HomeMy WebLinkAbout95-00598
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E"alc' "I Clara M. W~lso!l,_______
al.lll/alUlI'II as
I)ETITION I:OI{ I) ROllA TE and GRANT OF LETTERS
No, ____01 t~ - !f!Jff
To:
'm____ Regl,ler of \Vllh g" lite
ioJ;;Tz=ll9591J,...,.t/,\('t/, ('011111)' or Cum er and in Ihe
St/rit/I S,'..II,il)' Nu, ('onllllonwellllh of I'ennsylvllnlll
The pellllon of Ihe IIl1llersigned re'peclflllly rel"e,ell" Ilml:
YOllr pell1loller(,), who h/llre 1M )'eurs of uge ur older IIl1lhe e'eclllr ix
in Ihe IU'1 will of Ihe uhow decc'denl, dilled _ _ March 31
IInd e",lklll,) dilled December 1, 198"2
nllmed
. 1912-
(\Hue rdl'\3nl ~:h"'IlI11\II1I1~'I.'\, I.',il, u'nundnlinn, dl'i1lh ul' C\I.'l'U1ur, Cle,)
Decendenl wu, domiciled 11\ dell\h in Cumberland
h er 1I1S1 fllmll)' or prlnclplIl re,idenee III 1203 Indian
~.J;:g .MOru:oe......TololnFlhip
(11\1 \lr,,',,'I, numher Ulld l11U1h:ilmlil)')
..._ COllnty, Pennsylvania. wilh
...eg Road
PA 17055
Deeendenl.lllen 91 )'eurs of uge. died November 13 , 1993
al-HQ1Y_Jl-Rio t Hospital. Camp Hi 11, PA ,
E,eepl as follows, decedem did n'" mllrry, was nol <ilvureed IInd did nol have a child born or adopled
afler e,eculion of Ihe will offered fur prollllle: wus nOllhe vlcllmof II killing and was never adjudicated
Ineompelem:
Deeendenl III demh owned propen)' wllh eslimaled ,'aloes I" follow,:
(If domkiled in I'll,) Allpersonulpropeny S 500.00
(If not domiciled in I'a,) I'ersonalpropeny in I'enn,ylvllnla S
(If nol domiciled in I'a,) I'er,onulpropeny In ('oumy S
Vnhu,' uf rcal':\IUh,' In Pcnl1\)'lvnnin S lUU. UU
,l1uulc'd a, rollow,: .J"pL241J Section 16, Treasure Lake Subd1v1s1on,
sandy-To_wnahip~ Clearfield Countv
WHEREFORE, "ethiuner(,) re,peclfull)' request(s) Ihe prohulc of Ihe last will and eodlell(s)
pre'ellled herewilh IInd Ihe grunluf lellers--'l'es.t~ry
, Ih.'\lill1lt:ll1IU~; lIdmini\lrnllul1 c,l.a.: admlnhtrallon d,h,n.t.I,A,}
theron,
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uuMechanicsburg ,-PA--.L7J155__
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OATH OI:I)lmSONAL REPRESENTATIVE
COI\IMONWEAI.TII UF I'ENNSYI.VANIA }::I::I
COUl'OT\' OF Cumberland
The l,elllionerls)lIho\e-nllll1ed ,wearl') or IIffirm(s) 11111\ Ihe sllllemenls in Ihe foregoing pelilion arc
Irue ilud CUllecl 10lhe he" uf Ihe ~11ll\,ledge IInd hellef of pelilioaer(s) and thai as persooal represen-
tlllivel\l of 11ll' IIhovc' decedent "elilioner(,) will weIlJ1'~d In I)' IId~r Ihe estate aecording~ law,
SilO'" III 111 IIffirmed ulld ,"hscrlhed r-.at '-fj J~' ;> - 7.> '"
me 1Il).l~~t=-'~~--U]ffJJ1~~&,_~ ~a oLF.r.e.e1.lind l'
d ll~dwis Hc'~i,\It" -11 ~
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No, ?1 _ Q~ _ ~QR
Estate of
Clara M. Wilson
, Deceased
DECREE OFI)ROBATE AND GRANT OF LETTERS
AND NO\V AUGUST 10. 19-1L. In consideration of the pelltion 011
Ihe reverse side hereof. sUllsfllctory proof hllvlng been presented before me.
IT IS DECREED tllllllhe Inslrumen1(s) dilled March 31, 1979 & December 1, 1982
described therein be adlllllled 10 probale and filed of record liS Ihe 11IsI will of Clara M. Wilson
and lellers Testamentrv
are hereby granled 10 Carol Freeland
"lI/(Lu"~'~/';^~" fJn7~'
d ~'~!'I" or WUh
MARy C. LEWIS
FEES
Probate. lellers, Ele, ,,""", S 18.00
Short Cerllfieales( 4) ..,.. , .. "S 12.00
~e'1fne'rllon ..,..,.....,.... L-,
x~p~ij~s S-2Y'oH-
JCP TOTAL _ S 5.00
Filed "~~,~~?!, ,1,9~, ,1,~~?,5, ,.,. ,,1l6, liP"
Kent H. Patterson
ATTORNEY (Sup, Cl, 1,1>, No,) 15307
221 pin.. Sl:r....t-
Al>llRESS
Harrisburq. PA 17101
1'1I0NE
(717) 238-4100
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Mailed letters and order to attorney on 8-10-95.
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11Iast 3IIlIUl anb Wegtament
of
CLARA M. WILSON
I, CLARA M. WILSON, now of the County of Centre, in the Common
wealth of Pennsylvania, being of sound disposing mind and memory, do
make, publish and declare this my Last Will and Testament and I do,
by the act of executing this Will, revoke and render null and void
any and all wills, papers testamentary and writings in the nature
thereof at any time heretofore executed and declared by me.
Item One. I direct the Executrix or the Executor of my estate
hereinafter appointed to pay all my just debts and funeral expenses
as soon after my decease as shall be convenient.
Item Two. I direct that there shall be paid out of my residua y
estate all estate, inheritance and like taxes, together with any
interest or penalty thereon, imposed by the government of the United
States, or any state or territory thereof, or by any foreign govern-
ment or political subdivision thereof, in respect to all property
required to be included in my gross estate for estate, inheritance or
like tax purposes by any of such governments, whether the property
passes under this Will or otherwise, excluding, however, any property
over which I have a taxable power of appointment, provided, however,
that no residuary beneficiary shall, by reason of this provision, be
denied the benefit of any deduction, credit, favorable rate of tax or
other benefit which by law enures to such benoficiary.
Item Three. I grant to the Executrix or the Executor of my
estate hereinafter appointed the powers, discretions and authority to
sell real estate that I own, or any interest therein or subdivision t ere-
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of, which is not specifically devised herein, at either private or
public sale without filing or entering a bond or other security, and
to make, execute, acknowledge and deliver a deed or deeds or other
assurances necessary to transfer the title to, or'vest the title in,
the purchaser or purchasers thereof.
Item Four. I give and bequeath the following:
(a) To my granddaughter, Carol Freeland, now of Dil1sburg, Penn-
sylvania, if she shall survive me:
(1) My wall recliner chair,
(2) All of the fishing equipment which belonged to my late
husband, Jerome G. Wilson, and
(3) My white gold wedding ring.
(b) To my daughter, Lenora Moore, now of JUlian, Pennsylvania,
if she shall survive me:
(1) My ruby ring, given to me by my father, and
(2) My antique drop-leaf table, formerly owned by the
Blauser family.
(c) To my granddaughter, Dortha Moore, if she shall survive me,
my yellow gold wedding ring.
(d) To my granddaughter, Hilda Custred, if she shall survive me:
(1) My turquoise ring, and
(2) My jewelry box and the contents thereof.
Item Five. If any of the beneficiaries named in ITEM FOUR of
this my Last Will and Testament shall not survive me, then the beques
to such individual shall lapse and the subject property, along with
all of my clothing, jewelry, personal effects, household goods, furni
ture, furnishings, and automobiles and all other tangible personal
roperty not otherwise specifically bequeathed (not including cash or
shall be sold by my Executrix or my Executor at public
r private sale, and the net proceeds of such sale shall become a
of my residuary estate hereinafter disposed of.
.
Item six. I give and bequeath to each of my grandchildren who
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.tEl living on the date of my death, the sum of Two Hundred ($200.00)
Dollars.
Item Seven. If my daughter, the aforesaid Lenora Moore, is not
living on the 30th day following the date of my death, I give and
bequeath,
(a) To each of my grandchildren who is living on the date of
my death, the sum of Five lIundred ($500.00) Dollars,
(b) To each of my great grandchildren who is living on the date
of my death, the sum of One Hundred ($100.00) Dollars.
Item Eight. If my daughter, the aforesaid Lenora Moore, is
living on the 30th day following the date of my death, I give, devis
and bequeath all of thEkrest, residue and remainder of my estate,
real, personal and mixed, and wheresoever situate, which I own, or
have the right to dispose of at the time of my decease to First
Seneca Bank and Trust Company, a banking corporation organized and
existing under the laws of the Commonwealth of Pennsylvania, with it
principal office in the City of Butler, Butler County, in the Common
wealth of Pennsylvania, and a banking office in the City of oil City
Venango County, in the Commonwealth of Pennsylvania, as Trustee, to
be held under the terms of my Trust Agreement dated
1979, and any amendments thereto or substitutions therefor, or if
such agreement is not in effect at the time of my death, to hold in
trust under the terms specified in 'said agreement on the date of
this Will or of its last publication by Codicil or otherwise.
Item Nine. If my daughter, the aforesaid Lenora Moore, is not
living on the 30th day following the date of my death, I give, devis
and bequeath all of the rest, residue and remainder of my estate,
real, personal and mixed, and wheresoever situate, which I own, or
have the right to dispose of at the time of my death to my then-1ivi g
issue, absolutely and per stirpes, PROVIDED that if none of my three
(3) children, Lenora Moore, Robert Allison and Donald Allison, are
living on the 30th day following the date of my death, I give, devis
and bequeath the aforesaid rest, residue and remainder of my estate
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to my grandchildren, share and share alike, provided that the share
of any. grandchild who is not living on the 30th day following the
date of my death shall be distributed to his or her issue living on
the 30th day following the date of my death, per stirpes, and in
default of any such then-living issue, such share of a deceased
grandchild shall be added, in equal proportions, to the share or
shares for my other grandchildren and/or then-living issue of de-
ceased grandchildren.
Item Ten. I hereby nominate, constitute and appoint First
Seneca Bank and Trust Company, aforesaid, or its successor by merger
or otherwise, testamentary guardian of the estate, real and personal
of each minor receiving any property by reason of my death, if such
property is in excess of the amount which may be paid to the minor
or to the parent or other person maintaining the minor.
Item Eleven. I hereby nominate, constitute and appoint Carol
Freeland, my aforesaid granddaughter, Executrix of this my Last Will
and Testament; if the said Carol Freeland is unable or unwilling to
serve as Executrix, then, and in substitution, I hereby nominate,
constitute and appoint First Seneca Bank and Trust Company, aforesai ,
Executor of this my Last Will and Testament; and I direct that the
Executrix or the Executor of my estate shall not be required for any
reason to file a bond or other security in this or any other juris-
diction in order to qualify to this appointment, or in connection
with either the administration or distribution of my estate.
Item Twelve. At any time prior to the vesting of a future
interest in possession and enjoyment, my Executrix or Executor or
any Trustee to whom my residuary estate has been distributed shall
have the discretion to 'elect to prepay all or any part of the estate
inheritanc~ or 1ike:taxes thereon, and such election shall be bindin
upon all parties in interest.
IN WITNESS WHEREOF, I, CLARA M. WILSON, testatrix, have here-
unto set my hand and seal to this my Last Will and Testament, con-
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FIRST CODICIL TO
1Ea6t 111m attb We6tmtttut
of
CLARA M. WILSON
I, CLARA M. WILSON, do hereby make, publish and declare this
to be the First Codicil to my Last Will and Testament dated Maroh
31, 1979.
FIRST:
I do hereby amend Item Four of my Last Will and Testament
dated Maroh 31, 1979, so that after amendment it will read as
follows:
"Item Four. I give and bequeath the following:
(a) To my granddaughter, Carol Freeland, now of
Harrisburg, Pennsylvania, if she shall survive me:
(11 My wall recliner chair,
(2) All of the fishing equipment which belonged
to my late husband, Jerome G. Wilson, and
(3) My white gold wedding ring.
(b) To my daughter, Lenora Moore, now of JUlian,
Pennsylvania, if she shall survive me, my ruby
ring given to me by my father.
(c) To my granddaughter, Dortha Moore, if she shall
survive me, my yellow gold wedding ring.
(d) To my granddaughter, Hilda Custred, if she shall
survive me:
(1) My turquoise ring, and
(2) My jewelry box and the contents thereof.
(e) To my grandson, Robert L. Moore, Sr., my .22
caliber pistol."
SECOND:
I do hereby revoke in its entirety Item Six of my Last Will
and Testament dated March 31, 1979, and substitute in lieu thereof
a new Item with the same number, which Item shall read as follows:
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"Item Six. I give and bequeath to each of my sons,
Robert Allison and Donald Allison, who is living on the
date of my death, the sum of Five lIundred ($500.00)
Dollars."
THIRD.
I do hereby revoke in its entirety Item Seven of my Lalt Will
and Testament dated March 31, 1979.
FOURTII.
I do hereby amend Item Eight of my Last Will and Testament
dated March 31, 1979, so that after amendment it will read al
follows.
"Item Eight. If my daughter, Lenora Moore, is
living on the thirtieth (30th) day following the date
of my death, I give, devise and bequeath all of the
rest, residue and remainder of my estate, real, per-
sonal and mixed, and wherescever situate, which I own,
or have the right to dispose of at the time of my
decease, to First Seneca Bank and Trust Company, a
banking corporation organized and existing under the
laws of the Commonwealth of Pennsylvania, with a bank-
ing office in the City of Oil City, Venango County,
Pennsylvania, as Trustee, to be held under tho terms
of my Trust Agreement dated April 6, 1979, and any
amendments thereto or substitutiono therefor, or if
such agreement is not in effect at the time of my death,
to hold in trust under the terms specified in said
agreement on the date of this Will or of its last pub-
lication by Codicil or otherwise, and any amendments
thereto or substitutions therefor."
UIFTII.
I do hereby amend Item Nine of my Last Will and Testament
ated March 31, 1979, so that after amendment it will read as
followBI
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WItem Nine. If my daughter, Lenora Moore, is not
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living on ths thirtieth (30th) day following the date
of my death, I give, devise and bequeath all of the
rest, residue and remainder of my estate, real, personal
and mixed, and wheresoever situate, which I own, or have
the right to dispose of at the time of my death, to such
of my grandchildren as shall be living on the thirtieth
(30th) day following the date of my death in equal shares,
provided, however, that the then-living issue of a de-
ceased grandchild of mine shall take per stirpes the
share their parent would have taken had he or she been
then living. W
SIXTH:
I hereby republish and reaffirm my said Last Will and Testa-
ment dated March 31, 1979, as modified, amended and supplemented
by this First Codicil as if the same were set out here in full and
do incorporate the same by this reference thereto, and do hereby
republish and declare my said Last Will and Testament as so
amended, modified and supplemented as my Last will and Testament.
IN WITNESS WHEREOF, I, CLARA M. WILSON, testatrix, have here-
unto set my hand and seal to this, the First Codicil to my Last
Will and Testament, consisting of four (4) typewritten pages, at
Franklin, Venango County, Pennsylvania, this /51 day of December,
1982.
(j /dH..tT '-n1 ~ ~h~" (SEAL)
Clara M. Wilson
Signed, sealed, published and declared
by the said Clara M. Wilson, testatrix,
as and for the First Codicil to her Last
Will and Testament, in the presence of
each of us, who, at her request and in
the presence of each other, have subscribed
our names as witnesses thereto.
~~"r_ a, CY<Jk.Ad
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We, Clara M. Wilson and Julia A. Osborne, Patrioia L. Mac-
Cartney and Sheila F. Jacoby, testatrix, and the witnesses,
respectively, whose names are signed to the attached or foregoing
instrument, being first duly sworn, do hereby declare to the under-
signed authority that the testatrix signed and executed the
instrument as the Firs~ Codicil to her Last Will and Testament and
that she had signed willingly, and that she exeouted it as free and
voluntary aot for the purposes therein expressed, and that each of
the witnesses, in the presenoe ~nd hearing of the testatrix,
signed the Codicil as witneDs and that to the best of their know-
ledge the testatrix was at that time eighteen (18) years of age or
older, of sound mind and under no oonstraint or undue influence.
C!..L.., -v .'f '-~;r) LU_Y~/
Subscribed, sworn to and aoknowledgod
before me by Clara M. Wilson, the
testatrix; and subsoribed and sworn to
before me by Julia A. Osborne, Patricia
L. MacCartney and Sheila F. Jacoby
this )St- day of December, 1982.
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CERTIFICATION OF NOTICE UNDER RULE 5.6(a)
Name of decedent
Date of death
. Will No.
N/A
CLARA M. WILSON
November 13, 1993
Admin. No.
21-95-598
To the Register:
I 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
~anuarv 25, 1996 :
Name
Robert L. Moore
Darlene Reigle
Marlene E11ersick
Carol J. Freeland
Hilda Runk (nee: Custred)
Albert Moore
Dortha Weaver
Robert M. Allison
Joan M. Marshall
Richard L. Allison
Patrick L. Bielby
Allan Allison
Demming Allison
Mark Allison
Robert Allison
Irving Allison,
a/k/a Donald Allison
Address
3008 West Country Club Drive
Irvinq, TX 75038
1285 North Vine street
Middletown, PA 17057
301 Lauberman Cres.
Rochester, NY 14620
1203 Indian Peg Road
Mechanicsburq, PA 17055
R.R. 1, Box 305
Sprinq Mills, PA 16875
303 Vanessa Drive
Pleasant Gap, PA 16823
7397 Otisco Valley Road
Preble, NY 13141
Box 37
Central Bridqe, NY 12035-0037
Box 61
White Lake, NY 12786
Rt. 2, Box 213, Cora Street
Gassvil1e, Arkannas 72635
R.D. 2, Box 230 - Saltzman Road
B1ossva1e, NY 13308
43738 Beech Avenue
Lancaster, CA 93534
43738 Beech Avenue
Lancaster, CA 93534
43738 Beech Avenue
Lancaster, CA 93534
10 Willey Street
A1banv, NY 12203
43738 Beech Avenue
Lancaster, CA 93534
1
Notice has now been given to all persons entitled thereto under
Rule 5.6(a) except
Date: January 25, 1996
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Sig'nature
Name
Kent H. Patterson
Address
221 Pine Street
Harrisburq, PA 17101
Telephone
(717) 238-4100
Capacity: Personal Representative
X Counsel for Personal Representative
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~J '01 OATIS 0' DIATH Ann 12/31'" CHICK HIU
INHERITANCE TAX RETURN ~o~::g.umDITISCLAIMID 0 t
RESIDENT DECEDENT 'ILl HUM.II G
(TO BE FILED IN DUPLICATE .;J. I q 5 5 I
WITH REGISTER OF WILLS) COUNTY CODE YEAR NUMBER
DfClDfN '. COIl_I'll I ADDal
15
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COMMONWfAltH Of PfNNSYlVANIA
DfPAR'MfN' Of RlVfNUf
om, 210601
HAllIl$lUIIO. PA 17 21.0601
o IN ' HAM ILA ,'11 . AND .1041 Dlf INI IA'I
Wilson Clara M.
lOCIA' Iteulny NUMIIII DAn or DIA'H
II)
121
(3)
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151
161
P)
191
(101
(15)
(16)
(171
+
1203 Indian Peg Road
Mechanicaburg. PA 17055
COUIlI
AMOuNtalellVID IUIINUIUClIONII
~ I, O,I&lnal Rllurn
o ... lImlt.d E,'at. 0 "a, fUlur. Inl.r..t Comproml..
I'or dol.. of dlOlh oft.r 12.12.82)
P!J 6. D.c.d.nt Di.d T.,'ol. 0 7, O.c.d.nl Malntaln.d allYing Tru"
(Attach cop)' 0' Will) (Anach cop)' of Tru't)
ALl. CORRWONDINCI AND CONPID!NnAL TAX INPORMAnON SHOULD BE DIRECTED TOI
NAMt COMI'Un MAiliNG AOOIUI
Kent H. Patterson 221 Pin" Street
U:UPHONINUMIU Hit t"r isburg, PA
163-12-0959
o 2. Suppl.menlal R,'urn
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I, Roal E,la,. ISchodul. AI
2, Stock. and Bond. ISch.dul. 8)
3, Clolll)' H.ld Slock'Partn.nhlp Int.r,,' (5ch.dul. q
... Martgog.. and Not.. R.c.lvabl. (Sch.dul. D)
5, Caaht Bank D'po.lla & Mlac.llon.ou. P.nonal Prop.rly
ISc..d.l. E)
6, Jaln.ly Own.d Prap.rty ISch.dul. FI
7, Tran.'", (Sch.dul. G)ISchodul. L)
8. Total Gran Au... (10101 Un.. 1.7)
9. Fun.ral bp.n.", Admlnlalratl.... Call., Mlte.llan.ou.
bp.n... (5ch.dull HI
10. D.bta. Mortgog. lloblllll.., U.na (Sch.dul. II
11. Total D.ductlona (10101 Un.. 9 & 10)
12, Ntt Valu. of E,'at. (L1n. 8 mlnua L1n. '1)
13. Charitable and Gav.rnm.nfol B.qu..tt (Sch.dul. J)
U, N.t Valu. Sub'.ct 10 Tax lIn. 12 mlnu. Lln. 13)
15, Spou.al Trand.,. (far dOl.. of death oker 6.30.9.4)
5.. Inllructlan. for Ar,pUcoble P,runlag. on R.y.,..
Sid., (Includ. yalu.. rom Sch.dule Ie or Sch.dul. M,I
16. Amount of L1n. ,.. loxabl. at 6% ral.
I'nclud. yalu.. from Sch.dul. Ie or Sch,dul. M,)
17. Amoun. 0' lIn. ,.. taxabl. 01 15% rol.
(Includ. volu.. from Sch.dul. K or 5ch.dul. M,)
18. Prlnclpolla.ll due (Add tax from L1n.. 15, 16 and 17.)
19. C,.dlll Spou.al POy.rt)' Cr.dlt Prior Poym.nla
+
o 3, R.malnd.r R.tur"
Ilor do'" of d.ath prla, '0 12,13,821
o 5, f.d.rol e,'ol. TOIt R.tur" R.qulr.d
...Q 8, Talal Number of Safe Oepo.1I 80xII
17]01
942.56
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579.96
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4706.95
987.38
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12399.51
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5694.32
6705.18
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(18)
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20, II L1n. 191. gr.aler than L1n. 18, .nllt the diff.r.ncI on Lint 20, Thl. i. the OVERPAYMENT,
a O...rrl!":I..OI......_ ....-OI....I..H'I~'"..._'_I..ft'I"l1'l~_'....I_..'.IJItllJ...I"I...1 .
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21. It L1n. 18 It greal.r than lIn. 19, .nter the diff.r.ncI an L1n. 21. Thl.I.lh. TAX DUE.
A, Enler the Int.r.., on th. balonct due on lIn. 21 A,
B. Ent.r the latal of lIn. 21 and 2lA on lIn. 21 B, Thl. I. the BALANCE DUE.
MaSe. Ch.eSe Payabl. t,:,! R'a','.r of Will., A-'!I~nt
~ ~ BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND TO RECHECK MATH -<-<
Und.r p.nalti.. of p.rjury. I d.c1ar. that I hove .xamln.d Ihl, relurn, Including occomponying I(h.dul.. and ,'alem.nll, and 10 the be,' of my knowl.dg. and b.li.f,
.1 i. tru., carr.c! and compl.te, I d.c1or. Ihal all ,.01 ."01. ha, bun reported otlru. marh, yalu.. O.doralion 01 pr.parer olher Ihan th. p.nanal r'pr..enlatiy. is
IIDI..~_~~_ol~~~~rmalion D'_~~~ ~r'pare' .'!.~~..!!..n)' k,!.!..wJ!~.___~_ ______._.. _.. _ ___.___..._.._,_~_____ "_.
'.1 rAJUU '!UONIUI'O"~IIU' rtUNGR IURN ADDlIl.5o$ Carol J. Freeland, Executrix DAn
. C; <:/-c""....,i;,,,,,,, 1203 Indian Peq Road 10/14/98
',. "A UfO. I'AR ROIHUIHAN (I'RUENI..., l ADDUS, Mechanicsburg, PA 17055 DAn
(21)
121A)
171B)
402.31
142.28
548.59
Act '48 of 1994 provld.. for the r.ductlon of the tax rot.. Impo..d on the n.t valu. of trond." to or for
the u.. of the .pou... Th. rot.. a. pr..crlb.d by the .totut. will b.,
· 3'l1o (.03) will b. appllcobl. for ..tot.. of d.c.d.nt. dyIng on or aft.r 711/94 and b.for. 111/96
· 2'l1o (.02) will b. appllcobl. for ..tat.. of d.c.d.nt. dyIng on or aft.r 111/96 and b.for. 111/97
· 1'l1o (.01) will b. appllcabl. for ..tot.. of d.e.d.nt. dying on or oft.r 1/1/97 and b.for. 1/1/98
e Spou.al tranal." oceurrlng on or aft.r 1/1/98 will b. .xempt from Inherltanc. tax.
PLEASE ANSWER THE FOLLOWING QUESTIONS
BY PLACING A CHECK MARK (....) IN THE APPROPRIATE BLOCKS.
1. Old decedent make a transfer and,
a. retain the use or Income of the property tronsferred, ....,..,..................,........,......,............
b, retain the right to designate who shall use the property transferred or Its lacome, ..,............
c. retain a reversionary interelt; or ..........,........."...,.....................,...................,...............
d. receive the promise for life of either payment., benefit. or care' ......................,..,......,......
2, If d.ath occurred on or before December 12, 1982, did decedent within two y.ars preceding
death transfer prop.rty without r.celvlng adequote conslderotlon' If death occurred aft.r
December 12, 1982, did decedent transfer property within one year of death without receiving
adequate consideration' ......" ,........"...."..., ,.,.,., .....,...., .... t. ........,............, '..... .......... ........
3. Old decedent own an 'In trust for' bank account at his or her death'...................................,..
YES 0
'Ie
)(
)<
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES,
YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
"
"
"
UY,1l0' IX. 112.u] '*'
CllMMONWIAIT" O' P1HHIYlYAHIA
- INHI'"AHCI TA. mUON
UllDIHt DICIDI!"t
ISTATI O'
SCHEDULE A
REAL ESTATE
.iLi1lUMIIR
Clara M. Wilson
IP.....t1y 1.lnlly..wn.d with RI,hl.' SuovIY...hlp mU'1 b. dlscl...d.n Sch.dul." All r.;';.la,;;h.uld bo ..p.;....'d ~I ';'Ir mark., valu.
whish II d.hned allhl prlc. al which p..polly would bo ..chan,.d bo!woon a wlllln, buy.r and a wlllln, 1.11.., n.lth.. b.ln, comp.lI.d
Ia bu ar 1111. balh hayln ..allnabl. knawl.d,. a' Ihl ..I.vanl 'ad..
NU~rIR DISCRIPTION VAb~V~lr~TI
I,
Lot 241, section 16, Treasure Lake Subdivision,
sandy Township, Clearfield County, PA
(see attached settlement sheet from sale)
942.56
"
'I
;1
TOTAL AI.o .n'" an IInl 1, Rica Itulotlon
(11 more 'pace ;, n..ded, Ins.rt addi'ional .he." of lome ,'ze.,
s
942.56
I, ...". Md ~ 01 BcImMIf Im.;1~'~~r.':'nd. I'xecutrix ,,_..._oI~ N/II
,arcn M. zc1be
126 Barley Dr ve E/O Clara M. wilson
:luncannon, PA 17020 1203 Indian Peg Roa~ .,n<."
;:.__, ..~~ . PA
1,__ H, IW....~.. AgIN Kent II. Patterson
Lot No. 241, sec\:ion No. 16 T...O No 23-2457515
Treasurc Lake s~ivision ..... 01 ~II~..._A I. w....,.... 0tI0 , ~ ,
sandy Township 221 pinc Street
a~d~w.A Harrisburg , PA 17101 .. __T...D No,
163-12-0959
I, SUMMARY OF BORROWER'S TRMSACTlON K, SUMMARY OF SElLER'S TRANSACTION
100, GROSS AMOUN1'DUE FROM BORROWER: 400, GROSS AMOUNT DUE TO SELLER:
101- Conl..el ..I" o<lct 'U~ ..,(. 401- Contrlct "I.. oriel 'r.~L rC"t.
102, P.llon.1 Pro"""" 402, Pellon.lmo""rl"
'03, Seltl.menl ch......IO borrow.. (/in. 14001 :;,~ I ~(., 403,
1().4, 404,
'OS, 405,
Idiutrmen" (D' 111m. tJlld by ,./1" in '<N.ner ' II ~'Hd AdIU.I"""'" (D' illm. p.id by ,./1" In .<NMlCl'" egrHd
06, School TIM \.~ ~1\\..Jc. I!::J, 406, School r..
07. TIM 407, TIM
DB TIM 40B, T..
,09, Sew.. 409, Sewer
10, Tr.sh 410, Trl.h
It. WI'''' 411, W,,.,
12, 4",
20, GROSS AMOUNT DUE FROM BORROWER /7.J. 'T,.. ~20, GROSS AMOUNT DUE TO SELLER '/4L Sf,
00, AMOUNTS PAID BY on IN 8EtlALF OF 1I0RIlOWER, bUO, IlElJUCTIONS IN AMOUNT DUE TO SELLER,
01- Depo.U or ..,n..' manlY 50t. Elect" depos.. c..ln,tructiOl1')
02, Prlnc~ .moun' 01 n.w lo.nld li02, Selllemenl chlrllftS 10 lillie, 'f/nll 14tXn 'Ti, s:6
03, hl.llnn lo.nl.' Ilk In .ublecllo 503, h.lli"" 10lnlslllken .ubilCI to
"
().4, 604, PI_all .
05, 505 PI_all I
06, 506, I
07 507
DB, 50B,
09, 509,
diut""."" (", 111m. untJIld by III'" , .. ",owd Adiu.rmen" fOf I1M" unp.ld bv ../I" . II ...reed
10, s.."ool TIM 510, Sehool TIX
1" TIM SIt. TIM
12, TIM 512, TIM
13, Sew.. 513, Sew..
14, Tro.h 514, Trail,
16, WI'" 515, WI'"
16, 516,
17. 617,
18, SIB,
10, 619,
10, TOTAL PAID BYIFOR BORROWEn - ~"' - (.;JU. TotAL R~DUClION AMOUNT DUE SELLE II U.l l-/
".)
10, CASH AT SETTLEMENT FROMITO nonRowrn noD, CASH Al SETTLEMENT TOIFROM SELLER
J1- Grall .mount dUI Irom bonow" (IIn. 1201 q" ( -j,J B01. GrOll Imoun' dUI 10 ..II" IIln. 4201 '1 J.,) :"~{l
/..
12, Lell Imounll fllirl hv/for horrnw.r lIin~ :>:>01 I .. 1 no,. leu r"rtur.'inn\ in .moun' riut! ullll' IIIn.520t ,- r)'';' 58
)3, CASH I ill FROMl (" TOI BORROWF R q74 Iq~ 603, CASH 1'0/ TOI ,,, FROMl SELLER -0 ..
SOlIC1T,.T10N -/
995
"Setttement Sl8ttmtnt
U,a. DI, ,~..... of HouIInI Md \JrbM DI.11c.. LIlMt
APPliCATION .
HIJOo'!MIl MlII'A,H843OIl2
OIolB No ~-o?ft~
..._~~'lIT.A. T1llII...-~
IT afLDIn
DfllA . D'...... :lPCorw,u.-
a VA J a ec.w I.-
HOrt: rNllbtrftlllumleMdfiOf#wet'D"..,.,....",oI.'....",."..,.'eoefil A~pMd,.,~"""....",."..,.''''''''...,.,.., """""""",..0.'-
.....peId.,...... "..efN/nf'''''''''' """"' '*' lot 1n1Ot"..,.",.,~ .,wi,,. tto4 ~kJdfd""'" fofM
&,..-
, loen Number
. _,_c..-
You IN reQUIred by I.. '0 pt'~ thII MttltfM"' 10"" wtth your correct I._ p.y.r Id."IIUeaUon nu",,*. "you do not pnrrktl the..".......,., eo-m wtttl your coned
lPpllyM' 1denllllCl1lon "u"''*, you m.y be .ublect to cl...1l or crlmln.1 pen.IIl..,,,,poMd by I'.
CERTIFICATION
U"dtt "",I,n.. of _jury,' oMUy tN, the ""mbtr ~ on ''''I O'I,,",,nll' my eorr", ta.,.,.,.....tftClI1tOn ftUfNiIf,
S.n,r',51 n.turI 9.U.'" ~l n.lur. SaU.,., 51 "1Iur.
Slln~'ITUff ,oqq
Th,lnlo''''llIon contllned In hlockt E, 0, H,l, M '"d on IInfl4011,I"'JH)III"III- In"",,,.llnn Ind II belnQ lu.nl,hed 10 IhI lnl"nl' A.wlnu, Sarwln II vou "I
'eQulrld 10 III'. return, L ~lIve"C' Pln'Ily or olh" ..ntIIO" will be Impoud on yOU Illhtl 111m II requl'''' fa be ~td Ind lhalRS dllttmlnet Ihlll, hll nol been
reported,
.~
APPLICATION' PAGr 2
L, SETTLEMENT CHARGES
100, TOTAL SALESIBROKE R'S COMMISSION hllP" on I'"'' $ ~ 'lI.' PAID FROM PAID FROM
/J'~/sj(Jn of Cumm;ulon (1m, IOOJ,s lollows BORROWER'S SELLER'S
IUI. $ 10 FUNDS AT FUNOS AT
102. $ 10 SETTLEMENT SETTLEMENT
103, Comrnlulon oaid.t Selllemenl
104,
70S,
,
1100, ITEMS PAYAOLE IN CONNECTION WITH LOAN
HO\. lo.n O,igin,lIon FfltI 'llo
1102, Lo.n Oilcount '110
1111:1 Am".,..1 Fn ."
1104, C,edlt f1l'pOft '0
R05 lende,', Irnooellon Fu
IIU6, Mort~agl' In,uraner ^Ilpllcation F"r 10
U07, Auumplion Fee
IIOU,
ilU~l.
UIO,
,000. ITEMS REOUIRED BY LENDER TO U~ PAID IN ADVANCE
,001. Interest from 10 "'$ Id.v
, 001, Mortgdge Il1Iur.nce P,emlum for months to
~ 003, HoI/ard Imurlnr:t' PremIum tor yellin to
004. yur, to
! !lO5.
! 1000, RESERVES DEPOSITED WITH LENDER
t'UU\. H./,urlm"Ir,UII;l! mUlltln (ill $ pN munlt'
1002, Mortgago insuranco monlh, @ $ p'" monlh
1003, City flfoperty lue, munth, (Ill S pl'r month
-,U04, County property ...el munths Ciil S IlI!r month
1005, School property tues monthl tfi) S per munth
1006, lotn,im .nenmunt momhs ~... S l)er mnlllh
1007, munth, (pi S I)r.r mOn1h
'OOR, month, r~ S IHlrmfllllh
1100, TITLE CHARGES \':>\J-;/ER 1.)10 fJd r w f\ 'fT "TIT Le
1101. Sellleme"t or e1o'lng 'eu 10 .-l....,..IS v,z. A ~./(~ (r drJ- 'rl U~_ <;:e-A4.r..N
1102, AbUnct or title ,earch 10
1103, Title !kamlnation 10
1\04, Title imurance binder 10
1105, Document pre~arallDn 10
1106, NOla,v I.., lu
1107, Allornev', fco, to
line/lid". ,bovlI itom, nu",/Jlffl,' I
1106, Tille Insurance to T,A. TUlelnlurllncB Co. (lncludl1s If' '0' 101'04 I I I
1100, Lunder', cover.ge premium . $ 1""'IlIUIII CUVUI' bUill 1101l "" 1110
1\ 10, Ownnr', coverage $ ,.,."uo 01.
1111. Disbursoment cherge to
1112, End #100, End #300, End # 10
1\ 13,
1200, GOVERNMENT RECOROING AND TRANSH R CHARGES
1201. Aocnuhng hUI': DudS 13,50 , Mortgsl,!' S ; Rnluw $ I::' ';''1
12U2, Cily/county lu/"amp,: D..d $ . MUlII","" S '-, 13
12U3, Slale tax/Uamp,: Deed S ; MOIll1'Otl S "'I I..
1204,
1205,
1300, ADDITIONAL SETTLEMENT CHAnGES Nor ASSllONAIlU TOANOIHrll CATEGOny
1301. Sur VI!Y to
13U2, Pit" I",peclion \0
1303. Broku,', "rvlee,
1304, Deed preparalion
1305, -rAy r:t.",I'v' (1t/~,..",.... fCI~f'I~ (J "'A"'.~ v, '~?9: 't"J "lq4"'tY\ .,.s 9?" ,,/
1306, I...~.~ IS IV"''/ r"fI,,,,r. T.c, , " '1 " '17' .;~ .- "I
I.. ,
1307,
1308,
1309,
1310.
1400, TOTAL SETTl EMrNT CHAnGFS /t'1I1r'r on IIII",~ 10.1 S,.rrmn J dlU/,lin:' 54'rlm" J(J ~ ';r-. "'''/'-;' ="
11111 u/lI''''''1IIII'11 I,rltlllY ,II .II"WI"I/I/I' "", ,..,,,III1,,lflllll ."111 '1"'Jlf/~,,1 "I 0'" \1,""11,,'11' ,lit.' "'11"'" '"II I 1I/1r (.11I1I''''''~ u. &JI"'l"'" ,1/11 ,lIiiml"/I'U
hi
m"." dlJIl/bllllon alld ptfynl'tU, lit ICco,cJtlnrto hrH'Wflh 'nil" It "y","d 0"" ''''''''''''y ,IUlIm".I till Iltl/HMy'm ,,'" tlcru'"'y III ".",lIIy III ","US ",
"I.,g" no' 'r"o..d by tOfnlJ,ny or IIJ' ",l"", 10 Includ" on "II' Sf.lflm.nl ""m. I" ,II..,g..\ nol d,Jf/"..!,d'O tOfT'plny ", ..""m"",
BUYERS: ,\,', , " .'",\_v_ SELLERS: (J.,df,\I'''(d~.r. ti..,,,l,,',,
, ' I
A/lDI/ESS:
NEW ADDI/ESS:
,
lrv.uoeUtpollJ
'*
SCHEDULE E
CASH, BANK DEPOSITS AND
MISCELLANEOUS
PERSONAL PROPERTY
Ploo.. Print or l' 0
FilE NUMBER
~"~~~tlr.l1~lll"HIA
'll1SlD'iHT" oic'iDiHi
Clara M. Wilson "
(An ...-otY 1olo11\ ........ with .... ...", .. ...........hlp ..." ... d'"....d .. Sc........ ')
ITIM
NUMBIR
DISCRIPTION
YAWl AT
DATI OF DEATH
1.
Pa Dept. of Revenue tax refund
539.96
40.00
2.
Ring
S 579.96
(Attach addU'....I.". .. 1t~ .......,1..... IflOCO" .HCIecI,1
,_~fJ
.' ',~. 'C! c
.f'l.lJOtl1+ (11-11I
.
COMMQNWIAUH 0' PENNIYLVANIA
lNHUI1ANC! TAX Il:UU.N
.(IIDINT DIClDINT
SCHEDULE F
JOINTLY-OWNED PROPERTY
ISTATI 0'
PILE NUMBER
Clara M. Wilson
JoIn' 'onon'I.I.
A.
NAME
Carol J. Freeland
ADDRESS
1203 Indian Peg Drive
Mechanicsburg, PA 17055
----_.__.- -_._----_.~-_..'.,... -.-., .
RELATIONSHIP TO DECEDENT
Granddaughter
B.
C.
Joln,IYoOwMd proparty.
ITIM LITTIR DATI
I'OR
NUMBil JOINT MADE DESCRIPTION 0' PROPERTY TOTAL VALUE DECD'S DOLLAR VALUE OF
TlNANT JOINT OF ASSET '"' INT. DECEDENT'S INTEREST
1. A 1990 PNC Bank Acct.#5l40469292 21753.98 50% 10876.99
TOTAL (AI.o ont.r on lino b, Rocapllulatlan) S 10876.99
(II moro 'poco It n..dod In.orl odd/Ilona' .h..I. 0' .omo .1..)
..
1I\l.1J1I fl. p.,'1
J:~'~
-~
COMMONWEAlTH O' 'ENNSYlVANIA
INHUIrANCE TAX irWIN
IlUIDIN'DfcrOINT
ISTATIO'C1 . - -
ara M. Wilson
~ SCHEDULE H
FUNERAL EXPENSES,
ADMINISTRATIVE COSTS AND
MISCELLANEOUS EXPENSES
PI.a.. P,lnt or Typ.
ITIM
NUMBER
A.
"
B,
1.
DESCRIPTION
AMOUNT
2, Attom~Fo.. Kent H. Patterson 1500.00
Fun.ra'bpon..., Cocklin Funeral Home
Tionesta United Methodist Church
Lucille Wilson
231. 00
100.00
25.00
Admlnl.tratlvo Ca.t"
Porlonol R.pro..ntotl.. Comml..lon.
Soclol S.curlty Numbor 01 Perlonol Repro..ntoti..:
Yeor Comml..lon. paid
3, Famtiy Ex.mptlan
Claimant Relation.hlp
Addro.. 01 Claimant at decedent'. d.ath
Stroel Addro..
4,
C.
1,
2,
3,
4,
5,
6,
7,
8,
CIty
State
Zip Cad.
Prabate Fo..
66.50
MI...llan.ou. Exp.n...,
Register of Wills
25.00
3.60
7.00
95.00
The Guide
West Shore Shopper
Cayman Landing(Treasure Lake Assessment)
The Bargain Sheet
Naco(Treasure Lake)
4.00
104.00
100.00
87.14
Joseph Falcetta
Rivera Utility
TOTAL IAI.o enlor on line 9, R.capltulation)
(If mOrl .pac. I. n..d.d, In.." additional .h.... of .am. .1...)
s
..
.1~1J111" 1'011I
.
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE L1ABLlTIES AND LIENS
PI.a.. Print ar T .
fIll NUMBER
COMMOHWlAUH Of PlNN''f'l'-aHIA
tHHI......kCllA..UU.H
InIOINlOle'OINI
mATI Of
Clara M. Wilson
ITIM DISCI'mON AMOUNT
NUMB!R
" Internists of PA 6.69
2. Surgical Physcians 8.38
3. White Rose Ambulance 76.05
4. Therapy Care, Inc. 572.00
5. White Rose Ambulance 25.87
6. Dale, Woodard, Montgomery & White 283.00
7. ATS Medical Services 15.39
TOTAL (Aloo .nt" on IIn. 10, Rocopllulollonl
(If mol'l 'Pa.. I. nHdod, In..'' addillonal .h.." 01 .am. "..,)
$
987.38
. ,-; ,<r~' '~"'!"jto~~!J1~W.t~J'I!ltlo/l....~:~,hi;y~J .;(.jJ.,::2~;;;:28.:~t2V'';-*'1.'l]]';j--,:~'~~fl;;':i
..
SCHEDULE H (continued)
Estate of Clara M. Wilson
9. Naco(Treasure Lake) $ 99.50
10. Cumberland Law Journal 60.00
11. Patriot-News Co. 67.30
, . 12. Tax Claim Bureau of C1earfie1d County 876.97
13. Lee Ann COllins, Tax Collector 65.59
14. Naco(Treasure Lake) 15.00
15. Reserve for Costs 50.00
16. Treasure Lake property Owners Assoc., Inc.
17. Gary W. Fisher 51. 50
18. Treasure Lake property Owners Assoc., Inc. 1072.85
Total $4706.95
'i
'.
~=
"
IIV.I~IHI. 1"1)
*
(o-OltWIAlIH Of '1 NkinVANIA
INHII,'AH(I ,.. IUUIH
..... _ _~!JI~IH' DlCIOIH'
J
SCHEDULE J
BENEFICIARIES
ISTATI O.
.ILE NUMBER
Clara M. Wilson
ITlM
NUMBER
NAME AND ADDRESS O' BENEPlCIARY
RELATIONSHIP
AMOUNT OR
SHARE O'ESTATE
A. Talilabl. BaqulIlIl
1.
See attached list.
ITEM
NUMBER
NAME AND ADDRESS O' BENEFICIARY
AMOUNT OR
SHARE OF ESTATE
B, Cha,llabl. and Gavornm.nlal BoqUlIlII
\,
TOTAL CHARITABLE AND GOVERNMENTAL BEQUESTS (AIlo .nlor an lin. 13. Rocapllulallon) S
(If more .pan I. ft..d.d, In..rt additional .h,.tl 0' 10m. II..)
Name Address Relationship Amount or
Share of
Estate
Robert L. Moore 3008 West Country Club Grandson 1/14
Drive, Irving, TX 75038
Darlene Reigle 1285 North Vine Street Granddaughter 1/14
Middletown, PA 17057
Marlene Ellersick 301 Lauberman Cres. Granddaughter 1/14
Rochester, NY 14620
Carol J. Freeland 1203 Indian Peg Road Granddaughter 1/14
Mechanicsburg, PA 17055
Hilda Runk (nee. R.R. 1, Box 305 Granddaughter 1/14
Custred) Spring Mills, PA 16875
Albert Moore 303 Vanessa Drive Grandson 1/14
Pleasant Gap, PA 16823
Dortha Weaver 7397 Otisco Valley Road Granddaughter 1/14
Preble, NY 13141
Robert M. Allison Box 37 Grandson 1/14
Central Bridge, NY
12035-0037
Joan M. M Box 61 Granddaughter 1/14
Marshall White Lake, NY 12786
Richard L.Allison Rt.2, Box 213, Cora Grandson 1/14
Street
Gassville, Arkansas
72635
Patrick L. Bielby R.D. 2, Box 230- Grandson 1/14
Saltzman Road
Blossvale, NY 13308
Allan Allison 43738 Beech Avenue Grandson 1/14
Lancaster, CA 93534
Deunning Allison 43738 Beech Avenue Grandson 1/14
Lancaster, CA 93534
Mark Allison 43738 Beech Avenue Grandson 1/14
Lancaster, CA 93534
Robert Allison 20 Willey Street Son $500.00
Albany, NY 12203
Irving Allison, 43738 Beech Avenue Son $500.00
a/k/a Donald Lancsa tar, CA 93534
Allison
ATTACHMENT
SCHEDULE J
BENEFICIARIES
CLARA M. WILSON
~_,-~~~:_'~'~<",-';"__ ..0..-_........_
.
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUR!AU OP INDIVIDUAL TAXEB
DEPU8Oe01
HARRISBURG, PA 1712lJ.OllOI
RECEIVED FROM:
r
KENT PATTERSON
eel PINE STREET
HARRISBURG, PA 17101
FClO HERE .
ESTATE INFORMATION:
FILE NUMBeR
,
-- -, ~... - .,..~... --...
,
,
.."-'-'--'--';";"; -,;";-,,;,,._.;"'_..~....,--"';-'-'~----__________-i.;
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
'*
No.AA 324353 REV,,,",, '"' I"""
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
tn,
...l.all=fl ~Q
,-
FaD""'"
(Mil
. -.":P-:. /
NAME OF DECEOENT lLAST)
N CLARA M
OATE OF PAYMENT
I 4 99B
POSTMARK DATE
COUNTY
R
OATE OF OEATH
REMARKS KENT PATTERSON
SEALCHECK" NO CHECK ..
(FIRST)
TOTAL AMOUNT PAID
$548.59
PB
I
'I
I
REGISTER OF WILLS
RECEIVED BY
MARY C.
REGISTE
I
~-------------""'---:::'"..~~.-.~-"~7"""-'---------------7-:"-'-:---r. ....:
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. ' . .
."
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""'
~
..t
~._-."-
,
.,--------....;J
1i~
~-~,'
.....':-.
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---
,-'
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COMMONWEALTH OF PENNSYLVANIA
OEPARTMENTOFREVENUE
BUREAU OF INDIVIDUAL TAXES
OEPT,280601
HARRISaURQ, PA 11128_1
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
.
No.AA 324443REY'''''U(''''',
RECEIVED FROM:
r
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
-,
CAROL FREELAND
1203 INDIAN PEG RD
t 01
"~bD "'0
MECHANICSBURG. PA 17033
~. ;'
"""HERE
ESTATE INFORMATION:
FILE NUMBER
RllD HERE
(loll)
NAME OF DECEOENT (LASn
W L ON ARA M
DATE OF PAYMENT
12/22/1998
POSTMARK DATE
0/0010000
COUNTY
CUMBERLAND
DATE OF DEATH
TOTAL AMOUNT PAID
$548.59
REMARKS CAROL JEAN FREELAND
DO
RECEIVED BY /.. l.tA, t "'"
MARY C. L 18 ll/ /).Ar~
REGISTER F' WILLS/-r)1U!,1 q V'
SEALCHECKlt 1993
REGISTER OF WILLS
--- ----- ---- - - - - -- --- - ---------- ----.,--- -~___---,.,.I
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BUREAU OF INDIVIDUAL TAXES
JNItRlTAHCE TAl( DIVISION
DEPT. ZIID6DJ
IIARRISIURG, PA 171Zft-D60J
COMMONWEALTH OF PENNSYLVAN.'
DEPARTMENT OF REVENUE
..
NDTICE OF INHERITANCE TAX
APPRAISENENT. ALLDWANCE DR DISALLOWANCE
Of DEDUCTIONS AND ASSESSHENT Df TAX
....unn "'ltt-".
KENT H PATTERSON
221 PINE ST
HARRISBURG
" 1 ~
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
M
03-22-1999
WILSON
1]-]3-]993
21 95-0598
CUMBERLAND
]0]
CLARA
PA ~~101
r:"UI.
A_aunt Re.l Hed
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CD COURT HOUSE
CARLISLE, PA 17013
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS .....
RiV:is4rix--AFP--ioii:m--iioTici--OF-i-riHiififAN-CE-;'iiX-A-ppiiiiisiif€iiT~--Ai:rciwAiicE-O-R-----------------
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF WILSON CLARA M FILE NO. 21 95-0598 ACN 101 DATE 03-22-1999
TAX RETURN NAS. I X) ACCEPTED AS FILED
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. R..l Eat.t. (Schedule A)
2. Stocke and Bonda (Schedul. 8)
3. Clo..ly Hald stock/Partnarship lnt.r..t (Schadul. C)
4. Harig_g../Not.. Receivable (Schedule DJ
S. C..hl8ank Deposlta/Hisc. Per.onal Property (Schadul. E)
6. ~olntly Owned Property (Schedul. F)
7. Transfera (Schedule 0)
8. Tot.l A...t.
I CHANGED
III
121
13)
(4)
15)
161
171
942,56
,00
,00
.00
579,96
10.876,99
,00
181
HOTEl To insure proper
credit to Your account I
sub.it the upper portion
of thia for. with your
t.x p.Yllent.
12,399,51
APPROVED DEDUCTIONS AND EXEMPTIONS:
4,706,95
9. Funeral Expens../Ade. Co.ts/Hi.o. Expans.. (Sch.dul. H) (9)
10. n.bt./Hortgag. li.bilitJ../L1.ns (Sch.dule X) (10) 987.38
11, Tot.l D.duotion. 1111
12. N.t Value of T.x R.turn (12)
15. Charit.ble/Govarn..nt.l B.qu..ts, Hon-.l.ct.d 9113 Tru.t. (Schedul. J) (13)
14, N.t V.lu. of E.t.t. Subj.ot to T.. 1141
NOTE: I~ an assessment wes issued preViously, lines 14, 15 and/or 16, 17 end 18 will
reflect figures that include the total of ~ returns assessed to date.
ASSESSMENT OF TAX:
15. A.ount of Lin. 14 .t Spou.al r.t. 115) ,00 X, 00. ,00
16, A.ount of Lin. 14 t...ble at Lin..l/Cl... A r.t. 1161 6,705,18 X ,06. 402,31
17. A.ount of Lin. 14 t...ble .t COU.ter.l/Cla.. B r.t. 1171 ,DO X ,15. ,00
18, Princip.l T.. Dun 1I8) 402.31
~,6q4 ~?
6,705,18
,00
6,705,18
TAX CREDITS:
PAYHENT
DATE
12-22-1998
RECEIPT
NUHBER
AA324443
DISCOUNT 101
INTEREST/PEN PAIU 1-)
146,28-
AHOUNT PAID
548,59
BALANCE OF UNPAID INTEREST/PENALTY AS OF 12-23-1998 TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST AND PEN.
TOTAL DUE
402,31
,DO
8,82
8,82
· IF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
IF TOTAL DUE IS LESS THAN fl, NO PAYHENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT"' ICR), YOU HAY BE DUE
t ",.,.,..,.. "'r... .."',.......... ........ ..... _.,..... ........ ....... ...,..._......_..._.._ .
Inventory 01 the real and personal estate 01
Clara_M~,Wi.Laon.______._ decoased
No. 1995-00598
Real Estate - Lot 241, section 16, Treasure Lake
Subdivision, Sandy Township, Clearfield County, PA
PA Dept. of Revenue Refund
Ring
1.
2.
3.
t-
" ,',' Y',\ ;~\,
f'J
C"c,
'<t
-
>-
""
~.::
.; ~ ,- ~
rC -- "f :::;
iJc..:
942 56
539 96
4000
TOTAL
1522 52
r
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUM.IRLAND
UI
Carol Freeland
b.lng duly sworn .ccordlnll to I.w, d,poslI .nd s.ys th.t sh. ---------,.-
is the Exec~~___ of tho EIl.t. of Clara M. Wilson
lat. of __J10ru:.oe ,ToWIl.snip. __.'. n.___ _____, Cumba,land County, Pa" d....s.d and thl! tha
within Is an Invontory made by ...___..CarDLJ:'J:.ee.lAnd.-. ,__ _ --.-, th. ,ald-IDl.ecutrix ,_.-
of tho .ntl,o ..t.to of ,aid d.c.d.nt, conshtlng of .11 th. p.non.1 p,op.,ty and ro.lllt.t., ....pt ,..1 ..tat. ouhld.
tha Commonwoalth of Ponn'ylvanl., .nd thot tho flllu,os oppollt. ..ch Itom 01 tho Invento,y rop,ount It', f.l, valuo
.. of tho d.to 01 docodont', d..th,
Sworn
.nd ,ubscrlbod boloro mo,
fLjJ~M
Eltul., . Admlnl,",'.r
Carol Freeland
1203 Jndian Peq Road
Mcchanicsburg, PA 17055
19 .,,~
NOTARIAL SEAL ---,
TIM R SPR1NKLElHotary Public I
Mechanlcaburg eoro. Cumbtttlnd CaUl '~, ,
M Com I 'II!"
Add,...
D.to of D..th
13 NOV~illper 1993
DIY
Month
v..,
INSTRUCTIONS
I. An Inventory mull b. fll.d within thr.. month, .flor .ppolntmont of p.nonol roprount.t1vo.
2. A ,uppl.m.nt Inv.ntory mull bo fll.d within thirty d.ys of discovery of .ddltlon.llluh.
3. Addltlonol ,huh moy b. ett.chod II to po"on.lty or roolty
4. S.. Artlcl. IV, Flduclorlll Act of 1949.
0.
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_.__ _._ _.._. .________.__w"________......._-_. ~.^~..-.. "-~-..".. - ~-.---.--....-
_....__ __.______.___.....~___ __0__-__-
COMMONWEALTH OF PENNSYLVANIA
OEPARTMENT OF REVENUE
BUReAU OF INDIVIDUAL TAXes
OEPT,2B0601
HARRISBURG, PA1712S.0601
'*
No.AA 354832REV'''''EXI'''''1
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
RECEIVED FROM:
r
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
,j
PATTERSON KENT H
eel PINE ST
101
lSR.RP
HARRISBURG, PA 17101
.
.
FOIDHW
FCllll H<RE "-
ESTATE INFORMATION:
FILE NUMBER
21-1990-0098 SSN 1b3-12-09~9
NAME OF DECEDENT (LAST) IFIRSTI (MI)
WILSON CLARA M
OATE OF PAYMENT
3/14/1999
POSTMARK DATE
0/00/0000
COUNTY
CUMBERLAND
OATE OF DEATH
11/13/1993
REMARKS KENT H PATTERSON ESQUIRE
TOTAL AMOUNT PAID
S8.62
PB
/
RECEIVED SY
MARY C. L
REGISTER
Fl~ILLS W~fAA}4..'.~
SEAL CHECK" 3853
REGISTER OF WILLS
01 .
.
1 ..
~__,....,.,.,_____..__ __....~._____......,,~..o_._._..:~.~._-.__.~..,........._____.______
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BUREAU OF INDIVIDUAL TARES
INHERITANCE TAX DIVISION
DEPT. U060l
HARA151URG, PA 171rl-D6DI
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
J:NHERJ:TANCE TAX
STATEMENT OF ACCOUNT
~*
.n.lur".,'lll-.,.
KENT H PATTERSON
221 PINE ST
HARRISBURG
I " 1
DATE
ESTATE OF
DATE OF DEATH
FILl! NUHBER
COUNTY
ACN
06-14-1999
WILSON
11-13-1993
21 95-0598
CUMBERLAND
101
Aooount R..l Hod
CLARA
M
"
!
PA\~7101
ell
MAKE CHECK PAYABLE AND REMIT PAYMENT TOI
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
NOTE I To In.u.... proper credit to your .cc~t, .ubIIlt the upper portion of thl. fa'" with your tax pa)fltel'1t.
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~
ii!'y:i6ii7'-ix-"FP"COy:97y------iiiii;-iiiiiiR'iTAiicE"i'Ax-si'A'TEHE'IWOF-;.crciiuNr-iiiii---------------------
ESTATE OF WILSON CLARA M FILE NO.21 95-0598 ACN 101 DATE 06-14-1999
THIS STATEMENT IS PROVIDED TO ADVISE DF THE CURRENT STATUS OF THE STATED ACN IN THE MANED ESTATE, SHOWN BELOW
IS A SUllttARY OF THE PRINCIPAL TAR DUE, APPLICATlOll OF ALL PAYIIENTS, THE CURRENT BALANCE, AND. IF APPLICABLE.
A PROJECTED INTEREST FIGURE,
DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT, 03-15-1999
PRINCIPAL TAX DUE" 402,31
PAYMENTS (TAX CREDITS),
PAYMENT
DATE
12-22-1998
05-14-1999
RECEIPT
NUMBER
AA324443
AA354832
DISCOUNT (+)
INTEREST/PEN PAID (-)
146.28-
8,82-
AMOUNT PAID
548.59
8.82
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST AND PEN.
TOTAL DUE
402,31
,00
.00
,00
. IF PAID AFTER THIS DATE. SEE REVERSE
SIDE FOR CALCULATION OF ADDITIONAL INTEREST,
I IF TOTAL DUE IS LESS TMAN U,
NO PAYMENT IS REQUIRED,
IF TOTAL DUE IS REFLECTED AS A "CREDIT" ICRI,
YDU HAY BE DUE A REFUND, SEE REVERSE SIDE OF THIS FORM FOR INSTR\lCTlOllS. I
PAMNTI
DetMlh U. top portion 0' thh Hotlc. MIl tut.1t .,lth your ptI)'Hnt .... p.yetll. to the ,... .xl eddr...
printed on the rev.r.. aide.
If AUIDEKT Il(CEDDfT .... check or ~y or"'r p.vlld. tOI REGISTER OF WILLS, AGENT.
If NON..Rtl.IDOtT Il(CEDEHT ... check or ~Y order p.vllbl. tal CottttONWEALTH OF PENNSYLVANIA.
RUUND (CA)I A r.fund of a talC credit, Wllch .,a. not reque.ted on the hlC R.turn, ..y be r.....ted by cOIIPI.tlna an
-Application for Ra'lI'td a' Penn'Ylv.nla l""'rltanc8 .xl E.tat. Tn:- lREV"UU). Applle.t1on. ar. ""U"'la at
the O'flca 0' the RIlI1st.r of "Uh, ."v of the lS R.venue DI.trlct Offlc.. or 'rOIl thl Dep.erbMlnt'. 24"haur
~..,.rlna ..rvlea nuaber. 'or far.. orderlngl In Penn.vlvanla 1"laa"S6Z"ZISa, out.lde Penn.vlv."la
..s ..athln loc.1 Hlirrlsburll ar.. (717) 717-IOM. TOOl (7171 77Z"Zl52 U..arlng I.alred onlyl.
REPLV TOI ...Uon. rqardlng .rror. contained on thl. notice Ihould bft eddr...'" tal PA Pepar....,t a' R.v...... lur...
of Indlvl~1 TalC", ATTNI po.t A....seant R,vlew unit, Pept. '10611, Hlirrllburll, PA 17121"0601, phone
(7171 717"6505.
DISCDLIIT I
PEHAL TV I
INTEREST I
If MY tax 0.. II paid within thr.. UI ulllndllr .x1th. .ft.r the decedent's ....th, a flv. pareent (5XI dhc~t
of the tax ptI1d I. allowed.
The 15% talC ~.tv non"partlolpatlon pen.lty I. coaputad on the tot.1 0' ~ t.lC and Int.r..t .......d, .xl not
paid before J.nuIry 11, 1996, the flrst d.y .ftar thl end of the t.x ..-.ty period.
Int.r..t I. ch.rged bftglnnlna with flr.t d.v of delinquency. or nine (91 eonth. ~ onI (11 day froe the dlt. of
death, to ~ dlt. of Plv-ant. Tlx., which bee... delinquent b.for. Janu.ry I, 19" bftlr Int.r..t .t the r.t. of
.1. CAXI plrcent par ~ calcul.ted at a dally rat. of .000164. All tIXI. which bee... delinquent on .xl .ft.r
J.nuary 1, 1912 ..111 bft.r Int.r..t at a r.t. which will vlry froe c.lender YI.r to c.lendar Yllr ..Ith that rat.
announced by the PA Dlplrtsent of R.v~. The ~llc"'l. Int.r..t rat.. for 19" through 1999 .r..
V..r Int.r.at R.t. DeilY Int.r..t FlOtor V.er Inter..t Rat. D.llv Int.r..t FlOtor
,... lOX .00054_ 19&1"1991 IlX .IOUOl
1915 lOX .00041. I... OX .101147
1914 IIX .010SOI 1995"I994 n .100192
,..S 15>. .0"S56 1995"199_ OX .001147
'916 lOX .IIIZ74 1999 n .000192
1..7 9X .100247
--Int.r..t I. celcul.tad .. follow'l
IIlTEIlEIIT . BALANCE OF TAll UNPAID X "UnDER OF DAYB DELI"QUEHT X DAILY IIlTEIIEIlT FACTOR
-..Any Notice Issued .ft.r the t.x bacOll. delinquent will rlfl.ct ~ Int.r..t c.lculatlon ta fifteen (151 dey.
bftyond the data of the .....lMOt. If pev.ent Is .... .ft.r the Int.r..t coaputaUon data shown on the
Notle.. addItional Int.r..t .u.t be c.lcul.ted.
"
JRD/June 30, 1992/17858
REGISTER OF WILLS
Cumberland County Courthouse
. 9ne Courthouse Square
Carlisle, PA 17013
NOTICE pURSUANT TO RULE 6.12
PENNSYLVANIA SUPREME COURT ORPHANS' COURT RULES
To: Personal Representative
Counsel: KENT H. PATTERSON, ESQ.,
REI E5\ate of C'r,lI.RII. M WlT,!mN I Deceased, Late of
MONROE TWP
E5\ale No.: 2l~95~59B
Date of Decedent's Death: NOVEMBER 13 , 1993
Pursuant to Rule 6,12, the above named personal representative or the above na,"ed auomey, If
applicable, within two (2) years of the decedent's death, and annually thereafter until administration 15
completed, Is required to file with the Register of Wills a Status Report as required by Rule 6,12. In
substantially the prescribed form, showing the date by which the personal representative, or auomey, as
applicable, reasonably believes administration w1\l be completed, The purpose of this Notice Is to advise
you that ualess the requisite Status Report Is filed with the Register of W1\Is or Clerk of tho Orphans'
Court, as appropriate, within ten (10) calendar days after the date of this Notice that the Register ofWUls
Is requited to ootlfy the Orphans' Court Division, Court of Common Pleas of such delinquency and to
request that said Court conduct a hearing to detennlne whether sanctions should be Imposed upon the
delinquent penoD81 representative and the delinquent personal representative'S counsel, If any.
Accordingly, If the requisite Status Report Is not filed by DEC. 20 . 19.,2?you are hereby
advised that a request wU\ be submlUed to the Court in accordlllCC with Rule 6,12,
Date: DECEMBER 4, 1995 '--l0./cuJ))'~ltu,j].1!t1L..d-lf
Deputy Register or. 1\Is
Distribution to Estate File
JRD/June 3D, 1992/17858
Or:r: :' liOr.f5 Ii'
InRe: Estateof C1araM Wilson
Late of MONROE TOWNSHIP
ORPHANS' COURT DIVISION,
COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY
PENNSYLVANIA
Estate No.: 21 - 95 - 598
No,
NOTICE OF FAILURE TO FlLE CERTlFlCATlON AND REQUEST TO
CONDUCT A HEARING PURSUANT TO RULE S.6(e), SUPREME COURT
ORPHANS' COURT RULE
Personal Representative: Carol Freel and
Counsel for Personal Representative: Kent H. Patterson Esq.
Date of Grant of Original Leners: AU9ust 10, 1995
Date of Delinquency Notice: December 5, 1 '195
The undersigned. Mary C, Lewis, Register of Wills, in accordance with Rule 5,6, Supreme Court
Orphans' Court Rules, hereby nOlifies the Orphans' Court Division, Court of Common Pleas of
Cumberland County, that neither the above named personal represelllative nor the above named counsel
for the personal representative have filed with the Register of Wills or Clerk of the Orphans' Court his,
her or Its certification required by Rule 5.6(d), Supreme Court Orphans' Court Rule and that the requisite
notice, pursuant to Rule 5,6(e), Supreme Court Orphans' Court Rules, was given by the Register of Wills
on December 5. , 1995, and that the ten (10) day notice to file the certlficallon has expired.
Accordingly, In accordance with Rule 5,6(e) the Court is hereby notified of such delioquency and the
undersigned requests tbat a Court conduct a hearing to determine whether sanctions should be Imposed
upon the delinquent personal representative or counsel for the delinquelll personal representative,
@
Date:
December 20,
1995
Distribution: Personal Representative
Counsel for Persooal Representalive
Estate File 0 .n/_
A HEARING IS SET FOR ~:J hJJ. 7 ./1Pt2-AT I/:(f() /1.111.
IN COURTROOM NO. 1. ~ "
IF THE CERTIFICATION OF NOTICE IS FILED PRIOR TO THE HEARING DATE. THE HEARING
WILL AUTOMATICALLY 8E CANCELLED. ~ ~
L ~,,1 F ~~<z
O-tZ -&-u...e9.. .;)- \ -L( 10 .fTrJ LD E. SHlELY, ..
!t....,..
" ,
STATUS REPORT UNDER RULE 6.12
Name of Decedent:
Clara M. wilson
Date of Death: November 13. 1993
Will No. Admin. No. 598 of 1995
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:
1. State whether administration of the estate is complete:
Yell No xx
2. If the answer is No,
representative reasonablY believes
complete: February 1997
3. If the answer to No.1 is Yes, state the following:
state when the personal
that the administration will be
a. Did the personal representative file a final
account with the Court? Yes No
b. The separate Orphans' Court No. (if any) for
the personal representative's account is:
c. Did the personal representative state an
account informally to the parties in interest? Yes 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.
~ t- /ff~
ll"ignat.ure
Date:
2/16/96
("\
c -
Kent H. Patterson
Name (Please type or print)
221 pine street
Harrisubrg, PA 17101
Address
--
\i .'
(';
",-1
~ ~_l
<..;,1
(7171 738-41 nn
Tel. No.
,,-
\......
"
lIt)
Capacity:
Personal Representative
)( Counsel for personal
representative
(MAH:rmf/AM3)
, .
JRD/June 30, 1992/17858
In Re: Estateof CLARA M. WILSON
Late of MONROE TWP
ORPHANS' COURT DIVISION,
COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY
I'ENNSYL VANIA
No. 95-598
Estate No,: 21-95-598
NOTICE OF FAILURE TO ALE STATIJS REPORT AND REQUEST TO
CONDUCT A HEARING PURSUANT TO RULE 6.12, SUPREME COURT
ORPHANS' COURT RULE
Personal Representative: CAROL. FREELAND
Counsel for Personal Representative:
KENT PATTERSON, ESQ.,
Date of Decedent's Death:
NOVEMBER 13. 1993
Date of Delinquency Notice: DECEMBER 4. 1995
The undersigned, Mary C, Lewis. Register of Wills, in accordance with Rule 6,12, Supreme
Court Orphans' Court Rules. hereby notifies the Orphans' COUrl Division. Court of Common Pleas of
Cumberland County, that neither the above named personal represenlative nor the above named counsel
for the personal representative have filed with the Register of Wills or Clerk of the Orphans' Court his.
her or its Status Report required by Rule 6,12, Supreme Court Orphans' Court Rule and that the requisite
notlCClbPursuantto Rule 6.12, Supreme Court Orphans' Court Rules, was given by the Register of Wills
on EC. , 19:':. and that the tell (10) day notice to file the Status Report has expired.
Accordingly. in accordallce with Rule 6,12 the Court is hereby notified of such delinquency and the
undersigned requests that a Court conduct a hearing to determine whether sanctions should be imposed
upon the delinquent personal representative or counsel for the delinquent personal representative,
Date: n"''''''MR'''R-2.B. 1995 "-/) (C/.;'t..l,.jC, 'iu~ fU"c&)11,~Lt( J ~u
Mary C,lewis, Register of Wills I
Distribution: Personal Representative
Counsel for Personal Representative
Estate File
A HEARING IS SCHEDULED FOR FE..IJ....t" ~1t3t-
IN COURTROOM NO. 1. I F THE STATUS -REP~ is' FILED
DATE. THE HEARING WILL AUTOMATICALLY BE CANCELLED.
AT II: (/~ A.",.
PRIOR TO THE HEARING
~u \.l!...LL.lul
:2.. :22-CILP ,
C/
Register of Wills, Cumberland County
STATUS REPORT UNDER RULE 6.12
Name of Decedentl Clara M. Wilson
Date of Deathl November 13, 1993
will No.
Admin. No. 598 of 1995
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 estatel
1. State whether administration of the estate is complete 1
Yes -1L No
2.
representative
complete 1
If the answer is
reasonably believes
No, state when the personal
that the administration will be
3. If the answer to No.1 is Yes, state the following 1
a. Did the personal representative file a final account
with tho Court? Yes No -1L
b. The separate Orphans' Court No. (if any) for the
personal representative's account iSI
c. Did the personal representative state an account
informally to the parties in interest? Yes No-X-
The heirs have been notified that the estate is insolvent
and that there will be no distribution.
d. Copies of receipts. releases, joinders and approvals
of formal or informal accounts may be filed with the Clerk 'of the
Orphans' Court and may be attached to this report.
Datel
,,~- 22.-1'7
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Signatur '
'-'j
c_
Carol J. Freeland
Name (Please type or print)
e,
N
1203 Indian Peq Road
, .
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(..J C.:
Mechanicsburq. PA 17055-9798
Address
(717) 245-2404
Tel. No.
Capacity I -X- Personal Representative
Counsel for Personal
representative