAND COUNTY, PENNSYLVANIA
DEED BOOK L20, PAGE 148
.--~-- -..-.----..--.....-.~- ---.~..-----._._-----._-. ---'--'-.--_0
17013
~23,270.11
\
"
""
,.
,.
"
" .
.';,
". I,
,1
"
"
"
"
,
" .
,.
, '
.,.\
:1
,I"
, ,
"
".
"
"
"
, .
,"
!
I
I
;1,
.'
" .
.Ii
I
~
i
!
TOTAL IAllo Inll' on linl I. Rocapllul"lanl
(II mati IpaCI il n..dld, inllrt addillonallh"'1 o( loml II...)
S 23,270.11
.ev.lsn... 11-'71
.
COMMONWeAl'" O. ,t,.,,.,anVANtA
INNe'''ANCI 'AXlnUIN
""NNT OfCIDlNT
SCHEDULE J
BENEFICIARIES
ISTATI 0'
PILI NUM.IR
1994-727
LEROY H. BRINTON
ITlM NAMI AND ADDUSS 0' SlNIPlCIARV
NUM.IR
A. Ta,abl. 8oqu'lIl:
1. DONNA (BRINTON) MILLER
153 WEST LOUTHER STREET
APARTMENT #2
CARLISLE, PENNSYLVANIA 17013
2. DIANE BRINTON
153 WEST LOUTHER STREET
APARTMENT #4
CARLISLE, PENNSYLVANIA 17013
3. DONALD BRINTON
513 SECOND STREET
CARLISLE, PENNSYLVANIA. 17013
RILATIONSHIP
DAUGHTER
DAUGHTER
SON
ITlM
NUM.IR
NAMI AND ADDRUS 0' IIINIPlCIARY
B. Cha,lIabl. and Ga...nm.n'.1 BequI""
1. NONE
TOTAL CHARITAIL! AND GOVERNMENTAL BEQUESTS (All. In'" an IInl 13, RKapllulallan) S
(If mill IpaCI I. n"dld, 'n,," addltlonollh"tl II loml 11.1'
AMOUNT OR
SHARI 0' ISTATI
1/3
1/3
1/3
AMOUNT OR
SHARI 0' ISTATI
UY,II09IX+ (7,1l1
COMlffi~~~~~~IOMI~,~~~\l'ANIA SCHEDULE "F"
IIIIDINl DICID NI JOINTLY .OWNED PROPERTY
ISTAn 0' PILI NUMIU
LEROY H. BRINTON 1994-727
Jlln' '"nan'(11I
NAMI
A, DONNA (BRINTON) MILLF.R
A~I
153 WEST LOUTHF.R STREET
APTlRTMENT #2
CARLISLE, PENNSYLVANIA
ULAlIONSHII' TO DICIDINT
DAUGHTER
I.
C,
Jo'ntly..wnod I'1O",rlyl
:=r Lm1n DATI TOTAL VALUI
NUMII JOI~T MADI DISCIUI'TION 01' I'1I0l'mv DICD'S DOLLAII VALUI 0'
TlNANT JOINT 0' Assn "'INT, DICIDINT'S INTIIIIST
1, A 10/19/: 3 $25.00 SAVINGS BOND $80.71 50 $40.35
'/ll/.f #Q5122115439E
2. A SAVINGS ACCOUNT
YORK FEDERAL
ACCT. # 100-123903-C p,875.92 50 $1,937.96
I
TOTAL (AlIa Inlor .on IIno 6, RlCapllul.llan)
III maro IpOCI II noodod Inll" oclclltlano'lhHII 0' loml 1111)
S 1,978.31
!' .
leV.1S11 fit 11I6l
~:i'~
COMMONWEAltH Of PENNSYlVANIA
INH~RlfANCE TAX RETURN
~!llDr,!, O!~!O~W __.......
SCHEDULE H
FUNERAL EXPENSES,
ADMINISTRATIVE COSTS AND
MISCEllANEOUS EXPENSES
Ple.ale_!,rlnl or_ Type
-
Fill NUMBER
ESTATI OF
LEROY H. BRINTON
1994-727
..-.--------- --------- -- -- - --- ------------ -~
ITEM
NUMBER
DESCRIPTION
AMOUNT
- -------------- ------ - - ----- -~~ <---- ---.----.- ----
1.
Funeral bpenulI
HOFFMAN ROTH FUNERAL HOME
CARLISLE, PENNSYLVANIA 17013
CUMBERLAND VALLEY MEMORIAL GARDENS
$5,725.70
A.
2 .
$ 550.00
1.
Admlnlltratlve COlt11 188- 50- 2 6 5 6
Perlonal Reprelentatlye Cammllllanl 187 - ~ - 9 9 3 Q.
Social Security Number of Perianal Reprelentatlye, __:___
1995
Year Cammllllonl paid ________
$1,500.00
B.
2.
Attorney Feel
MICHAEL A. SCHERER, ESQUIRE
$1,500.00
3. Family Exemption
Claimant ______ Relatlonlhlp _
Addrell af Claimant at decedent'l death
Street Addrell__________.._.._______
City ________._..___..___Slale .._._ Zip Code.
4. Probate Feel
(REGISTER OF WILLS, SENTINEL, LAW JOURNAL) $ 216.20
C, Mlscollaneoul Expenlell
1. PRUDENTIAL(HAZARD INSURANCE) $ 134.00
2. UNITED TELEPHONE SYSTEMS $ 1. 39
3. UGI $ 31. 30
4. PP I), L $ 202.01
5. CARLISLE IMAGING ASSOC. $ 11.86
6. DARLENE MOYER(TAX COLLECTOR) $ 480.08
7. BOROUGH OF CARLISLE(WATER/SEWER) $ 124.02
8. CARLISLE RENT-A-SPACE $ 268.08
9. U-HAUL $ 112.80
10. HENRY LINE(JEWELRY APPRAISAL) $ 25.00
, 11. DOUG HEINEMAN(REAL ESTATE APPRAISAL) $ 150.00
...- -<_._--~------------- ----.--------.-.
TOTAL (AIIO enter on IIl1e 9, Recapltulatlonl 5 11,032.44
(If more spau Is needed, Insert addltionallh.ell of lam' Iln)
t:' --
11'00 TotIJ ..lttIBtoktt" Com"" bllld on prle.l
DMJI'.Vl of Ccn-..1wu.-,n (ItI' 7(0).J ''''',)~,
111,00 10
UI,OO 10
L. 8EnLEMENT CHAROn
.'/L'.',~I,~.:;J
aI.OOO,OO
,., .
l,soo.on
'"
,.,
,.,
704 COrmlulon Il.ld.l Stlli,rllln!
1I'0lt. . Ib"rer
c:.JltIUY U Ir~"'1I
,..
i.qo,~'li_Vf,bltlnOon_t1C)nW1th.LOa/ll. " ".1 I;.",': ,..,,'. '1I,Vi'.U/',/.
11,4011;lg.AtrlI 0001 Totllcn.'V...llnt.,OlttllllUghlll"
101 LOlli O~Q'(l.t'lon Fu .00 "
102 LGln[).scounl ,00 "
80:1 AWI".I F.. to
1>>1 CftOlln.po.1 to
105 ltN1et".I/\tP.etJon r.. 10
806 I.lOI1~g'lr\Su'.nC4 All(lllCIllOfl F.u 10
eo7A"~IOf'IF.. to
~ Applioation r.. to
109 InlP41otlon h. to
1'0 Doouaent puparatioa. t.. to
1111 to
,""I"""""'" "",'''':JB'',I'",~:.:.....:.ofri..,'~ld''''~'.li'"'''''.' in"'., ,t,ll1".'1'.lt",.\}\.<,..n'I'"
,1OO,,-,,,,,,,u,qU;trw .y...~t~lV."" ," .olIn'''\lIVnoeU"\{.\",''ii,,t,'~., 'I rJ/ll,,!).f~ . ,;j
got Int""l From 15-0.0"" 10 fltfday.
802 l,4011g.9t 1r\.iUllflCO rflmum 101
to3 HIlIrd Ifllllranet Pltmltnl 101
mO'\I"'~
OIl<
I,,.
.~iI........ De" .It.cI'''''fi'''''':;U''V/,'I.
".............. po ."" ""'lll'Ot (. I . , .
1001 H,turdlnllltlrw:;e
1002 l,lol1gtQo"ll'llUf'f'lCtt
1003 CiltpropfrtyllJlt.
1004 COlA'llyPlOptttyluU
1005 AMuIlUMumenll
'''''
1007 8c:MoIlul.
'''''
~l4ri'.'!lllt~Ii~~i\,;'!,.f'i
1101 S41111/T'l11'l1 or dotJr'Ig '"
1102 Abtlrlct o(~tl'a..l'th
ya.l1lo
ytltllO
. J:
. .c~"'U'a,',~.t...'":;;".:.:......,.",""',.,,.'.
"I.\;,~~"",I'":" .,."..,.,..~".,~,,(~I;~.l": ",' ,.,'
/T'Q6 0 ptlmonlh
mot, 0 ptlll\1f\!h
mot. 0 $0.00 pel rro:l(\lh
mos 0 ptl month
rroa 0 ptlmonlh
mo. 0 plt~lh
mot. 0 _0.00 Pltmonlh
mot. 0 p,1 month
; ,...?l,;(l~W,'f".\j1r~,~:', "/~ l\~; '.' "" '.- : ,I.', "\,'~!.it~..1 ~.' :~.", ....f...
":J':'~,"'.l,'., <l'lH-'1 " ;1 ''', ... ,
~~~J' :~Jit.r!J~ 1 ,lJ:f ~':(~' ....~ :f ~~:: {~~j1 !
.
.
~
.
.
10
10
1103TIII".amlnIII0l'l
1100tT111tInlullnctblflder
tl~ OoC\lf'l'ltfllpt"tplflllon
Hoe Noltry'H'
1107.Allomty"""
(mudtt lbovt UlfT'4 tolJ'l'oberl
1108 TI1It1l\lUrllle4
lif'lCludtl AbOvt n.rrd nunbcua
1108 Lffld.(.Cov.r1oe
1110 (htmfrtCOYtI.gll
1111
1112
1113
ii~Gowm~1 AlOordlng ind 1111"". Charge'l
1201 Rteordlfl9II" 0Hd _12.00
1202 Clly/counlyl.llmps Dttd uso~no
12M Sltl.lItJ.I.t'f'tlS C>tt<I USO.OO
llO<
1205
11IIO'A,ddIUon'l Sel\t.men' Oh'lg~1I
cuh
rref , Tilef/Mia~el A. Saherer, .1
~
. , : :'~ ~ ' OJ;'
:if,.l"./'
R.I..... _
Mortgag.
Mortgag.:_
Mortg.g.:t
1301 SUN'.,.
"
n02flOlllf\1plI,I,on \0
nOJ Cun.n' Tau, (llll IrGfT180rrow,rIStlltl
1304
1305
1306
1307
1100 TnI.1 SetUlment Chllg.. (Inltl onlln.. i03, SecUon J .nd 802,8Io110n ~l
0.00
.'r
-
.
...
rloeNo, 2
.._.._u.. r,ldFrom -
fl.ldFrom I'/CO
Oor,o..I'" Stiltf'.
Fundi II Fundi II ,.,
S.lUlmtnl S,ttltmtnt ,.,
'0'
1,500.00 ,..
'..
" II. '" ",1. ~
0.00 an,
0.00 802
803
...
IO!
~
107
...
...
.10
'"
. ,:.\Vi.~~~} 'l;l;t.\, ','" ""t,' ~*\!'I!,\j~i!'S' ~
:\ t
10'
IlOil
803
OIl<
...
1.',;:',..;-' G.9o :~)J\ ~1;~i9N;\;t::;{j!~" ,~
,,', , , ,',""',['
'0<"
100'
'00'
,...
'005
'''''
'00'
'''''
ioJ,:','!: ,. 'i..f.{}i rUli..i.. '.\ .1) " 1100
nOI
".,
"00
"...
liD!
..00 "..,
q. 350.00 150.00 1107
I
1I0B
I
"OIl
1110
11 It
1112
. 1113
i i,'i."
" ., '100
13.00 '201
~50.00 '202
350.00 1203
"".
1205
, 1100
'10\
110J
1303
1304
1]0'
"'"
'30/
512.00 1,90e.OO '.00
................. .......~.......I.. '--
I..,
~~;ij~
l(l'HhlNWl"'t111 (H ",H4\IlVMII'"
III,Ull,llld Of .'''''llIl
INHUIlANtI 'All DIVltlON
0"1/ll.'Nl1
IIURI\lURr".. '111.OMl PI P I I 1
. ....!al...' n O~. .v.JlO.-,~~.
MUST BE COMPlHED BY REPRESENTATIVE Of flNANC'AlINSTIIUIION WIIERE SAfE DEPOSIT BOK IS lOCATED AND RETURNED 1CJ Ab,),'1 ADDRESS
C.OUNTY CO.DE ... FIll NUMUR --.sOCIAL SECURiTY OR DEATH CERTIFICATE NiiMBii-'---
'"1.-1 /')f)1( ~ ).).7 r-- ,I)J I' (O'!/...
'DECADENT'S NAMElIAII. "'11. M'Olllii . . D DATrOTDiATH
IS (' .." n J l.... IZ - .( 1-1 I. J 2.", ~
ADDRESl Of DECEDENT IIIiEfl) ICIIYI . -...-..
/G,(i qC qtV<Jd/'. ... s, "q .. . {)"'''/'J t. r.4
NAME AND ADDRESS or PUSON RlQUUTING THE OPENING OF THE SAFE DEPOSIT.BOX- .-----.-- U_.
(No\MEf
(}'1'hr.n~'1M.<-""J A Sc.hrrl.\ L~<v,~:r<rj
[STRfET AOORESSI (CITVI
II WA.,t 5v.l(..~ 'ST {'q"'/'J~ I'll /7od
...__ ______..u....__.. ._. _.._ u_____ ___.._____._____........_.. ..______~
I .N~~E,A.DD_R~SS~NERE~~TI().NSHIP~fA.NY'_TO DE.CE~ENT, Of PERlONll'PR~I!NT AT THE BOX OPENING .___. ......
a. (NAMEI IRUA110N~HIPI
..HQ~."'.rJt'"__u6(,q"'1_..:.,J_..... .... .~.~Cu__.
I~U.fEl AOOR~ssl _ (CITYI .
/J S IN /...... rL./'T .!" ~,.,,;" 'I.- C" - I,~ t.,
SAFE DEPOSIT BOX
INVENTORY
111A"1 IIIP COOE)
I) "/.J
IltAlEI
IIIP COOl I
IltAlll
p..<!:....
111P COOII
b. (NAME) IfHlATlONStHPI
OI",.J~ (ob(,v,".lrJ Cf'?
._._._.__n__..___._~.___.____.________ ___.._______. _.___ __ ._ ....______. ..____u____..___.___.. .. ____.___
lImE! AOO'IIII ICIlY) IltAlEI (lIP COOfl
/.1J L.AI /.v "-r-J.,.,, ~~- /'Wr 'i (".,...../,.-!' t'A-
.._..._____.._,_._.___~____.._______._._..__ .__.._.____.._.__._...____m_____________.._..__.. _
c. INAMEI liElA"ONIHIPI
______~'...~!:LJL.55..!.'.~! !C_....___.__.C!:.t1;7 " .~_
IIT'm Aoomll / V ICilY)
/ -r t<..4, -I- h.d/, b,-- t'.'fr I, J {, r 1/ no, J
---------~._...._---._-----~---_._-_.- -...-..-...-----...--- --.-..-----
NAME AND ADDRESS Of fiNANCIAL INSTITUTION WHERE THE SAfE DEPOSIT BOX II LOCATED
lNAMEj-----..-----..--..- _._-.---~_._-----_.._-_.._._------_._-_._--~--_.._.._------.,...
_JY...&' '" ~ ,J.$f.,-~_k;:.__.__._u.. ...._uu___.
IIT,m;oo;V1 1.1.1,.;(/,/ (r Si (:. r (,. (, I'll' .>~-~c:~~---....-.-.---li"(^iii.--llIP.COofI
I NAMiof-PERSONMAKING LAlT ENTRY---'-"- ..... ..~ OAIIAND TI~E OF LAIl INTR'''' . u u..
._ L\..ru'1...J)(." -t."'1urm----n_n m' C l.. I' J-y . ...
DATE.OfCO~R~~T_~~.rT B~I_':MBE~F'~3X ._.q ...n. .L'm't'~.~~:tHI6 ;~~ r~IITERED .. . _..__...__
NAME AND ADDRESl_~f PIRSONIS) HAVING ACCnS !O B~._.
a, (NAMEI b.lNA~\Ei"----
..
IltAlEI
111P COOE)
IST,m AOOml1
Isr"R"fEfi,ooRESSI
iciiYj'-"."-'" ... ..._n. "-'-"'--'(ITA,ij-
IIIP COOEI 1""1
----ISTA1fI-iiIP COOII
NAMEANDiiTLE OFE';\PlOVfiAKING THETN"VlNiORY ...._- ...- m..
.n'. ~!!:~...AJ ... ~~'":..~v~.___.2~~..nh_
WAl A WILL IN THE BOX? . YES;:;g- II ylI, a. D.".f will,
b. Nam. and add,... of p.uunal r.pr...ntallv., If namld In th, will
Ir~^MEI
1~'RfEi .AO.CIRf"SSI .
ICIIYI
.-'-jllA'iE)--'TzTP COO!)
c, No.mi-and ad~i"... ofatto;~;-y:-ii~~.v--~-..-
(tMMEI
(!)TRffT AOIJlIIS'J1
. h-'-(ciiII'-.-'--'---'.---ii"A"lii' 'iziiTciiii)
,
,
A. 14"J?o
REV-1547 EX AFP (12-941
COH"OHWEAlTII OF PENNSYLYANIA *
DEPARTHENT OF RF.VEHUf
BURt AU Of INDIVIDUAL lAKES
OI'P!' ZI0601
II.\RRISlUflD, PA I7IZ8-0601
ISTA1'l OF -SllNTON - ---rrRW
DATI OF DEATH 05-02-94
;'-1/1
NOTICE OF INHERITANCE TAM
APPRAISEHENT, ALLOWANCE OR DISALLOWANCE
OF DEDUCTIONS AND ASSESSHENT OF TAM
ACN 101
CJo~(
FILE NO.
COUNTY
DATE 04-17-95
~4-0727
CUMBERLAND
-
NOTE. TO INSURE PROPER CREDIT TO YOUR ACCOUNT, SUBHIT THE UPPER PORTION OF THIS FORH WITH YOUR TAM
PAYHENT TO THE REOISTER OF WILLS, HAKE CHECK PAY,IBLE TO "REOISTER OF WILLS, AOENT"
REMIT PAYMENT TOI
MICHAEL A SCHERER ESQ
OBRIEN ETAL
17 W SOUTH ST
CARLISLE PA 17013
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
r .- An.ou:t_ R.nl tt.d l
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~
R iV: iS47' EX" Ai: pU f i 'F94 r - NoYi or -6 F' "iNHEiiii' Ailc! - Yi. x' i,PPRA" i BEMENT ~.. ALL DWANC!' ciFi.......... -.. - -..
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF BRINTON LEROV H FILE NO. 21 94-0727 ACN 101 DATil 04-17-95
If an assellment wal ilsued previously, lines 14, lS and/or 16, 17 and 18 will
reflect figures that include the total of Ahh returns assessed to date.
ASSESSMENT OF TAXI
15, Allount of L1n. 14 .t Spou..1 r.t.
16, Anount of Lln. 14 t...bl. .t Lln..I/CI... A r.t.
17, Anount of Lln. 14 t...bl. .t Coll.t.r.I/CI... B r.t.
lB. Prlnolpol To. Du.
TAX CREDITS I
PAYHENT
DATE
02-02-95
TAM RETURN WAS, (X I ACCEPTED AS FILED
RESERVATION CONCERNING FUTURE-INTEREST . SEE REVERSE
APPRAISED VALUE OF RETURN BASED ONI ORIGINAL
I. R..I E.ht. (Soh.dul. A) (I)
2. Stook. and Bond. (Soh.dulo BI (2)
3. Clo..ly Hold Stock/P.rtMr.hlp Inhr..t (Sch.dul. CI (3)
4, HortO'O"/Not.. R.c.lvoblo (Sch.dul. 01 (41
5. C..h/B.nk D.po.lt./HI.o. P.r.on.1 Proplrty (Soh.dul. EI IS)
6. Jointly Own.d Prop.rty (Sch.dulo F) (~l
'1. Trln.1or. (Soh.dull 0) (71
B. Tohl A...h
APPROVED UEDUCTIONS AND EXEMPTIONS I
" Fun.r.1 E.p.nu./Adn. COlta/Hilo. Exp.n... (Sohldul. H) (9 I
10. D.bh/Horto.o. Ulblll tI../U.nl (Sch.dul. I) liD I
11. Totol D.duotlonl
12. N.t Volu. of To. R.turn
13. Chlrlt.bl./Oov.rnn.ntll BIRU.ltl (Schldul. Jl
14, N.t Vllu. of E.t.t. Oubjlct to To.
NOTEI
) CHANOED
OS
~i ~'
,
23,270,00
:31~'1
,Oll ;",
,00
. , 00 l..J
5,~98,23 ,
1 ,9-Z~' 31
;I:. ;',,00 I' .',
- ClJ
(81
11,032.44
.00
llll
1121
1I31
1I41
USI .00
U61__19,914.21
U7l. ,00
RECEIPT
NUHBER
AA022779
DISCOUNT
INTEREST
(t I
(-I
".00
K ,00,
K ,06,
K ,15:
1I81
AHOUNT PAID
1,194,85
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST
TOTAL DUE
. If PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
'r1
III
"JJ
:"rl rtl
u,
30,946,65
11 . D3? 44
19,914,21
,00
19,914,21
,00
1,194.85
.00
1,194,85
1, 194 ,85
,00
,00
,00
IF TOTAL DUE IS LESS THAN 81, NO PAY HE NT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CH), YOU HAY BE DUE
A REFUND. SEE REVERSE SIDE OF THIS FORH fOR INSTRUCTIDNS.)
RESERVATION I Elt,t" of d.c.dlnts dying on or beforl Olcllblr 12, 1912 .. If any future Intlrl.t In thl IIt,te II tran.flrr.d
In Po.....lon or InjoYI.nt to Cla.. I (collatlral) blnlflolarll' of thl dlcld.nt aftlr thl .xplratlon of any I.tat. for
llflor for 'lIar., th. Co..onwealth hlrlby .lfpr...h rll.rVII thl right to appralll and a..... Iran.flr Inherlhno. Tan.
at thl la~ful Cia.. I (oollatlral) rat. on any .uoh future Int.rl.t,
PU!lPOSE OF
NOTlCEl To fulfill the "qulr...nt. of s.ctlon 2140 of thl Inh.rltanc. and E.tat. Tal( Aot, Act 22 of 1991. 7Z P.S.
Station 2140.
PAVHENTI D.tllch the top portion of thlt Notlcl and .ubllt with your plly..nt to thll RlIghter of Will, prlntld on thl r.ver.. ,Id..
"Hakl chtek or .0nlY order payablt tOI REOISTER OF HILLS, AGENT
All pay..nt. rlcllv.d .hlll flr.t b, Hppll.d to any Int.r..t whleh .ay b. due with IIny r'lalnd.r applied to the tal(.
REFUND (CR), A r.fund of . tax crldlt. ~hlch WI' not r.qu.lt.d on the Tax Return, .ay bl requI.tad by cOIPI.tlng an "Application
for R,fund of Plnn'Ylvanla Inherltanc. and E.tat. lax" (REY-I513). Appllcatlon. are avallabl. at the Offlc'
of the R.gl.ter of Will., any of the 23 Rlvlnul Ohtdet OffiCII, or by calling the lipllclal lot-hour
IIn.wlrlng IIrvlcl nUlb.r' for fOri' ordllrlngl In P.nn'Ylvanla 1-800-362-2050. outsldl PlInn,ylvanla and
within local Harrl.burg area (111) 187-8094. TOOl (711) 772.22~2 (Hillring IIPalrld Onlyl.
OIJECTIONSI Any party In Int.rl.t not .atl.fled with the appral.t..nt. allowanc. or dl,allowanc. of dtduotlon., or a..t..~.nt
of tax (Including dl.count or Int.r..t) a. .hown on thl. Notice .u.t objlct within .Ixty (60J dBY' of r,cllpt of
thlt HottCI by,
..wrlttln prottlt to thl PA OIPart..nt of Rev.nu., Board of Appeal., Dept. 281021, Uarrl.burg, PA
...l.ctlon to have thl utter dthrtln.d at audlt of the account of thl Plrtonal rlP"..ntatlv..
- -apPIII to thl Orphan.' Cour t.
11128-1021,
OR
OR
AD"lH
lSTRATlYE
CORRECTIONS,
Faotual .rror. di,coYlr.d an thl. a.......nt should bl addrl...d In writing to: PA nlPartllnt of Rlvlnul,
Burllu of Indlyldual Tax.., ATlNI Po.t A.......nt R.vllw Unit, n.pl. 280601. Harrllburg, PA 11128'0601
PhOll. (711) 781-b~0~, S.. pape 1 of the bookllt "In.tructlon, for Inher1tano. TIIM R.turn for a nutdlnt
Dlcldent" (REV-ISOll for an .xplanatlon of adllnl,tratlv.IY corr.ctahle error.,
nlSCOUNT I
If .ny hx dUI I. paid within thrll (5) calendar lonth. after Itll dtc.dent', death. a flvI perc.nt (SiO dluount of
the tax paid II allowld.
IHTERESTI
Intlr..t I. chargld blglnnlng with flr.t day of d.llnqulncy, or nln. (9J lonth. and on, (1) day frol thl dati of
death, to thl dalt of pay.ent. Tult whloh blc"" d.llnqu.nt b.fore January 1, 1982 bolt Interut at thl rat. of
.IM (6%) pero,nt per annul calcuhttd at a dally rat. of .000164. All taMIt which b.ca.. dellnqu,nt on and .fltr
January 1, 1982 will bur Interllt at a ralt whiCh will vary fro. callndar yur to cal.ndar y.ar wJth that rate
announc.d by the PA D.part..nt of Rlv.m.l. Th, applicable Inter..t ratll for 1982 through 1995 arll
'!!!! Interllt Rat. Dally Inter..t Factor !!!! Interllt Rate Dally Interll~
1m 20% , 000~c.8 1981 9% .000241
I'U 16% .000418 1988-199l 11% .000301
1984 11% ,0001Dl 1992 ,% .000241
1m 13% .ooom 1991-1994 IX ,000192
1916 10% .000214 19'-S 9% ,000247
ufnternt It calculat.d II follow"
INTEREST . BALANCE OF TAX UNPAID X NU"SER OF DAYS DELINQUENT X DAILY INTERES" FACTOR
"Any Notice ltlllld afhr the tax h.cn," dlllnquent will r.fI.ct an Inter..t calculation '0 fiftlln Us) day.
blvond tn. date of the ~..,..t.nt, If plly"nt I. .,de aft.r the Inter..t cOlputatJon date .hown on the
Notlc., addltlonll Int.r.,t IUlt bl calculat.d,
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STATUS REPORT UNDER RULE 6.12
Name of Decedent I Ler~~ fI, !J/I'II-f"n
Date of Deathl~~-~~~~
Will No. 'Z. I ~ I 'I C, "1 - c 7 t. 7 Adm in. 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:
2. If the anBwer is No, state when the personal
representative reasonably believes that the administration will be
complete I -------
3. If the answer to No. 1 is Yes, state the following:
a, Did the personal representative file a final
account with the Court? Yes No X
b. 'rhe separate Ot"phans' Cout"t No. (if any) for
the personal representative's account iSI
1, State whether administration of the estate is complete I
Yes~__ No_____
c. Did the personal representative state an
account informally to the parties in interest? Yes X No
d. Copies of receipts, releases, joinders and
approvals of formal or informal accounts may be filed with the
Cerk of the Orphans' Cout"t and may be attached to this report.
*"
Datel
~. ~6'Cf(P
#tA'M~~
Signat.ure
;t/r&hll~! fl. )t. /'t!"'~/
Name (Please type or print)
ct.1 II :r l-e
17 ~/.
Address
~,,11, S'<J.
.)(-
FaNlI'I~
{2e.lt..u Jf
5d+}eMM + ~ r'/l~ I
J/?YIItI ~ d I /
pM h'(!f ,',. inrtttr1 tI f 1M
()f (etQ(() ,'", f'\.,'s (LlHO
Atr," ~ i, 11l~5'.
(MAH I rmfl AM3)
11111 lL.t"l- b~;3
Tel. No.
capacity I
personal Representative
K counsel for personal
represent a t i ve
()~