HomeMy WebLinkAbout94-00827
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IFU FOR THI9
CEAmlCAlE U 001
WARNING: IT IS ILl.EGAL TO AI.TElI THIS COpy OR
TO DUPLICATE BY PHOTOSTAT OR PHOTOGRAPH.
COMMONWEALTH OF PENNSYLVANIA
OEPARTMENT OF HEALTH vrrAL RECORDS
LOCAL REGISTRAR'S CERTIFICATION OF DEATH
CERT. NO. 2200656
SeptembVl 21 , 1994'
- D/llll 011111111 01 Thl~ C"llhr"Ilon
Name of Deoedent
C LA I [L._____.__..hh.hh...H.. ...__.______......$T A.&RL__
FilS! M,(l-II" lHI
Sex Ma.ie
Social Security No.___.J19-.Q?:,6.tJ.L.._..__.__._Date of Death~~J2..h 20. 1994
Date of Birth 02/24/1919
__ BI rth placeP-:Lf f-6b1Ji(!tL y'Qk k..f9ll!1JlILPel!!1.1H1Y.f1,lltll _.___
Place of DeathHoftl SP-<!UJ HO-6))itae. EMt Pe.ill.L~bQl9_J.Q!~!1-!>.I1.{R.'___Cltm.9.~_'t..fand C()ltnJ!l.t..-._------'=-Qlli1svlvanla
F4C'iiiIY N.mo (,<>,111/ Cllv Ij')!(>lJlJh Uf T'JIIIlI!l'p
RaclCi1UCJl.~_. Occupation lliwiliW!lelLLN,I.!!glH.u.,{./t..f.QIr,C.L Armed Forces? (Yes or No), Ye-6
Decedent'n
Marital StatuR WidawQIt ___ Mailing Address UO.l__Un({!I(l,Il!.c;(I1LML.AP-tl_}Jl~. Mec.Mll{~bm.... PA 17055
NLIJlitllH ~oIlo'''! C,ly or 101111 SttlO
Informant SIlMn lLMLLIi.__Ir.Cl.IJ--____._.___ Funeral Dlrector.1LJM'ULfQ~~UlL_.lP-.Pl!1}} 1- L
Name and Address of
Funeral Establishment _CO.cKL1ILJl1NE.RAL/11m~......1LN,_Clte-l\tl!lILSju__PlggkQll!!9.J.L) 7019- 042 4
: I nterval Between
: Onset and Death
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Part I: Immediate Cause
(a)r. .tJ.P .0.
(b)
(c)
Part II:
(d)
Other Slgnlfloant Conditions
~p IlfI f F a)J'Il!l p A . S .11.Jl....JLJ..JJ..___m_.__.______
Manner of Death:
Natural [)
Acoldent 0
Suicide 0
Describe how Injury occurred:
Homicide 0
Pending Investigation 0
Could not be Determined 0
Name and Title of Certifier __...cMtC1UL-pf..eat,(lelttr...__.At,V_I________________________._
(M.D., D.O., Coroner, M.E,)
Address ._.6.....MMIteL!'JJ\l..It.W!lY. Jle.CJwLZC.,lhltk 9L.P.tL..!1.e.?1.._______._____.. _._____ ..__.
This Is to certify that the Information here givon Is correctly copied from an original certlllcate of
death duly filed with me as Local Registrar, TIll) orlginul certificate will be forwarded to the StRta
Vital Records Office for permanent filing. )J}-<<~_ ~ &J!:'::V.:___~ 7{~q:
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lO/26/69.4IWILLS
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LAST WILL AND TESTAMENT
OF
CLAIR 1-1. STARRY
I, CLAIR H. STARRY, of Lower Allen Township, Cumberland'
County, Pennsylvania, being of sound mind, memory and
,understanding, make, publish and declare this to be my I,ast Will
and hereby revoke all Wills and Codicils previously made by me.
lTEM I.
I direct my Executrix hereinafter named to pay
all my legal debts and funeral expenses, including the cost of my
gravemarker, and administration expenses of my estate, ae soon as
practicable after my death.
ITEM ]_~ I give and bequeath all of my automobiles,
jewelry, wearing apparel, books, pictures, household furniture
and furnishings, and all other articles of household and personal
use or adornment, together with any insurance existing thereon,
to my wife, BETTY M. STARRY, if she survives me; but if she
predeceases me, to my children, MARNITA A. EGGSWARE and SUSAN M.
MURRAY, to be divided among them as they shall Bee fit, but if
they fail to agree upon such division within a period of two (2)
months after my death, then the items with respect to which there
is no agreement shall be sold, and the proceeds therefrom shall
be added to, become a part of, and administered with my residuary
estate, as hereinafter set forth.
ITEM I II. All the rest, residue, and remainder of my
property and estate of every kind and nature and wheresoever
situate, inclUding all lspsed legacies and bequests, and
including any property over which I may have a power of
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appointment at the time of my death, I give, devj,ee, and bequeath
as follows I
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A. If my wife, BETTY M. STARRY, survives me, to her
absolutely and forever.
B. If my wife, BETTY M. STARRY, predeceases me, one-half
(1/2) thereof to my daughter, MARNITA A. EGGSWARE, or if she is
not then living, to her issue per stirpee, and the remaining
one-half (1/2) thereof to my daughter, SUSAN M. MURRAY, or if she
is not then living, to her issue per stirpes.
C. In the event that a daughter of mine shall predecease
me without issue her surviving, her share shall be distributed to
my other daughter, or if she is not then living, to her issue per
etirpes.
JTEM~, All estate, inheritance, legacy, succession, or
tranefer taxes, including any interest and penalties thereon,
imposed by any domestic or foreign law with respect to all
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property taxable under such laws by reason of my death, whether
or not such property passes under this Will, by operation of law,
by contract, or otherwise, shall be paid without any right of
reimbursement from any recipient of any such property, wi thollt
any right of apportionment, and without postponement.
JJ'.E;ILV--,_
Should any person entitled to a share of my
estate be a minor, at the time of distribution to him or her, and
should the value of such property be more than the amount which
may be paid or delivered to him or her or in his or her behalf
without the appointment of a guardian or other fiduciary or the
delivery of security, such share shail be paid and distributed to
my Trustee hereinafter named to be held IN TRUST and managed,
invested, and reinvested, together with the accumulation of
income thereon, if any, and the Trustee shall use and apply from
tims to time such portion of the income and principal thereof as
it deems neceseary or desirable for the minor's reasonable
maintenance, support. and complete education, including
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preparatory, college, poet-graduate, or professional training, or
to make such payment for such purposes to the guardian or person
wi th whom such minor resides or di rectly to or for the beneH t of
the minor without further responsibi li ty to such minor or any
person taking care of such minor, and when such minor attains the
age of twenty-one (21) years, any principal or innome not so paid
or applied shall be distributed to such minor, or if he or she
dies prior thereto, to his or her personal representative.
.I.~~r~LYL. In addi tion to the powers granted by law, my
personal representative shall have the following powersl
A. To sell at public or private sale, to exchange, to
lease, to pledge, to mortgage, to transfer, or convert or
otherwise dispose of, or grant optione with respect to any and
all property, real or personal, at the time forming a part of my
probate or trust estate, in such manner, at such time or times,
for such purpoees, for such price or prices, and upon such terms,
credits, and conditions as shall be deemed advisable or necessary
under the circumstances.
B. To compromise any claim or controversy.
C. To invest in all forms of property without being
limi ted to legal investment.
l~ErLYUJ.._ I nominate and appoint my wife, BETTY M.
STARRY, but if she predeceases me, fails to qualify, or ceases to
act, I nominate and appoint SUSAN M. MURRAY, but if she
predeceases me, fails to qualify, or ceases to act, I nominate
and appoint MARNITA A. EGGSWARE, but if ehe predeceasee me, fails
to qualify, or ceaees to act, I nominate and appoint DAUPHIN
DEPOSIT BANK AND TRUST COMPANY, Harrisburg, Pennsylvania, as the
sole Executor of this my Last Will to serve without bond for the
faithful perfOl"manCe of dutieEl in any jurisdiction, and I
nominata and appoint said DAUPHIN DEPOSIT BANK AND TRUST COMPANY,
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CCllllfIC"ll\HiJl
WARNING: IT IS Il.LEGAl. TO AI.T~n TItIS COpy Ofl
TO DUPLICATE BY PHOTOSTAT on PHOTOORAPIt,
CllMMONWt^LTlI OF I'tfjNSYLVANIA
DEP^RTMtNT OF II/'^L HI VIAl. II/!COnlll/
LOCAL REGISTRAR'S CERTIFICATION OF DEATH
CERT, NO. 1758713
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Name 01 Docedent ..
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amy.
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..SJ ARRY. ...
l.l\!
Sox F~/l1a-ee
.Soclal Socurlty No,
.Z03-IOc29' 9
. Dalo of Duath
OS/28/7993.
Dllte 01 Birth lJ/ 15/1920
Birthplace MOil gllll t OWIl, WV
Murilal StaWs MMIt~ed ,
Sp'<W"How<ta.t. CMt PenMb~,~~ JOWII,MI{P. CumbellfW,I~""S9,lmt.V,1
Occupatlun Hou06e W{6e/Home MllReJt Armod Forcos? (Yon or No)
Docodont'n
Mnlllng Adclross
..P'e'lQsyIY!lIl.!.!!
Plnco of Doath Hotl/
Raco CaUCM{lln
No
Informant cta-llt H.StCVIIt!(
Namo ancl AcIclress of
Funeral Estnbllshment COCKLIN FYNfRM HQME,
II,?,',,,, L{ndlIMl C~,~,ltt, Apt.. N'q~1" j,Mechall{c.tobU{\Q;I
Funoral DirtJctor J, LaM!( CQck:f..tIl.. . FDO 1 0331, L
PA.
(u)Rel.lp-tltatoll!( Fa-ltWt e
(b)C.O.P,D.
30 N. CIte.l.ltmd St., P,iU-6bulIg, PA ,17.019-.0424.
: Interval Botwoon
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Part I: ImnlOcllnto CalJso
Pari II:
(c)
(d)
OlllOr Sloniflcant Condlllons
..Sp-<tlaiCMdJIl6aJl.c.t
.~..~ ._hN-,__.~ . H!S.H! l>!.....
Mannor 01 Dealh:
Doscrlbe how Injury ocourrod;
Natural fl Homicide []
[J , [nl
Acoldont Pondlng Invosllgullon
Sulolde IJ Could not bo Dotormlnod LJ
Numo and Tlllo 01 Corllllar
CARLOS F. DELAFUENTE, M.D,
6 MMRet Ptazll Way, Meclwl-tCl.lbWtg, PA 17055
(M,D.; D.O,nCoronor;'M.E.)
Addross
Thl!! Is to certify Ihat tho Informutlon 11010 (Jlvon is corroctly copiod from un original certlfloato of
death duly filed with mo all Lecnl RO(Jlstrm, The orl(llnlll cCHllficnle wilt bo forwnrdod to the Stato
Vilul Records Offico lor porlTlanonllillnll, '2-1 '.' . ,t/? ... .'
Z. 4!.<C/!'?.. ':;-;..!>/)"(:1.) 6->7btJj'
f/I'l /1: .81({iff1:j;/~f~(. . /~'''''I?t)/t.
M",<< I"~l~ ~ "'}1~~.,3111l"" \1It! '.1'",,:,\ Ilr,'" !'d~tJllh IN.,,Jr,P
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, ESTATE II~FORMATION, L ___
m FilE NUMBER _ ,
" 81-1994-0ee7 saN 179-0e-6187
m NAME OF DECEDENT IlASTI IFIRST! IMII
I;jJ STARRY CLAIR H
~ DATE OF PAYMENT --_
Iii LaLl-'l194
S POSTMARK DATE
COUNTY 0/00/00
CUMBERL.AND
DATE OF OEATrr---
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, II N~./fA022605 COMMO~~:~~~~f~: R~~I~~:YLVANIA
"V.II6I j, "'" OPPICIAL RECEIPT · PENNSYLVANIA INHERITANCE AND ESTATE TAX,
----= ~'4_--= ..__ '_-.:;;;;_
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r.ECEIVEO FROM!"
ACN
ASSESSMENT 'l'
CONTROL 1;1
NUMBER
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AMOUNT
YET'TER ROBERT E ESQ
111 MARKET STR~ET
F' 0 90)( 93
HARRISBURG PA 17108
--
101 .e.736.00
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REMARKS
o
SUSAN M. MURRAY
m TOTAL AMOUNHAIO ____ 'e. 736 . 00
. ",,,~P:Jl?, ~'
JiG ONA1VR
MARY C. LEW
REGISTER OF WIL.LS
SEAL
CHECKII 10
REGISTER OF WILLS
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IN THE MATTER OF THE
ESTATE OF CLAIR H. STARRY,
DECEASED, Late of Upper Allen
Township
IN THE COURT OF COMMON PLEAS
CUMBERLAND COUNTY, PENNSYLVANIA
ORPHANS' COURT DIVISION
NO. 1994-00827
CERTIFICATE OF NOTICE UNDER RULE 5.61al
Name of Deoedent
Clair H. starry
September 20, 1994
Date of Death
Estate No.
1994-00827
I HEREBY CERTIFY that notice of beneficial interest required
by Rule 5.6(a) of the Orphans' Court Rules was served on or mailed
to the following beneficiaries of the above-captioned estate on
January 6, 1995.
~
A9Qress
210 Cockleys Drive
Mechanicsburg, PA 17055
641 Erford Road
Camp Hill, PA 17011
Notice has been given to all persons entitled thereto under
Rule 5.6(a) except: None
Susan M. Murray
Marnita A. Eggsware
Respectfully submitted,
.' ." METZGER, WICKERSHAM, KNAUSS
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OJ (" ' :;'!'" Rob rt E. i'e ter, Esqu
TJ 1:-~ f'~&::
"-..... -;; , , Attorneys for Personal
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1'"\ ,:; RepresentatJ.ve
Ie:: 1,,>' 1,_1 ':)
a: ()cj
& ERB
re
Dated: January 6,1995
P.O. Box 93
Harrisburg. PA 17108-0093
(717) 238-8187
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^, If my wHn, IlF.1'TV M, AT^RRY, nurvlvon 010, I:n hor
ohnolutnly nnd fo,'nVM'.
B. If my wifn, IlRTTY M. DT^RRV, predoeno"n" me, ono-holr
(1/2) tho,'oof to my doughl:ol-, M^RNIT^ ^, f:aaSWMF., or if eho in
not thon living, to hnr Innue per ntlrpoo, ond thn romftinln~
ono-holf (l/~) I:hnrnnr to my doughtor. SUA^N M. MURR^Y, or If nhn
In not thon living. to her In"uo pnr ntlrpnn.
C, In the nvnnt thAt e dRughter of mine ohnll predoeoAno
mo without lnnue hor nllrvlvtng. hnr ohue nholl he dintrlbutnd to
my other dllllghtnr, or If nhn I n not thon II vlng, to hltr innuo por
ntlrpe.,
!'l:f,M .IV. ^Il ontAte, inheritAnco, lngAcy, nueconnlon, or
trAn.fer tAxon, Including Any intnront end pennltio. thereon,
impoRed hy ony domoAtle or foreign lew with reApee~ to ell
property tnxnhle under nlleh lown by rnenon of my deeth. whethor
or not nllch propnrty ponnon under thin Will. by opnrntlon of lew,
by eontrnct, or othorwlne, ehell be peld without eny right of
I'elmbul-nement from nny I'eoipient of eny such propnrty, wi thout
nny right of opportlonmont. nnd without pontponnmont,
l.TF.11.V. Should ony pornon entitled to A nhArn of my
entAto he 0 minor. ot tho time of diotrlbutlon to him or hor, end
nhould tho volllo of nueh property be Inorn then the nmount which
moy be peld or delivorod to him or her or In hie or her behalf
without tho oppolntmont of 0 gllardlon or other fiduciArY or tho
dnllvery of .eclIrI ty, nueh nhere eheU be peld end dlntrlbuted to
my Trunteo horolnoftor nomod to be held IN TRUST ond meneged,
Inve.ted, ond rolnvontod, together wi th the necumnlAtlon of
Income thereon, If nnv, nnd thn Trustee AhAl1 unn ond npply from
time to tlmn olleh portion of the Incomo end prin"lpnl thnreof no
it doomn 11ocnnnnl'Y 01' clnnlrn\lLn Cor tl18 minorlg ronn01lAbln
melntnnnnc", nllpport, nnd comploto ndncetlon, incllldlng
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IH'opArAI:ol'Y, collollo, "OAt-ql'Adllot., or Pl'OfooAlonAI trAlnlnll, or
to mokA nlloh pAymnl1l: (nr nllch pllrpOAAo to tho lIuordl nn or pnrnon
wit.h wlwm nlld. II1J IInl' I'nn I dnn 01' <II rnct! V to or Cot' thA hAnnH t oC
thA mlnnl' wll:houl rlll'!.hot' ,'ooponnlhllltv to AIICh mtnol' ot' AnV
pnroon tAIling "nl'n of nuch minor, And whon nllch minot, ottAlnn tho
allo of 1',wnntV'Otlo (7.1) von"n, AnV principal or Incomo not no "aid
or oppllod nhnl I bn dlntrlhutocl 1:0 olleh mlnol', or If he or ohe
dloA 1'1' I 01' I:hol'o to, to h I A 01' hor pornonol rap"ooonl:A U Vo.
.1Tf:M VI. In Addltton to tho pownu g\'ftnt.cl bV low, mv
pArAonol ropl'AnonlAt:lvn nhA11, hAvA thn following pownrn.
A. To nnll At public Ot' prlvotn OAI., to "XChAnqA, to
leane, to plnclgo, to mortqnge, to trnnsfer, or convnrt or
othorwlnn cllnponn oC, 01' ql'Anl optlono '11th re.pnct to AnV And
all pr<>pnrt:v, I'onl 0" pOl'nonAl, nt the Umo fOl'mlnq n PAl't of mv
probAte ot' tnlnt: nntllto, ill ouch mAnner, nt: ouch time at' timon,
for Bllr:h ptll'ponon, (nl" nur:h pt'ice 01' pricen, nnd upon nuch torm",
crndl to, nnd condl U ol1n An nhA II ho clnnmed Advl AAbl not. noeonnAl'V
under tho c1 rC\lmntnlwon.
B, To compromlnn nnv clnlm or controverev.
e, To I nVnnl: I n A II Cormn oC proporty without hnlng
Ilmltnd to loqnl lnvnnl:mnnl,
.I1:EM"Vlll, nomlnntn nnd nppolnt my wHo, RETTV M.
STARRY, hlll: If nhn prodnconnoR mo, Cnil. to qllollCy, or cnn.e. to
oct, I nomlnAto And nppolnt RUSAN 1'1, MURRAY, bllt If Aho
prodocnnnon mn, Cntlo to qllollCy, at' conSOn to Act, 1 nomlnnto
ond Appotnt flARtllTA A. F:OORWARF., hilt H oho prodocon,.o. mo, fnll.
te qllnllfV, ot' connnn to nct, I nominata and Il'ppolnt OAUPIIIN
DEPOSIT IWIf: ANIl TRIIST r:nr1PAIIY, IInrrl Aburg, FnnnnvlvnntA, An tho
ooln F.xnclltol' of I:hl n mv [,Ani: Will to oervn wlthollt hond Cor tho
CAllhCul pnrformAncn of dlltlnn I~ anv jurledlctlon, ~nd I
~omtnal:n n~d nppol~I: /lAid IlAIJPflIN Dr-POSIT BANK AND TRUBT COMPANY,
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INHERITANCE TAX RETURN
RESIDENT DECEDENT
COMMONWEAlTH Of PENNIYlVA"'^ (TO BE FILED IN DUPLICATE
O!PARTM!"lOf REVENUE W
11AlmfJG6. WrJbe 0601 . WIT~ Re.GIST_~~.O!-- ..ILLS) COUNlY COllE . .~EAR
ofe'OIN1" NA.M( IIMT,-;IU,:;Ull MIOO"ll itlltlMI ;,=jiICltlliTI7ftOMPITtf AU\l..n-r-
Starry, Clair II. 110! l,indham Court-Apt, 304
'rXIAlllCUII1YIlUMifl----' . - . ..\O.l'cifOl;;;if----1i;A1I6fiiilll-. -, 11<\chllnlcuburg, PA 17055
179-05-6127 9/20/94 J 2/211/19 Coo", Cumberland
. "'~'~I;" ,....,""""':.....:.':'- '"~:'::""~J .'":''':~:;':i''''"..'.'::..::-
QIl \ Original R'lurn lJ 2, Suppl.mental R.lurn I] 3, Remalnd" R.lurn
liar dOl" 01 doalh prior 10 \2, \3.82)
o " L1mit.d Ellalt lJ 'a, Fuluro Inl"..1 Campramlll 0 5. hd"al E.lal. To. R.lurn R.qulrod
(lor dol.. af d.alh oil" 12.12.B2)
[]l6. llIC.dtnl DI.d T..lal. ['j 7. Oe"denl Maln/aln.d a living Trull
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.OR DATlSO' DIATHAnlR 12/31/91 CHICK HIRI
IP A SPOUSAL
POVIRTY CRIDIT IS CLAIMID 0
mfNuMiiii '-''l1~91J4-:=O'!lZT----'
NU~~~R
_ 8, Talal Numb" 01 Sol. Oepo.11 80'"
III Mllrkot Street, P.O. BOK 93
l\nrriuburg, PA 1'/106'1-0093
c,
( 1 ) ..._.__............_____. ..-
(2\ __,___..____._.~__' -------.,'
(3\ _-.------
(A) _------.-----.
(5)___52LHL.~.L----.
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(7) ,_,__--.--.---
(q I__JIJ 214.~..____
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(151
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(II) . 9,201.49
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=
I. Real E.lale ISch.dule AI
2, Sla<k. and Bond, ISch.dule B)
3. ClalOll H.ld SlacklParln",hlp In,,,..1 (Schedule q
A. Marlgag" and NalOl Rec.lvabl. (Sch.dul. 0)
5. COlh, Bank Depallll & Miscellaneous Personal Properly
(Schedul. EI
6, Ja1nlll Own.d Praporly ISch.dule F)
7, Tran.I." (Sch.dule O)ISch.dul. l)
8, Talal Ora II Aile" (lalallln0l1.71
9. Funeral EllplnllJl, Admlnhlrallvo COlh, Mllcollanooul
E.peniOl(Sch.dul. H)
10, Oebl', Marlgage llablllilOl, ll.n. (Sch.dule I)
I I. T 0101 O.duclianl IlalalllnOl 9 & 10)
12, Nel Volu. 01 EIIO'e Illn. S mlnUlllne 11)
13, Charllabl. and Gavornmenlal B.quOlII ISchedule I)
14, Nel Value Subl'" 10 To. (lln. 12 mlnUlllne 131
\5, Spou.al Tranllor. (lor dalOl 01 d.alh altor 6,30.94)
St. Inslruct!unt for Applicable Per(8nlage on Reveru
Sid., (Indud. valulI from Sch.dul. K or Sch.dule M,)
16. Amaun' allln. 14 10. obi. 01 6% role
(Includ. ,aluOl from Schedul. K or Sch.dule M,)
\7. Amaunl allln. 14 la.abl. 01 15% ral.
(Includ. valuOl from Sch.dul. K or Sch.dul. M,I
Ie. Principal 10. duo (Add 10' from llnOl 15, 16 and 17.)
\9. Credlll Spoulal Poverty Credit puor Payments Ohcounl
. + 2,736.00 +_J.~OO_-
20, II line 191. gllalor Ihan lIn. lB, .nl" Ihe dllloren.. on lIn. 20. lhll1. Ih. OVERPAYMENT,
moo
21. IIlln. lB II gllalor Ihan 1I", 19, enlor Ihe dlllor.nca on lint 2\. Thll I. Ihe TAX DUE,
A, Enler the lntlfllll on Ihe balance due on lIne 2 \ A.
e, EnlO! Ih. 10101 01 lint 21 and 21 A an lIn. 21 B, Thl,lIlh. 8AlANCE DUE,
Mok. ChICk Po~abl. tal R.ghl" of Will., Ag.nt
~_- ~ 1 .. ,~ ~ . BU,UlIE TO ANSWER ALl.QUEsTIONS ON RlVERSE SIDE AND TO RECHECK MATH ' ~ ~:
UndO' p.nalilOl 01 porlurl, 1 d.c1are Ihall have ..amlntd 101. rolurn, Including occampal\ylng \Chedula. and Ilal.m,nll, nnd '0 Ih. bOIl 01 my knawledg. and bell.l,
Ii II true, carre" and campi.,., I d.c1are Ihal 011 real 01'01. hal boon roparl.d 011"0 marke' valuo. Ooclara,lon 01 proparor alhor Ihan Ih. pe"anol reprll.nlatl.. II
baled on alllnformollon 01 whlcn preparer hOl ony knowlodge,
"O",~~f Of 'iRiO"Ti.m"~"'IoiII'tHG",lIiR"--'i:~~~clTh"." ......---.-..----- .."..----..". ....-----.--- .,,-..- ,.It
1:~ " II !..~l,.,~,:,~~,:t_ ..'!\;;,;r"W", ".,,,,,,,,,,,,,,, ."-,,OSS
-"I'2lf.' ',,,'1-;,,,.,,,. .,,0, ""'.93 '- ",,'.h" '" '^ 1710",0093
J '... /
_K .06 Q ,____~,604.97
)(,__a
(171 -
Inlero\1
_K .15Q
(lSI
7, , 604 . 97
(19) 2,88~.oO
(201 _-..-112.03
121) __ ____u_._____-
121Al . . ." d._ ".---------.--
(21BI .' .---..........--------
flJj2J.J2---
OAt(
~L19/95
" /'
11\1.1111'" p.", J
,~
COMMONWIAUN 01 HNNIYlVANIA
INIIUlt'N~1 !All mURN
AlIIOIN! OICIOINr
SCHEDULE H
FUNERAL EXPENSES,
ADMINISTRATIVE COSTS AND
MISCELLANEOUS EXPENSES
PI.a.. Prlllt or Type
Clair II. Starry
--
ITEM
NUMBER
DESCRIPTION
AMOUNT
A. Funeral Exp.n"'1
1.
2 .
Cocklin Funeral 1I0me, head stone
Cocklin Funeral 1I0me, funeral services in the amount of
$5,124.25 paid by proceeds of insurance of Forethought'Life
Insurance Co., Policy No. 001103074. with Cocklin Funeral
Home as named beneficiary.
46.79
5,124.25
$ 5,171.04
B. Admlnl.tratlve Coil. I
1. Penonal Reprelenlallve Commlul'.lnl
Social Security Number of Penonal ReprOlenlatlve:
Vear Commllllon. paid
2, AIlorney Fltl - Metzger, Wickersham, Knauss & Erb 2,630.88
3, Family Exemption
Clalmanl . Relatlonlhlp
Addre" of Claimant 01 decedenl'. death
Slroot Addre"
City Slale Zip Code
4. Probate FeOl 112.00
C. MloCtllan.ou. Ex!"en....
1. lIarry M. Wimer, appraisal of household
and furnishings. 100.00
2, Patriot-News Co., legal advertising 55.80
3. Cumberland Law Journal, legal advertising 40.00
4, Register of Wills, file inventor>' 10.00
5, Register of Wills. fils account 95.00 300.80
6,
7.
8.
TOTAL (Aha onlor on 11M 9, Rocopllulolion)
(II more .pace I. needod, In.ert addltlonal.hoo.. of .ame "10,)
s
8.214.72
Uy,ItUU.IJ.l1j
,
W
COMMOHWIAlIIl or f!utHnYAtj'A
INHII"ANCI'''. utU1N
IISIOIN' ElIUDIN'
_J
SCHEDULE J
BENEFICIARIES
J
UTATI O.
fiLl NUMBER
Clair H. Starry
ITlM
NUMBER
21-1994-0827
.,._--------~..---'----
NAME AND ADORnS Of BENEfiCIARY
RELATIONSHIP
AMOUNT OR
SHARE O' ISlATI
A. Taxabl. BoquolllI
1. Marnita A. Eggsware, 641 Erford Road, Daughter one-hlllf. of estate
Camp lIi11, I'A
C~
2. Susan H. Murray, 210 ~ n Drive, Dnughter one-half of estate
Mechanicsburg, PA
"
ITlM
NUMIIR
NAME AND ADDRESS Of BENEfiCIARY
AMOUNT OR
SHARI 0. ESTATE
B. Charllablo and Govornm.nlal Boqu"I',
1.
'iOTAL CHARITABLE AND GOVERNMENTAL BEQUESTS IAI:a onlor an IIno 13. Rocapllulallan) $
(If more .paco I.nooded, Inoo" additional ,hoot. of .ame 1100)
DAUPHIN OE:;PDSIT BANK AND TRUST COMPANY, HMfHlSUUHO, PENN"IVLVANIA
PA'3
PME No
2 of 3
To
Metzger, Wickersham, Knauss & Erb
Name: Clair H. Starry SSN: 179-50-6127 000: 09/20/94
AcocQ\t No. 0057686572 5335614692 4301720710688202
------------------------ ------------------------ ------------------
Type Checking Statement Savings Charge Card
-----~------------------ ------------------------ -------------
Date Opened
or Issued 06/27/89 06/27/89 09/26/89
-_..,-------------------- ------------------------ ----------
Date Closed
or Matured 10/17/94 (Clossd) 10/17/94 (Closed) 09/29/94 (Closed)
------------------------ ------------------------ -------------
Date of Death
BalllllC8 $15,886.72
$6,146.16
-0-
PLUS
--------------------...--- ------------------------ -------------
Date of Death
Acorued Int. $3.05
$31.66
Joint OWners
(if /lilY) None
------------------------ ------------------------ ------------------------
None
Betty M. Starry (Decd)
----------------------- ------------------------ ------------------------
Date of Joint
Ownership 09/26/89
------------------------ -------------------~-- ------------------
------------- ------------------------ ----------------------- ------------------------
-
Special Oolmlents: N/A
Additional infOrMation availabl. at '20,00 per hour, One ~lr .ini.u..
Date Prepared: October 27, 1994 Prepared by: Cheryl A. Bowers
CUstomer Management Information Dept, (OMI)
Telephone No. (717) 265-2054
\,
A, If my wife, BEny M, STMRY, Burvlvu me, to her
nbnolutely nnd forever,
n. If my wlfn, BETTY M, STMRY, predeceaBee me, one-hdf
(1/2) thereof to my deught:er, MhRNITh A, EOOSWARE, or If Bhe Ie
not then living, to her Innue per ntlt'peB, and the rema.tninll
olle-hn If, (1/2) thnroo [ to my dnuqhtnr, SUSAN 11. MURRAY, or if Bhe
Ie not then llvlnq, to her Innue per etlrpee,
C, In tho ovont thot a dnuqhter of mine nhall predeoe..e
me without Innuo hnr nurvlvlnq, hor .hue .hnll be dletrlbuted to
my other dnuqhtnr, or if nho In not then liVing, to her heue per
ntlrpee.
rrgM..l'(., All entetn, Inheritance, leqecy, eucce.elon, or
tronefer tnxBA, Including nny Intelent and pennltien thereon,
Imponed by eny dom.otlc or forelqn law with raepect to all
property taxeble undel' ouch lown by reeeon of my death, whether
or not nuch propnrty pnnonn under thl. Will, hy operation of law,
by conb'act, or otherwlnn, AhAll he paid without any right of
reimbursement from ony l'.ciplent of nny euch property, without
any right of npportlonmont, and without poetpon.ment,
J.Tgr~1..Y,.. Should nnl' porAon entl tied to . .hue of my
entate be e minor, at the time of dl.trlbutlon to him or her, and
ehould the value of Auch property be more than the amount which
may be paid or delivered to him or her or In hie or h.r b.half
without the appointment of a guardian or other tlduciary or the
delivery of eecudty, Buch Ahare Bhall be paid Bnd dletrlbuted to
my TruAtee herelnnfter numed to be held IN TRUST end managed,
InveBted, and relnveBted, together with the accumulation of
Income thereon, If ony, nnd the Truatee shall Uee end apply from
time to time Buch pOl'tion of the income and principal thereof Be
it deemn necnnonry or doolrnbln for the mlnor'B reaBonable
maintennnce, Bupport, nnd complete education, Including
- 2 -
preporntory, collogn, poot-groduote, or profeeeionol trolning, or
to mokn nuch poymont (or nuch purpooee to the guoreBon or pel'eon
with whom nuch minor I'nnldnn or dirnctly to or fOl' thn bnneflt o(
thn nlillO.' wi tholl!: (1II'thn.' I'onponolbili t,y to ouch minor aI' nny
pnrAon toltlng co"n of AIICh minor, ond when euch minor ottoin. the
ag. o( twnnty-onn (21) yonl'o, ony principal or inoon,. not .0 poid
or opplied Ahall be diAtribut.d to euch minor, or if h. or ohe
die. prior thoroto, to hlA 0" her pereonal repreoentotlve.
l'1'J:tL'lL, In nddltlon to the powern gronted by law, my
pereonnl reproAontntive nhnll hnvo the following power.,
A. To Aoll nt: public or prlvnte eale, to onehnngo, to
leaee, to plodgn, to mortgnge, to trnnefer, or convert or
otherwlnn dlnponn 0(, 0" gront optlonn with reopoct to nny nnd
all proporty, I'nol or poroonol, nt the time forming a part of my
probate or trllot nntntn, In nuch monner, nt ellch time or tlmeo,
(or euch plll'poeon, fOI' ""ch price or prlcee, nnd IIpen Anch tnrme,
oredlte, nnd condi Uone nA nhAlI be deemed odvieable or necoe.Ary
under the olt'ollm.tAnc...
B, To compromlnn nny ,,101m or controverny.
C. To Invoet In nil forme o( property without being
llmi ted to IngA I I .",entmont,
l1EM..YLIJ, nomlnAto ond oppoint my wifo, BETTY M,
STARRY, but if nhn p.'odMoono. me, fAll. to quolify, or ceane. to
oct, I nomlMto nnd nppolnt, SUSAN M. MURRAY, but l( .h.
predeceoAoA mo, fnlln to qunll(y, or cooeOA to Act, I nomlnot.
and appoint NARNITA A. EOOSWARE, but, if eh. predeeeonee me, (nlle
to quoll(y, or cnnnoe to oct, I nomlnote nnd IIppoint DAUPHIN
DEPOSIT BANK AND TRUST COMPANV, Hnrrl nburg, Pennnylvonla, an the
oole Enocutor of thl n my (,nnt Will to oerve wi thout bond (or the
(alth(ul por(ormnnco of dutioe In nny jurlediotion, and I
nominato ond nppolnt Anld DAUPIIIN DEPOSIT BANK AND TRUST COMPANY,
.3-
1\(.,
I
j
;' ,,;, I'
, ! r
Jll,:;, ~ 1-9
~
Ri!V"l!147 I!X AFP 112"94*
C_AllH Of PfHlltYlYAHIA
Ilt:PlIlTHEHT Dt' IlEYEIAJE
IUREAU OF INDIYIDUAL TAXEI
Ilt:PT, 210601
HARtlIII/JAO, PA 11121'0601
HOTICE OF INHERITANCE TAX
APPRAISEHENT, ALLOWANCE ~R DISALLOWANCE
OF DEDUCTIONS AND ASSESSHENT OF TAX
ACN 101
DATI! 09-04'95
FILl! NO.
DATI OF DI!ATH 09-20'94 COUNTY CUMBERLAND
HOTEl TO INSURE PROPER CREDIT TO YOUR ACCOUNT, SUaHIT THE UPPER PORTION OF THIS FORM WITH YOUR TAX
PAYHENT TO THE REOISTER OF WILLS, NAXE CHECX PAYABLE TO "REgISTER DF WILLS, AgENT"
REMIT PAYMENT TOI
ROBERT E VETTER ESQ
METZGER ETAL
PO BOX 93
HBG PA 171 08
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
r
A_t Rul ttod
CUT ALONO THIS LINE ... RETAIN LOIIER PORTION FOR YOUR RECORDS ....
iliW Uiii'i" EX"-Ai;p"n'Z-:94T"iliific""oP'"iN'HEiiii'ANCi"TA'if 'AP jiR'AisEHEilr;.ALDSWAN-ci-ifri-...----.........
DISALLOIIANCr. OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF STARRV CLAIR H FUE NO. 21 94-0827 ACN 101 DATI! 09'04-95
TAX RETURN WAS I (X I ACCEPTED AS FILED
( I CHANOED
HESERVATION CONCERNINO FUTURE INTEREST . SEI! REVERSE
APPRAISED VALUE OF RETURN BASED ONI ORIGINAL RETURN
1, R..l E.t.t. (Schedul. Al (II
2, Stock. end Bond. (Schedul. II (21
s. CloHb Held Stock/p.rtnerahlp Int....t (Schedul. CI (51
4, Mortgage.IHot.. R.c.lyabl. (Schedul. DI (41
S, C..h/lenk D.pollh/Hho, Per.on.1 Prop.rty ISehedu,\. EI (SI
6, JointlY o.n.d Property (Schedul. Fl (61
7, Tran.f.r. (Schedul. g) (71
I. Tot.1 A...h
.00
,QO
,00
,00
52.617.67
.00
,00
(II
52,617,67
APPROVED DEDUCTIONS AND EXEMPTIONS.
9, F_r.l ex""".../AdoI, Co.h/Hhe, Expen... (Schedul. HI (91 8,214,72
10, Debh/Mortllllllll LlabUltI../LI.... (Schedul. II UOI 9S6, 77
11, Totol Deduction. (111
12, Het Value of T.x R.turn U21
IS, Ch.rltabl./Goy.rneent.l I.que.t. (Schedul. Jl (151
14, Net V.lue of Eatota Subject to T.. U41
NOTEI If.n ........nt w.. i..uld prlvioully, linl. 14, 15 .nd/or 16, 17 Ind 18 will
refllct figurl. that includl the tot.l of ~ return. ......~d to date.
ASSESSMENT OF TAXI
1&, AlIClUIIt of Line 14 .t Spoua.l rata (151 ,00 X, 03.
16. _t of Line 14 taxabl. .t LI....I/C1... A r.t. (161 43,416,18 X ,06.
17, _t of Line 14 t..abl. .t Coll.tarel/Cl... I reto (171 ,00 X ,15.
18, Principal T.. Due UII
TAX CRI!DITSI
PAYHENT
DATE
12'19-94
Q ,:>01,49
43,416,18
,00
43.416,18
,00
2,604,97
,00
2,604,97
RECEIPT
NUHIER
AA022605
DISCOUNT (+l
INTEREST (.1
130,25
AHOIMT PAID
2,736,00
TOTAL TAX CRI!DIT
BALANCI! OF TAX DUE
INTEREST
TOTAL DUI!
2,866,25
261,28CR
.00
261. 28CR
. IF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST,
( IF TOTAL DUE IS LESS THAN fl, NO PAYMENT IS REQUIRED,
IF TCTAL DUE IS REFl ECTED AS A "CREDIT" (CR), YOU HAY IE DUE
A AEFUND, SEE REVERl.E SInE OF THIS FORM FOR INSTRUCTIONS,I
IIUPYATlOlh E.IaO.. 0' _0. clvl... '" .r boloro _r U, INI .- II lIlY "'tvr. Inl"..O In tho ..0,0, It O,...lo.....
In PO'Hlllon or enJOYMl'lt to ClI.. I (caU.,....U benefiol.rllI of the dtoedInt IU,r the ,xp'rltton of MY "'It. for
lIf. or for Vllr., the C~1th hlrliy ,xpr'lIb r...rv.. thl right to ."r.... Ind ...... t,.,I"r lmerit... TIXII
It the l...fu1 e.... . (ooUI',r,U r.te on In'l NOh future lnt.rllt.
_llI'
NOIICl!. T. Iulllll tho ,,,,,1,_0. ., 10011011 1110 0' tho lr/ltrU..., tnd E.O,O, T.. AlO, AG. II ., 1"1. 7E P,I.
IooU", 1140,
PAVIOT. OIl.... tho 0... porUon 0' thl. 11011" ond II.IloIU with ....r p,.-I I. lho Rllltl" 0' Will. print. '" tho ,_rPl .Ido,
..""" .- ., ""'. .rdo, po"",l. 001 aJlQJlTER OP NULl, AIlEICT
All pt.-" '10,1.. tholl II". be ...11111 to tn. InO....1 ""loll DlV be WI with tnV ,_Indor .....11111 I. .ho ...,
It!fUND (aI)1 . rllft of . tlX credit, which WlI not r....tect on the Tax R.turn, _'I be r~.ted by oo.pl.U", In "AppUoeUon
f., R.,..., ., !'om.vl...l. Ir/ltrlt..... ond E.tol. T"'. (IIEY-ISISI, AppUOIIIOII.... ...1It111' ,. tho 0111..
., tho RIII.I" 0' Will., tnV ., tho II R...... nlt',I.. 0111..., .r bv 01111.. tho _1.1 Z4.hour
.,....'1"1 "rvlc. nuItMIrt far forll orderlngl In PIm.."lnnl. 1-100-141"20", outside PlMlYlwnl. Ind
dthln I_I 1tt..ltb"'1 .... (7171 711-1094, TIlDI (7171 nl.ztsl (Ittorl... 1....1'. Clnl.l.
DIJICTJOHII Atr1 "rtv In Int.rll' not ..thfled with Uw ."r.l.....,t, .UDMWIM or dlllUowno. of dltUUonl, or .....-..nt
., ... (lnoludl.. dl.....,O ., Inl""U II _ '" thlt IIoUOI ...1 DIll'" within .IM.. (101 ..... .f ,_Ip. of
thl. 11011., b.,
..wrlll" prol... '0 tho PA 1ltp"I_t.f R......, lo..d 0' Appoolt, Doll', mUl, HI..I......, PA 17l1....U1. O~
...INUlIn to hIVe ttM _ttlr at.r.lned It IUdAt of the MComt of tt. pertcnl ,epr...,,'IUYI, O.
--."..1 to the ar~.' Court.
AIIIIIW
IlTUTlVl!
COAMCTIOHIl '.hIIl .rror. dllOOverld on ttlll ....llIIftt Ihould be eddr..Hd In NrU'nt tal PA OIpIrtNnt of AIYIhUt,
lureeu of Indlvldull 'IX", ATTN. Polt ......-ent Rlvlew unit, Dept. "0601, Hlrrllbur'J PA 1711'-0601
Phone (711) 711-6105. ... P'" S of the booklet "lnltrUGtlonl for IMirU.1Oe TIX btum for I Rllldlnt
Deoedlnt" (REV-IIOI) for en 1XP1lnltlcn of edllnl,tr.tlvllW correotlbl1 .rror..
DIICClIIT. If lIlY I.. duo I. pold within th,.. (Il ",1_' ""th. ,fltr tho _.'. dootn, , II.. po,_, (1X1 dl.-... .f
tho .'" pold It '11_,
INmlIITI In...... It ....,..... boIl",l.. with llrot .... ., doll......v, .r nino (91 _th. ... _ m .... f'.. \hi doO, of
dMth, to the d1t, of ,.v-nt~ 'IXI. Nhloh beoIM ddl"",,*,t ~for.. ......rv 1, 191' bMr Int.r.., It the rite of
tI. (1X1 po,.... por ""'" 011...111111 .t . doll. roO. 0' ,010114, All ..... ""loll _ doll...." '" tnd ,ft"
........rv 1, UII will belr Int.r..t It. rlt. which will wry 'rOIl eel..., ",r to alendlr yeIIr with thet r.t.
IftnOUnOId bv the PA o.plrtlent of A.v~. The 1PP11C8blt lnt.r..t r.t., for 1..2 through I". .r"
~ tnt.r..' lhItl Dilly Int.r..t FlGtor !!!r IMlrllt bt, Dallv Intere.t FlGtor
INI lOX .000Mt 1m 9. .001147
1911 IIX .001411 1911'1"1 II. .000101
19M lit ,000101 1"1 9. .000147
INI IIX . QOOIII I"I.I~ 7l( .00om
1911 lOX .010174 1"1 9. ,000147
ulnter..' I. oeloullttd I' follow.1
JItTBIBIT . IALANCE OP TAlC VllPAIO H IlVIlIEI OF DAVI OBLJHllUIIIT H DAILV JHTEIIIT PAero.
'.AnV IIoU.. I.."... ,II" lho 11M *OIt. doll_t will ..,11101 on Inl....1 OII...I,U", 10 1111_ (Ill dov.
be_ tho dol, ., lilt ....._1, If po.-I It _ ,II.. tho Inl....O _I,U", dol, _ on tho
Notl.., Idl1ltlOMl Jntlrllt w.t be Clloul,.tld.
PAVlENTt
Dotooh tho lOll portion of thlo Notlo. and .\ll>01t with your PIV...,t _ p.VOIIIt 10 lho n_ ond oddr...
printed on the rlv.r.. .Ia.
II Rt!111lfNT DECEDENT 0"" chook or .....y ordor .nytlll. to, REGISTER OF WILLS, AGENT,
1I11011.Rt!IIDOlT DECEDENT """. chook or ...... ordor .tVtIll. to, COHllONWEALTH OF PENNSYLVANIA.
All P'PIn" rM,JIJH .hlll tM IPPllld flr.t to IN'IV lnt.rut whloh '1>>' bl due with ,"V r..llndtr 1fIfI1Itd to the taM.
Rf1UNO (e.t) I A r.flM'd 0' . tlJC cr,dlt, Ithlch "II not r.qullted on thl tOle R.turn, MV bI reque.tld bt cHpI,UntI en
"AppllolUon for RI'\ond 0' Penn,ylvlnl, Inh'rltlnel and E.t_t. TIM." CREY-lSU), Appllo.tlon. Ir. Iv.U..1' at
the OfflO1 of the Rllht.r of Willi, WlV of thl ZS RlvtnUI Dhtrlot OffiCI' or 'rOIl thl o.p'rtlMnt" Z4-hour
en.werlnt ,.rvlol nulbtr. for for.. orderlngl In Pennlvlv~l. 1-800-56Z-Z050, out.lde PIOn'vlvant.
Ind within 10C11' H,rrhburg tr.. (111) 711-&OM, TDO. (717) 77Z-2Z5Z CHearlng I..lred onlY),
RfPLV TOI Mlttont rl..rdlng .rrorl contllned on thh noUol lhoUld be Iddr...1d tal PA Pep.rt'."t of R.VInlJI, BurMU
of lndlyldull Ta)(II, ATTNI po.t A.....""t R.ylew Unit, Dl9t. 210601, H.rrhburg, PA 1712'~0601, phone
(711) 71NIOS,
DISCOUNT I If MV tllC due It paid within ttir... U) caltndtlr "nth. .ftlr the tMcIedent'. cltlth, I flvl p.rcent U~) dhoCK.f1t
of the t.1C Plld II JUowtd.
INTEREST I lnt.rllt I. chlrged bealnnlng with flr.t dl)' of dlUnquenoy, or nine (9) Rnth. end OM (1) dlY frOl the det. of
~.th, to the d.t. of Plv-ent. rllC,' which bee... dtllnqutnt before JlnUlrv I, 19a2 bllr lnt.r..t It the rat. of
.IIC (6X) Ptrcent p.r ennui calculltld It . d.11Y rat. of .000164, All tlICI. which beu... dlllnqutnt on end If tar
Jenuary 1, 19.2 will bI.r Intlr..t It . r.t. which will varv frol c'ltndlr y.,r to c111nd.r y..r with that rlt.
~Id b)' thl PA Dlp.rtllOt of R.vtnUl. The app1lelbl. Int.r..t r.t.. for 19.2 through 1995 Irll
Vllr Int.rllt. A.t, D.lly Int.r..t Factor Vllr Interllt Rlt, D.lh Int.r..t FltOtor
1911 EOX ,OODl41 1917 9X ,000247
1911 16X ,000411 19"-1"1 IU ,000101
1914 IIX ,000301 1"2 9X ,000E47
1911 lSX .000116 1"5-1994 7X ,000192
1916 lOX .000174 1"5 9X ,OO0E47
-~Intlr..t II naloulltld II followlI
ImlElT . &AWe! OF TAK UNPAIO K NUMBEI OF OAYS OELINQUEHT K OAILY INTEIE8T FACTO'
....Any MoUat IIIUId Ift,r the tI)( becNMII dll1nquent will r,f1Mlt W\ Int.rut ellouhtlon to flft"" UI) den
blVoM the dltl of ttt. ......""t, If P'VHnt II aMII Ift.r thl Int.rllt ~tlUon dtIt. .hcM1 on the
NoUel, edcUtlontl Int"e.t lU.t be cllcullted.
..., - I" <( - I
PLFASE FILE l1JIS REPORT WIl1lIN 'M YEARS OF DATE OF 0&\111 RmARDLFBS OF 111E &'TA'l'US OF 1lIE
FSI'ATE. IF ESTATE IS tm <nfPlEI'fD, FILE A 6.12 ~l.lRM YEARLY UNI'IL <n1PlEl'IOO. 6
~.TAT!!.e...Rl';l'oWr,_Y.!!!?f!L RULL-L.g
Name of Decedent,
Clair Jh-~JaJ;_!:.L_____
Date of Dllatlll-.Sept~!1!.l?_~L~_QJ__~.2.9_1.._,
W ill No, 199 4::.llll1l21__....,._______ _....__.. AdmJ n. Nil, _._1~.1~,::9.9.~1.L____
Purlluant to Hulu 6,12 of t.he SUpl'Hme Court Ol'l'hllnfl'
Court Hules, 1 roport tlw followIng with l'OR!lfHll t,o cOn/ploUon of
Lhe adminisLrllUun of LIlA rlbOVll-CllpllOlllld UAt.lllol
1. Stllte whethel: adminl.fltl'aLlon ot t.he eslat.e i8 compleLe,
Yes_x-_____ No..__.-.
2. If the IInRWlJl- IA Nn, At.ilt.a whfln lha purRnn.ll
representative reasonably bel1eves that the administration will be
complete,
J. If the answor to No, 1 is Yes, state t.he fOllowing'
a, Did the personal representative file a final
account with Lhe Court? Yos No.~,
b, The S(!(l.l I'll La OrphllnA' CUllrt No, (I f any) for
the personal representative' 8 account is, nla
c, Did t.he per80nal representative state 6n
account l.nformally to the parties in interest? YosJ_ No___
d, Copios of receiptfl, releases, joinders and
approvals of formal or informal accollnt.s may be filed with the
Cerk of t.he Orphans' Court and may be attached to t.hia report,
..--) (-..
Dot.. DMombo, " 1995 __~:! ..Li;~ - ~_
Sign'ilttre ,
Robert )i:_...1sJJ;.t;gtJ_J;!Lq,U.!.L~
Name (Please type or print)
Metzger, Wickersham, Knauss & Erb
__l.iLM.~,t:g.LStr_~!l!L,_,~_____._
AdpnHIBBox 93
Harrisburg, PA 17108-0093
L_1.l.L~.1e_,:~lU___. ________.___,
'I'el, No,
(MAHlrnll/AMJ)
Cdpllclty' ___rel'sonai Represent.atlve
_.x "Counsel for personal
t'epreBent.aL i vo
/lW-27