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HomeMy WebLinkAbout95-00629 /;:IIcII,' ol -....RO.LE_L...HARSHBARGER_.__ aln] klluw" us _._u__.~_.~__ I)ETITION I"OI~ I)IWIJATE Ilnd GI~ANT OF LETTERS No, _c2/-=-.'L5 - (p~1- To: Regislel of Wills for Ihe -. f),'('('u,,,,d, COIIIII)' of Cumberland In the Sodal S""/lrIIY No, -1.B.3~.=2.Q66 Commonweallh of Pennsylvania The pelillon of Ihe IInderslgned re'peelhllly repre'enls 111111: YOllr pelilioner(s). who is/lire IN )'ellrs of IIge nr older lInlhe e~ecIII.IiceB inlhe IIISI will uf Ihe lIbow dee,'denl. dilled -Har_ch 8 IInd eodlcll(s) dilled -----N/.A named , 19~ ('Hill' fl'll'HlII1 dh'IlI1l\lnl1~'\.'\. ,',t!. 'l'Il11lldilllnll. d"i1lh ur c\cL'ulnr, I:'le,) ()ecendcnl WIIS domldled 1I1 demh In -Cumbetland '_ CUIIIlIY, Pennsylvania, with h i R hIS! flllnll)' nr prlndp"1 resldencc 1I1 107 Herman Avenue 111\1 \11",'1, IIl1l11hcr ;lI1J IIIl1Jh:irmlil)') Dceendclll, Ihen ----2.4_ )'ellrs of lIge. died -Al.\gJ.Uit 13 . 19 95 , al-BJ.,ue-Ridge-Haven-West..r-Camp_ Hi " . EXeCI'I a, follows, decedelll did 'I(lImllrry. WllS nol ~ivurced lInd did nnl huve u child born or udopled afler execulion of Ihe 11'111 offered for probme; was nOllhe vicllm of 1I killing und was never adjudicated Ineompelenl: NIA Decendellllll deulh owned properl)' wilh eSlimllled vulues liS follows: (If domldled in I'll.) All personlll properl)' $ 97.000 (If nOI domiciled In I'll.) Personal properl)' in l'ellns)'lvanill $ (If nm dumidled in Pu.) Persunul properl)' In COIIIll)' $ Vllllle of reul cslllle in Pennsvlvuniu $ 70.000 sllllllled liS follows: 107 Herman Avenue, Lemoyne, PA 1111..'1'011. WHEREFORE. pelilioner(s) respeclfllll)' reqllesl(s) Ihe probale of Ihe lasl will and codlcil(s) presellled herewilh und Ihe grunl of lellers testamen tarv lIL'\lillllt'lllnr~'; Ul.hnini\1rnllllll 1.'.1.11.; ndrnlnhmulnn d,h.n.c.l.a.) <<~~~~ -Mg~v~own:~PA 17051 ----?4 S'~ /)~~? _7-9LKeckJ.Rr Rn"d ~::!lH~bunv.:~g l," ~~M-i?Ej-:&4-L-IICJL- . 8. 11'7"7' \l:_~..c:a", ," ~ ~.~:~_" 'U.f.-Ls~~~=~=== , " " c :37 G';: o:~ ~.g ;~ Eo: :: . ;! 0, :.n OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH 0... I'ENNSYLV ANIA } 1:18 COUNT\' 0... CUMBERLAND The pClilillnCrls) "hove-n"llled sweur(s) or "ffillnls) Ihlll Ihe SUlIemenlS inlhe foregoing pelillon arc III1C "1ll1 corrccl III Ihe hesl or Ihe ~nowledge and helicr of peliliuner(s) und Ihm as personal represen- 11II11'cls) or Ihe "hnve dccedcIlI pelilioner(s) will we~'nd Irnl)' "dll1\in" Ihe eslule according 10 law. Sworn 1,0 or affirlllcd and Sllhscrihed~',....;O ~~,,~_ ~ berore Ille Ihl, __--1.6.tlL___ day or '1~ ~~' ~UB,b):r 1\'Mi_ ~'n"..~--'!. S. l/./~_C., _ . _ -~_~72J" ' ~ 15-,51 _ &' MAR(f C. L W 5 H"):;.""r _ _ ~ .,...., , r--......'''''''''.~' \. I '-0 !..,. No. 21 - 95 - 629 Eslale of ROY E. HARSHBARGER , Deceased DECREE 0..' PROBATE AND GRANT 0)<' LETTERS AND NOW August 23. 19~, In conslderallon of the petition on the reverse side hereof, satisfactory proof having been presented before me, IT IS DECREED that the Inslrllmenl(s) daled Ma rch 8. 1995 described Ihereln be admitted 10 probale and filed of record as the IlIsl 11'11I of Rov E. Harshbarqer and Letters rrpa+:;::Im,:ln~:::."'y arc hereby granted 10 T."v"ll" II. p"r...""y "nil I1Rtt.y !;pRR"R FEES Probate, LeUers, Etc. ......... $ 235.00 Short Certlncales(lQ .......... $ 30.00 Renunciation ................ $ X-Pages $ 9.00 JCP TOTAL $ 5.00 Flied .... A~\1V.S.'( .?~.,.. m.5..... .~~~ :~.~ R'I"ler or Will. MARY C. LEWI~ ~ho.rle.:> E. Pe.trie. I !s~. 29029 ATTORNEY (Sup. CI. 1.0. No.) 3528 Brisban street H"rri Rhllrg. PII 17111 ADDRESS ('717) <;F;1_1Q"lQ PIiONE CI - \l) :5~ :) /q I'J D " n. .:? \0 - f:: ",,) ~ r..j '-'. ., U i',) ~E <ua: ~ ;:,j a: -::> uu 0 ~CE u I/) - '-::I _'!! N ,J~-__" *" -, ,'}p; - 0.. ,9, "" - '-'. i:- '-;:') \0 .,~, .... 1": '" ;\ !'B- " I;r ~-! '" ..., , ':~ l:ri~'l ' .4')'- . .., ~' 't':.E wcc ~::J a: uu , \ 6~9 - 56 - ~~ LAST WILL AND TESTAMENT I, ROY E. HARSHBARGER, of 107 Herman Avenue, Lemoyne, County of Cumberland, Pennsylvania, do hereby make, publish, and declare this to be my LAST WILL AND TESTAMENT, revoking any and all prior wills and codicils, in manner following, that is to say, FIRST, that I direct that my Personal Representative shall pay all of my just debts and funeral expenses as soon as this shall be practicable. SECOND, that upon my death I give and bequeath the following o cash gifts to the beneficiaries indicated: a. I give and bequeath the sum of Five Thousand Dollars ($5,000.00) to my nephew DALE SPADE, JR. b. I give and bequeath the sum of One Thousand Dollars ($1,000.00) to each of the following nieces and nephews: DEBBIE NEALMAN, DONALD MURRAY, BONNIE FRICK, and BEVERLY SPADE. THIRD, that I give and bequeath my lawn mower and my extension ladder to my neighbor RICHARD MAXWELL. FOURTH, that I give, devise, and bequeath all of the rest, residue, and remainder of my estate, real, personal, and mixed, to be divided equally among my brothers and sisters: VEr,DA STUCK, DESNA WAGAMAN, LEVADA PARCHEY, HAROLD E. HARSHBARGER, and JAY RAY HARSHBARGER, per stirpes; that is, if any of my brothers or sisters has predeceased me, then I direct that the share of said predeceased sibling shall pass instead to his or her surviving children, in equal shares, FIFTH, that I direct that all inheritance taxes and other assessments against my estate shall be paid as administrative expenses out of the residue of my estate. SIXTH, that I hereby appoint LEVANDA PARCHEY and BETTY SPEECE as the Co-Executrices of my Estate. Their fee for their services shall be the sum of Five Hundred Dollars ($500.00) each. I direct that my Personal Representative shall not be required to post bond in this or in any other jurisdiction. IN WITNESS WHEREOF, I have hereunto set my hand and seal this eighth day of March, 1995. Rfig;: ~Hfi~~~~ wJ~1r'<'~~~--.n- WI'f::~ E A-c' -, ACKNOWLEDGMENT COMMONWEALTH OF PENNSYLVANIA COUNTY OF DAUPHIN . I, ROY E, HARSHBARGER, testator, whose name is signed to the attached or foregoing instrument, having been duly qualified according to law, do hereby acknowledge that I have signed and executed the inst.rument as my Last Will and Testament; that I signed it willingly and that I signed it as my free and voluntary act for the purposes therein expressed. Sworn or affirmed to and acknowledged before me by ROY E. , HARSHBARGER, the testator, this eighth day of March, 1995. 9 ~ :tIA<-~P?- R . HAR ARGER ~~ fA a-h(j NO LIe NOT^RIA~ SE^~ KE~~Y R PETRIE, NolOry Public POAbnl) Boro. O:lupllln County M C()mmi5~2!!...E~.~'.nn, "1, 1007 AFFIDAVIT COMMONWEALTH OF PENNSYLVANIA COUNTY OF DAUPHIN WE, CHARLES E. PETRIE and JOHN R. BOSTWICK III, the witnesses whose names are signed to the attached or foregoing instrument, being duly qualified according to law, do depose and say that we were present and saw testator sign and execute the instrument as his LAST WILL AND TESTAMENT; that ROY E. HARSHBARGER signed willingly and that he executed it as his free and voluntary act for the purposes therein expressed; that each of us in the hearing and sight of the testator signed the will as witnesses; and that to the best of our knowledge the testator was at that time 18 or more years of age, of sound mind and under no constraint or undue influence. Sworn or affirmed to and subscribed before me by CHARLES E. PETRIE and JOHN R. BOSTWICK III, witnesses, this eighth day of March, 1995. zflfll...J(fl~'~"'--5 fJ~ +: t.It ~ /'Ld'E~ WITNESS \ ~a, NO AR BLIC Q~<,/ NOTAR1Al SEAL KEllY R PETRIE. Notary Public P:all.t.1ng eor". O:tuphin County M COmml!l~ICln EllCUt', .Jru" 27. 1007 ~ ,-,', .~ ~ . 'c>'i. '.l,~ :~,: .f,)' %::,~:~c:\ ;'-~~-~,'. ' \~~P ",1' tet, .J' }~~i'~; \~,,- t!iri~:;-' ...~ .~, j',._h' ~1~;; ~Tf."l" ~ ~;-~~" ,; " !1t1i:- ~;~ . - - ,< ;l;W,.;i;t ,;.~,. :~f7t.~~~:.r',.'. '~r.J.:F--'P " ~~!~:~~.:.-~',:-. I .... ;- o 'D~ ,~;?;.~-' ;.'1t'.' .- _ " J """' , U:-l-ij. .0 1/), N- Q. .. 1;!c lla:: ,g: n -^,-, ...~ u ".;.::: . .-~i. ,~.:. .~ .f" -::' ;~ .~ f-~ ;{"'" __.~lp ..,,-.... '~'-'.. -' -~" , ",:.:\ .: \ ~ - .,' ~ :f.,,- '.m.~~~o.."'.~ _ H -.I14l'l . 1.=- - 01, . f4' rd.. ~....."' Ii< .a tlll _1lQ -1.11I....-40 ; .I~il~ sa-.....- OlD"''' ~N"''''' ....Ill"''' ....l'll%:..... --,""iY,1 ,-~ , 'l~,): oJ. ~ ,~ . i)>~ :';'~ _.:,::r!t<.f . ':;~:-f .), .-: ~'.\ ,t> ";.;-', I IlQ ~ ','. t_..-,'- > "", -:' , . .... .. > .. .... I ~. ... 4'. ''O.~, .... -.. . -~ -- -- --- - - ---- - ~ --------- --- -. -------------- - -- ------ ,.............' " 1';'.' :.'AA1~082309>C~",M()NWEALTH OFflEN.NSY'LV..~N.IA:'" . tic:),. -', -:"" ""-_-',)" '_ ,-},;,-_ ': -DlPAIl'IMINT.OP IlIYINUI . l"'-"":\;':V""';"'/-,_C'cl",;,:.'':'i.c:.:.', ',';"-"><.;"-,' '.' '",_.. -'-,'.., ':'-c".. -, ...- ...... :".. .....,. " '.: '_, [~:~I;"~~li~';,g;';'. sV:,OPP/CIAL RICII".. PINNSYLVANIA INHERITANCE AND EST AT! TAX, ACN II! ASSESSMENT P:I RECEIVED FROM. II CONTROL 1;1 NUMBER -.... .. ..... .......:.,.;;..,"".....'.. "':"_::~'.:/~;- ':< .. ',' . -- , . .. ," ~.. . _ d:- AMOUNT PETRIE CHARLES E 3!SeS BRISBAN ST 101 .el!,I!83.I!!O HARRISBURG, PA 17111 -',aOHnr ESTATE INFORMATION, !:t FilE NUMBER U 21-19ge-06e9 r:t NAME OF DECEDENT flAST' ~ HARSHBARGER ROY E II DATE OF PAYMENT m POSTMARK DATE COUNTY 'OlOHU, SSN 183-12-e066 (FIRST) IMI) CUMBERLAND DAlE OF DEATH I I PB I ( ',1 /,.,P I RECEIVED BY "t:IJ.M l.. - ,;{t2o"-{A/ ;,71'-,--, I 51 . , REGISTER OF WILLS ~~Hr SVER L~~ 191 LL~i:/.j(-: /; ,I 't i . , I :-.=.-.....,------ -------. -,.....,......,.....,-,....., -:- -,-'- - ----- ----.- ---.------~ ... ' I , :.- SEAL BETTY 8PEECE & LEVADA PARCHEV C/O CHARLES E PETRIE ESQUIRE m TOTAL AMOUNT PAID .2e,eS3.eo REMARKS y"-- "',--- --:;.~ , ... -: , I . ~' " '" \- -, t I, . . , " r""""""'" r... - --.':.... - __.J_ I I -.- q~ ._ ~ _~. 4... /[; -6-' .-G INHERITANCE TAX RETURN RESIDENT DECEDENT (TO BE FILED IN DUPLICATE WITH REGISTER OF WILLS) I.'" UOQ tJ. l' 'UI t~ COMMOHW\A\lIt o. ,um,nVAWA DIPAII MUtI Of .,VIIHJI PHI 110<00 t _H.....IU~!I.,glM "_!I.~I ___ MilA .' ,H MI l IUI I 15 fil III .. ~ ..:5'" Illa:" =~!3 ..~.. .;," ...i!i .... ..z 8~ Fulur. Int.rl'l Compromhl (fo, dol.. 0' d.olh 0'''' 12.12.821 o 7, Olc.d.nl Malntaln,d allying Trult (Alloch copy 01 T ,u.') CONfil1ll TIA !l' J COM'L1 I MAIUH A 3528 Brisban street Harrisburg, PA 17111 IIAR"IIRARGlW / IlD_y-E iOOiriUulm HUM,it PA (0 0 A H II' ""IICAlIlIlu."YIHG IKNn-. ,.....II\..n..I." "HI) 11I1 rn t. O"g'nol R"u,n o 4, lIml"d E.,o" l3a 6. Olc.d,nt DI,d T..lol. (Alloch copy of Willi 'ALLICORRESJ!ONDENCErAN .. o 2, 040, fOI DAlI. O' DIATH A"II 12131191 CHICK HIli . A SPOU'AL 'OVUIY ClIDIT II CLAIMID 0 PILI HUMIU (_~( Jl ~- -0.A'7 COUNlY COOl YIAR NI!.MIJR . I . 107 Horman Avenue Lomoyne, PA 17043 c",' cumberland AMOUH' lIClIvlD tnl IHU.UCIIOH~1 Supplemental Rtlurn o 3. R.malnder R.lurn (fo, dol.. 01 d.olh p,'o, 1012.13,821 0$. Fed.rol hlal. Tolt Rtlurn Rlqulr.d '('''''-ofi, r:~_~:t:','''''',,':,j':'ir~1:~,!:;r~.'':.;;t , d.:eE~SUR I ..\v.;e.~ Und.r p.nalll.. 01 p.rlury, I d.clar. Ihot I have examln.d thlt ,,'urn, Indudlng accompanying Ich.dul.. and .tar.m.nll, and to Ih. b..t of my knowl.dg. ond b.ll.f, ill. ',ue, corrlCl and campl.lt. I dtdar. Ihat all rtal .lIale hen bun report.d at trut morbi valu.. O.daratlon of prepartr ath., Ihan Ihe ptnonal rep"..nlallvt It bated on 011 Information 0' which pr.pare, hot any knowltdge. 5IQNA'URE Of 'U50N If5r0 llll lOR 'lUNG IfTUIN AODlfU DAlf ~ ./ /'11,1' !ftt~ I. /'" 11/11/1/- CAlf 11/11/1"- Char es E. Petrie lfU'HONf NUM'U 561-1939 z .. S E ~ III .. 1. R.ol E.,o" (Sch.dul. AI 2, Slock. ond Bond. (Sch.dul. B) J, Clo.ely H.ld S'ock/Po,'n.nhlp Inl.IIII (Sch.dule C) 4. Mortgag.. and Not.. Rte.lvobl. (5chtdult 0) 5. Co.h, Bonk O.po.III & MIIt.llon.ou. P.nonal Properly (Sch.dul. E) 6, Jointly Own.d P,oporly (Sch.dul. fl 7. T,ond.n ISch.dule GI(Sch.dul. II 8. Total Gro.. A...II (lolallln" 1.7) 9. Funeral bp.n..., Admlnhllallv. CO'"' Mhetllontou. hp.n... (Sch.dul. HI 10. Oebll, Mortgag. Uobllllles, U.n. (Schtdule I) 11. T 0101 D.ductlon. (lololll... 9 & 101 12. N,I Valut of Ellatt (lint 8 mlnu. lIn. 11) 13. Charltabl, and Governmental a.quelll (5ch.dule J) 14. Nel Value Sub tel to Tax line 12 mlnu.lIne 13 15. Spaulal Tron.f." (for dOl" of dtolh after 6.30.94) S.. Inllruellon. for Appllcabl. Peretnlooe on Rev.ne Sid.. (Include volu" from Sch.dul. K or Schedule M,l 16. Amount of lIn. 14 loxabl. at 6% rat. (Indud. valu" from Schtdul. K or Sch.dul. M.) 17. Amount of lIn. 14 lallabl. at 15% ral. (Indud. valulI from Sch.dul. K or Sch.dul. M.) 18, Prlnclpoliax due (Add lox from lIn.. 15. 16 ond 17,1 19, Credil. Spou.al Pavert)' Credit Prior Poym.nll z .. !:i .. ~ :IE .. .. ~ .. _ 8. Tolal Number of Soft O.pollt Bou, 111 ( 2) (3) (41 IS) ( 61 (7) fil1_fiRl , RR 101.68R.23 18} 166.370.11 (9) (101 6.3Q7.22 3.599.54 9,996.76 156.373.30; (ll) (121 (13) 14) 156,373.35 (151 (16) (171156,373.35 K._- K .06 - K .15 - 23.456.00 (18) OIICaunl + 1,172.80_ Inltr..1 1.172.80 22.283.20 + 20. If lln. 191. 9,,01tr Ihon lIn. 18, .nter the dlner.nce an lIn. 20. Thlt 1.lh. OVERPAYMENT. m O...:m:II.llliI.............I...liI,."U-'lIlh....liIMm-="_.....,..............111"111 (19) 1201 21. If lint 1811 o"at.r Ihon L1n. 19, .nltr the diner.nce on lIn. 21. Thll It Ih. TAX DUE. A. Enter th.lnter"t on Ih. balance due on lIn. 21A. 8, En'" tho 10101 ollln. 21 ond 21A on lIn. 218, Thll I.,h. BALANCE DUE. Mak. Check Payabl. tOI R.alat., of Willa, Agent (21) (21A) (21BI AOOIlU .J 5"",'1' /J'rl~/'" JI.-J . /'x- A UI ll'ARU fH HA f I f c./~ "r 4~,-,- //{ rnu' '''''.Utllel II.'U n..UClnIU8 ^. S.'t'~III.1I1 S11I1clIIC1I1 !!:..!.tl! If lAu "'17.:1118" 18n,eW-gl I"'"'' "I" ,..U"....OI ~~~~ D............"II , 8~" . .. ..,..,......., ..1_........ .,'l.......w-t_..._. 1 (jJ c_ u..... 130""I:',r, C.NOTl. j\lm',.,1 II}" ).... U"'IIIII" ".".., '"IIt",,., '''11. AIII""",-I I. ...11, lA, ,."""',,., .,,,,, ",",, ...,I.i ."'.,.,.J. II." ,..i ...1I'i, lA, ''''''''1 lit., ,., .,,"'" A".,,, "it..".-...., /"II'"'' ~i ""'''''"/.11. ~~- _!Zi:~r U 00'.11 'UD.OA AMOUHl'DtmT !IILLERI 70 520.88 i.ll'r.l~I!W.Wi Sltf,31_:}~M~\:?.!ffiii~;JI1~~'Sm1 :f;tf'!!:'f,v,is)'b?" JOJ. ....dll'J!!'lq~lltlll tu~!!!'!..~. ~~~ (jUijjiJf,i1mrn~ioiiiIW~~~i"lsm"r1lmlll~;,!j.~ ~!!~ OJ (~'1~!!Iil ~~O'~!l!.rr"':ll...~~~~n~.{.ti,,~.t'imm::ll~~ .~~ ... ":::I\~~'.. iil"""''''''''''''''''~, ~-"'=''''''''oii'ir.'1'''' 1l1/~.IO'ii:l...- .." ~ 1101_""''-''",,", ..~.I.fd,if;,.n'.,"" 'OJ =,,,,,,,,!;ct= """"""""-""''''''''-' t.;;I""""""'~""_=''''''''~I' -" ~:if~i"\l""''''" .:r.r~~~.~..a::dDl~~".. ..:tnn =-r-;..ri.;;.ttH ,op, UNrAlD DY lftLLl.R. ADJUIT14NUfOR ITEM. UNMlD IY RURR, ,.110 "'" 'L . . 1I!!..9!ID2.!~,/&__.},~.,..~_ . ;ml.~.. m'o'iii"'r- '-""'~~~--,-m~h'IlG~~~~.F,r;f.l u.'l'3' ~-_..__........~~--~--- nl.U:.O!!l!!r'..!..'!l!--_M I. ..>I~fIl~~ll!=~~~J<\l-'~~~"I1ll!lllmt!~/1:iIii,'ff: JJ4. _ Ia Jl4 . 10 . !ffr.'h",."__u"t"""""""'."""..,,..........__ ~""-"",,, .."'jP...."..."..lIl""-"""'_"""""",,,r. !!lWn.....!'.,.~,. ~L;'~~-~~~"::;F.'ldm.'=ti:w~~~~.f~.'tt"..r.::.1;:,:;if.l !~J'~,__!~t'.. _3 ~aS5 ~}i~j}l;:...J....,,:iif:t.t.a""'~ ~W..5'f1a3a :l!;,., '0 ',~'_.' 'lIO, .... 101. lolfrF.r~~r.m :10.. AU'UIlMIHt. roll 3111. TUTAL rAID Ur'tUK . DOIUtOWIRI . 12.. TOTAL M1:UUCTIONI 70 OOO~OD INAMOUNlDUKRLLlftl 5 83'.DO JQI9~"'il'~I!!l!!l.ml!l.1lJll.. --:n..Q.9.h!~ !2t...Q"""'mi~'I.l1.IlV".(Il;i/~m ~Q !20.), Julh"t.lllr..ll:i(M'lfr""r.I'lif~tlliJlI1:ll~ .(l;>'WIl/.'~!lO.\lil ')lAl~';;;ll. "(,,"lMiliin"'; . ar.w"~~M f11iIl,jk'ffl:!iK6'1 lOJ. eM" @IX.H)I 0 rn) _alUlall'J:A, ~,OO'..' .oJ.CAsn r(!J""r 0 'If oM] DU..ERI U,'81.88 IIUD.l (,J.I') '^Oll I Hull IIUI...IItl-..;I l.IIIU I , ,.. IV\UI.UY...,I 1"1:J~' "1~'8 I'.~J,'U ,.,. .. Ill""" 11.,.,OJI"&o4 10,000.00. if,YOO.oU rAIII fROM .mU'U\UR'. .. 'MM~;' .,1L ....!f.'eiill...-.l M!I1OtH:WFlj.tl(~1i . m'r~_ j ~~~lJll.\l_~' ~, ~Htoil~ilk'iii 'l!fu,'liffi,1ll~;\~ cllWa'~irIf1.r".. ,.~ ....,...._=!!!t!!1l!@!~~4~;~~~i~~'L ~!i!l'\l;~.ffi WJ:>lwiiillttl "\I~jlP.~.I'!l\"-.J"'!P_. t.l.9P,.1:.U"c'll.t'I\~~y,.~nIUI,tiiJln!i.Jt~IIls__._",,,,,,,, .~~~ul~!!-'-"L rmlll=" \'-'" f,IUaffi~ ~Wl.~foCmIi.~~~"ii\'tl&;.t'tttl~....._..::t~'~\:f1 it! _~;"!.~:,'::~~-=~;!\~ . ..tJ. JU!mi :~iUiH~1l~t4m.~ ~~n ltln. l!!!!c.'.......... W~lnlll)~ ~~ ~1\l9mwJi1j._ I nihil ......... . :~~~~2SJ 5~1 ... ..'. ~rfi:~f.S=ftm~; _n*.. .t!~' ..:m~Qie:~~,j.:rIlIH"'.1~ "'" ~~IUtm ~J' ".- - - - ~!'__I' 5\~-:;;;:;~~~2...~~-_."'-- .... . ." . ._;e.J"""""",W"u"'''''''i!',,'''-i.';:-~ ;P;P---"-'iii.'~ IM'mlr;;lW"~.. '~,1J..""",,~~I!..'~~"t!t='~~l!l~o;;or.;;l:;-""""" '" A'~ 'I ~=i:iHfCiit~i.~",.~~~l1fo!(J .. . ll~.J~.'I!!l.~!i:l;' 'l r~ln1ilUtii1i. .. ,.~ ~,~ I!!UJd........"iM.. Illll:ll\Hllillflll:\l\'\lW,lIN,1, Jm.,mli\'gil.'lll~llI.lil1!m'iir."'immmiWmlV.Ill.lW~ ~\vtgmmf.1.~ .J.vm~~;.:::~~.'[~~~~I~~gt.:~r.gA!S:6~ ~~2;;;~oo un. "......,...1_'" ah t'll'" ..trJ.., x.quit'. roc .....,.--,...,.~", 1101-1105 I 1',I_i';;1 '. 11"""': ~._'lf~"'''" "... ~~;;,-...;;~ ;em!' ~~ l~it~~i~"'.,",' ~Q.: t.: ~:lll.., W '.lJ~' .l:~:\IIIlJ.iI: ~tla~~~J='" ~;I.; ";:1 =;1~!t~'11.'i ~ ~ K. t ~ " . . . EU5 miiii 5! -- ... Ol ~Uil~~~ 1.Jl't~"-';~'!..\........... ,g:J,~.0.J'=--"-'''''-Gf.:-C;:;-' _'IM"""""" ""'""""..... 01\ ~Yml'R'ilm~ n ltr.\I;'r\.v.,\Lb.i~.Yr~'iif"'~S11';r.f:!....l1'. _ ";,h1i;~ qu;ruUUii\"i'ii.ii..... niniri\'\...,.;,1:v:. ~1!jl..~vA~fJl.\'lI.I'II~".l,!l M~~,'4L~~U~'l~"l\'!.tq!l;~'}Jil'~~~~l-'-"-"'?'~ """~...,.,~~ 1=l1i".!71!i-~ .ulit.Q:-uljj\UiiWlHiii', J.J:u:dif.m'AoWUI:~~~s;f~~L'ii:__ ..t.-r..Hm n~._ ;t;P#.tl Tn ,hJ~.. 6u -~--'\OI,..-."""""......--.,,~at.- . . ."",,,,,.,...,,""= ='....."'= . ~lIl~."r.od'i;'r.."""';';o-ri'ftl!it~~;;~r!':tWi . f.a7K".-::-.1I1~', ml;h~!t':':1 \lfjll/./!'fI\ll\I.1j'Ill/li,'mi~'IlI_ .6!'ll1Ji."!jiJi:'Ml!:Kjjlilm,'itNl~)Jlli!llT~l4a'Jll'ifl1lt''l!i!li\j\ji_~L11ta':i.iojlj\ !'; .' jp3' .Ui . l1\iI'Ill~'''',ili';YJ UO'~Af.!!:'''~...''''''MIIll'" MI, ~oO.OO ..J~"III . 100.00 K1l1'oM~wm .'.' .~Wil-T.:lTldllm:4m-.'l!ilillll~~:.&1 msr5Wlfli~il ~ Illf:1lmrtto;a It". . p '~:'_'-:~'~;;'';~''-''-~ =n.... ... .. ._':\-.....wt.:..........~U'.:r. . I.J.I:I'.ofJ ....~~~., =r.--r..::::aj.;(rtCf .. ...... -. '. ..-;;:,~~...l-o..- ......~ ''::'\:"--;;:;==;=~ ........~t_ ll;:::~:': r lAJ\GES '''.11 'Ill IDI, ,Jml", ,..J.an. lr11. Stefl'" IQ ~'i:Jt..~=~w.r.."'trttf'~~I-:-II-"'''''''''''''''''''~''''' .00;. ......,.'~.."".,,_.................._~.......---_.......~.......- .,~ -::::... 0./01/15 ~ . Do.oI "'l)o. DoloI r .' .. rv 01/01/95 ..., 0'/01195 ..., - .,_....__...._.._,..?t;._..~Z.~ ~AtED.._lllc..-t A.::f.J", J - p.." -il.lLOt/91] ;' .) rAOe) IIVUotU.II"1 ,. SCHEDULE E CASH, BANK DEPOSITS AND MISCELLANEOUS PERSONAL PROPERTY co"'t3~'~I\~"~.~~'lr~~I\'tANIA .1I101NT DICIO,Nt 'E TA E Of Roy E. Harshbarger (AU pr.p.rty lolnll.,...n,d with th. Right of Swrvlvonhlp m"'_ b. dl.d...d on s.hodul. '1 ITEM NUMBER 1. 2. 3. 4. PIIO.I Prlnl or T pi DESCRIPTION Dauphin Deposit account number 41472762 Dauphin Deposit account number 94256691 carpenter's pension fund Auto insurance refund 5. Beverly Enterprise refund Professional Hospice - Medicine Refund Coin collection! a. silver Coins - $60.00 b. Kennedy half-dollars and centennial quarters - $30.00 c. canadian money - $3.00 d. Silver certificates - $7.00 e. Barr dollars - $60.00 f. Two-Dollar Bills - $8.00 g. Wheat pennies - $2.00 8 certificates of deposit 6. 7. 8. TOTAL Also entor on IIno 5. Roeo (Altam addltlanal BY,'" )( 11'" ,h..'slf mar. 'pac. Il n..d.d.) VALUE AT DATE OF DEATH $1970.77 18,745.16 2,000.00 203.00 956.56 642.74 170.00 $77,000.00 . .-----,-..---- ,_..... --~ ..t I'VIIII".I''', \),'l~'i. ~..~ COMMONWlAlfH 0' PlNNlnVANIA INHUI1ANCI fAX IlUUIlN IllllDlNf DlCIDlN' SCHEDULE H FUNERAL EXPENSES, ADMINISTRATIVE COSTS AND MISCELLANEOUS EXPENSES Ploa.o Prlnl 0' T 0 ROY E. HARSHBARGER ITEM NUMBER A. Funoral Expon.o), l. DESCRIPTION AMOUNT B, Admlnl.lratlvo Call.. 1. POrlonal Ropro.ontollve Commllllon. Social Socurlly Numbor of POrlonol Ropro.onlallyo: Voo, Com million. paid 2. Attornoy Foo. 3. Family Exompllon ClaImant None Rolallon.hlp Addle.. of ClaImant at docodonl'. doalh Slroot Addroll ClIy 51010 Zip Codo 4. Probato Foo. C. MI..ollanooul Expon.o.. 1. Mileage for Co-executrix 2. Postage 3. Copies 4. Telephone calls 5. 6. 7. 8. $1 ,000.00 $5,000-.00 279.00 80.00 10.00 2.52 25.70 I,. I ....-- TOTAL (AI.o onlor on lino 9, Rocapllulallon) IIf more .pa.o '" noodod, In.ort addltlona'"hool" of )amo .1.0.1 S 6397.22 ":"11I''''''''. COMMOHWIAIIH Of 'INN'''YAkIA INlIlIllANCI lA. .nURN II'IDIHIDICIDIN' SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES AND LIENS PI.a.. Print or T . BER E. Harshbar er ITEM NUMBER DESCRIPTION AMOUNT 1. Bell Atlantic $89.49 15.39 19.21 2442.00 8.65 1024.80 2. PAWC 3. PP&L 4. Kelly Services 5. Foot Care Center 6. Pharmacy Corp of America TOTAL (AI.o .nlor on IIn. 10. Rocopltulollon) (If more 'pae. js n"d.cl, inSl" additional .h"ts of 10m. siz..' $ 3,599.54 . ""':'~:,"'t'o~~%~{~r\~~~t~f~~~1;~~it.~,~:t$., SCHEDULE J BENEFICIARIES NAME AND ADDRESS OF BENEFICIARY Harold E. Harshbarger 506 Westmoreland Avenue Enola PA 17025 Velda M. Stuck PO Box 52 Granville PA 17029 Levada A. Parchey RD 2 Box 141-P McVey town PA 17051 Desna P. Wagaman 1298 Lowther Road Camp Hill PA 17011 Jay R. Harshbarger RD 2 Box 141-N McVey town PA 17051 Beverly Spade RD 1 Box 134 A Thompsontown PA 17094 Donald Murray RD 1 Box 134 C Thompsontown PA 17094 Dale Spade, Jr. RD 1 Box 134 A Thompsontown PA 17094 Bonnie Frick RD 1 Box 134 C Thompsontown PA 17094 Debra Nealman RD 1 Honey Grove PA 17035 Richard Maxwell l05 Herman Avenue Lemoyne, PA 17042 RELATIONSHIP AMOUNT OR SHARE OF ESTATE Brother 1/5 of net estate Sister 1/5 of net estate Sister 1/5 of net estate Sister 1/5 of net estate Brother 1/5 of net estate Niece $1,000.00 Nephew $1,000.00 Nephew $5,000.00 Niece $1,000.00 Niece $1,000 Neighbor Lawn mower, Ladder ,---. - -_." .. LAST WILL AND TESTAMENT I, ROY E. HARSHBARGER, of 107 Herman Avenue, Lemoyne, County of Cumberland, Pennsylvania, do hereby make, publish, and declare this to be my LAST WILL AND TESTAMENT, revoking any and all prior wills and codicils, in manner following, that is to say, FIRST, that I direct that my Personal Representative shall pay all of my just debts and funeral expenses as soon as this shall be practicable. SECOND, that upon my death I give and bequeath the following cash gifts to the beneficiaries indicated: a. I give and bequeath the sum of Five Thousand Dollars ($5,000.00) to my nephew DALE SPADE, JR. b. I give and bequeath the sum of One Thousand Dollars ($1,000.00) to each of the following nieces and nephews: DEBBIE NEALMAN, DONALD MURRAY, BONNIE FRICK, and BEVERLY SPADE. THIRD, that I give and bequeath my lawn mower and my extension ladder to my neighbor RICHARD MAXWELL. FOURTH, that I give, devise, and bequeath all of the rest, residue, and remainder of my estate, real, personal, and mixed, to be divided equally among my brothers and sisters: VELDA STUCK, DESNA WAGAMAN, LEVADA PARCHEY, HAROLD E. HARSHBARGER, and JAY RAY HARSHBARGER, per stirpes; that is, if any of my brothers or sisters has predeceased me, then I direct that the share of said predeceased sibling shall pass instead to his or her surviving children, in equal shares. . . \I: FIFTH, that I direct that all inheritance taxes and other assessments against my estate shall be paid as administrative expenses out of the residue of my estate. SIXTH, that I hereby appoint LEVANDA PARCHEY and BETTY SPEECE as the Co-Executrices of my Estate. Their fee for their services shall be the sum of Five Hundred Dollars ($500.00) each. I direct that my Personal Representative shall not be re~uired to post bond in this or in any other jurisdiction. IN WITNESS WHEREOF, I have hereunto set my hand and seal this eighth day of March, 1995. '~ e:~~- RO HARSHa R./> ~M'1'''-:Jl&~f!'r /"11 l~' { jt-d-v~ Z /;..:.-u... WITNESS \ . AFFIDAVIT COMMONWEALTH OF PENNSYLVANIA COUNTY OF DAUPHIN WE, CHARLES E, PETRIE and JOHN R. BOSTWICK III, the witnesses whose names are signed to the attached or foregoing instrument, being duly qualified according to law, do depose and say that we were present and saw testator sign and execute the instrument as his LAST WILL AND TESTAMENT; that ROY E. HARSHBARGER signed willingly and that he executed it as his free and voluntary act for the purposes therein expressed; that each of us in the hearing and sight of the testator signed the will as witnesses; and that to the best of our knowledge the testator was at that time 18 or more years of age, of sound mind and under no constraint or undue influence. Sworn or affirmed to and subscribed before me by CHARLES E. PETRIE and JOHN R. BOSTWICK III, witnesses, this eighth day of March, 1995. .md'-f..Jr;?....~--'-'> 8~-&:;.~ ;L:JOJS (i/ - - -:Jj'- /TL.M ",,- r /k.:.. WITNESS .-;7{a." /1. f)-/7i II NOf'Alt.?UBL (r! NOTARIAL SEAL KELLY R PETRIE. NOlDry Publio P4).bng Boro. Dauphin County M Cnmmls510n l!x irOIl ,Jnn. 27 1 Irr noo O. 1/9'1 I ~- r - I ' r:.) - ,oJ - t;.-. ,,~:I~'~\'l .....~W.ur (OMMOUW\A1111 Of rUWUlv,tW" 01'''. M~'" 01 _IVWUI _ ______!...."I~J!6, ~~0_l''Jh.~1001 .. .. M I'" .. ."" MI ~ ~~~ Ul" s INHERITANCE TAX RETURN RESIDENT DECEDENT (TO BE FILED IN DUPLICATE WITH REGISTER OF WILLS) .0. DATil D. OIATH Ani' 1~1~1I91 CHICK HI.. II A IPOUIAL PO.VI,.T_LC_~.!I.I!J~ CLAIMIO 0 rill HUM.I. (I ('" ( . 'I , ";11 ,-," :J, c()_~tm COO! Y!"'A.._ INIIAII tl ' NUMIU .. III 1. O,lglnol R.'urn o 2. Suppl.m.n'ol R,'urn o 3. Remolnd.r R.turn (lor dale. 01 dealh prior 10 12.13.B21 o 5. Fed.rol E,tot. TalC Return R.qulred M 1 1ft ~ '" _1I^RSllllARGE.R.~OYj: lOOiillCui", NUM'" OAII O. DIAIH 1_1'_'Ofi(, 111 I" ...'''I(....UI '''hl.I'rO 'IOU" 'N......I "...". 'I'" "'NO "llP~"'11 107 Horman Avonuo Lomoyno, pA 17043 c.,", Cumber land AMOUN' U(lIvIP tUIIN' IU(IIO"'1 o A. lImlt.d E,'ot. 0 Aa. Future Int.r..t Comproml.. (for datil of d.oth after 12.12.B2) Ga 6. D.c.d.n' DI.d T,,'ol' 0 7. DIC.d.nt Maintained a living Tru't (AlIa,h ,apy of Will) (AlIa,h ,apy 01 Tmll ~LL CORRUPONDINCI AND CONPIDINTlALTAX INPORMAnON 'sHOULD'BI'DIRICTID.TO.'Wirl,')'~ , COMPUn MAlliN AD f 3528 Brisban Street Harrisburg, PA 17111 Discount + + 1.172.80_ 20. If lIn. 191s grlo'.r than lIn. lB, .nflr thl differlncl on lInl 20. This Is thl OVERPAYMENT. iii 0 21. If lInl 18 Is grloter ,hon lInl 19, Intlr ,hi diff.rencI on lIn. 21. This Is the TAX DUE. A. Enrer theln'erest on Ihl baloncl due on lIn. 21A. B. En'er the to'ol of lIn. 21 and 21A on line 218. This Is the BALANCE DUE. Malee Check Payable tal Rlal,'er of Willi, Aglnt tillii tc", tcz fl~ Carles E. Petrie UU'HONf NUMIU 561-1939 z '" S E ~ bl tc 1. Real Ella.. (S,hedule A) 2, S'a,k. and Band. (S,hedule BI 3. Closely Held Slock/Portnenhlp Inl"e" (Schedule C) A. Mortgages and Notes Receivable (Schldule 01 5. Cosh, Bank Deposlls & Mllcelloneous Penanal Property (S,hedule E) 6, 10lnt1y Owned P,ap.rty (S,hedule F) 7. Tranrl... (S,hedule GI(S,hedule L) B. Total Gran Anllt (Io'ollln.. 1.7) 9. Funeral Expens.., Admlnlstrallvl Cosls, Miscellaneous Expens.. (Schedul. H) 10. Debit, Mortgage L1abllill.., liens (Schedul. I) 11. Total Oedudlan. ('ota1 L1n.. 9 & 10) 12. Net Value of Elfote (line 8 minus line 11) 13. Chorllobl. and Governmental Beques" (Sch.dule J) IA. Net Value Sub .et 'a Tax 11Ine 12 minus line 13) 15. Spousal Tronsf.n (for do'es of death after 6.30.94) S.e Inslrudlons for Appllcobll Percen'age on Riven. Side. (Include volu.. from Schedule K or Schedule M.) 16. Amoun' of line 1.4 taxable a' 6% rote (Include valu.. from Sch.dule K or Schedule M.) 17. Amoun' of lInl 141 roxoble at 15% rate (Includl volu.. from Sch.dule K or Schedule M.I lB. Principal ralC due (Add tax from lIn.. 15, 16 and 17.) 19. Credlls Spousal Poverty Credit Prior Poymenls _ 8. Tolol Number of Safe D.posl' Box.. . ;'~"1'~}4:t:",t(it;: '\!I.q~,~,!4(~ (1) (2 ) (3 ) (4 ) (5) (61 (71 fi4_F;Rl , RR ,,-^,:': "/I;J ,. BE SURI TO ANSWER ALL QUESTlONSONRIVERSUIDE AND TORICHECKMA11t_I'i' *', 'iI'~ .~ Under penoltl.. of perlury, I declare Ihot I hovl examined this return, Including accompanying schldul.. and state menU, and to the bell of my knowledg. and blllef, It It true, correet and comple'e. I declare thai 011 real ..tote has been reported at true mo;lcef value. Declaration of pr.parer olher Ihon Ihl penonal r.p,.senrotlvl It balld on olllnformOllon of which preporer has any knowl.dg.. . SIONATUI! 0' PUSON aura IIU ,oa 'llING anuaN ADoaus DAn IW/' "flt~ .;,. /t' 11//1/11- DAn J 5;..1.1' .!jI"..J /,/ f. /'X- IIPI/ll-- z '" >= ~ :I '" u g 101. 688.23 (B I 166.370.11 (91 (101 6.397.22 3.599.54 (II) (12) (13) (14) 9,996.76 15fi.371.35 156,373.35 (15) (16) (171156,373.35 K._- )( .06 II )( .15 iii 23.456.00 (IBI Inte"ll (Iwd!. 111.:11.: if you ale fcque\ting (I refund of yOUf overpoyment. (191 (201 1.172.80 22,283.20 (21) (21AI (21BI Act .48 of 1994 provld.. for Ih. r.ductlon of the 1011 ral..lmpa..d on Ih. n.1 valu. of Iran".,. 10 or far Ih. u.. of Ih. .pou.., Th. ral.. a. pr.lCrlb.d by Ih. .Ialul. will b.1 . 3% (.03) will b. oppllcabl. for ..101.. of d.c.d.nl. dying an or aft.r 7/1/94 and b.for. 1/1/96 . 2% (.02) will b. appllcabl. for ..101.. of d.c.d.nl. dying on or aft.r 1/1/96 and b.far. 1/1/97 . 1% (.01) will b. appllcabl. for ..101.. of d.c.d.nll dying on or aft.r 1/1/97 and b.for. 1/1/98 . Spou.allran".,. occurring on or aft.r 1/1/98 will b. .1I.mpt from Inh.rllanc. 1011. PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING A CHECK MARK (...) IN THE APPROPRIATE BLOCKS. YES NO 1. Old decedent make a Iransfer and: a. retain Ihe use or Income of Ihe properly transferred, ....................................................... b. retain the right to designate who shall use the properly transferred or Its income, ............... c, retain a reversionary tnterest; or ................................................................................... d. receive the promise for life of either payments, beneFits or care' ....................................... 2. If death occurred on or before December 12, 1982, did decedent within two years preceding death transfer properly without receiving adequate consideration' If death occurred after December 12, 1982, did decedent transfer properly within one year of death without receiving adequate consideration' to 10...... ....,........ .......... to............ .............. .............. ............ ...... to.. It 3. Old decedent own on 'In trust for' bank account ot his or her death'...................................... IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST C;:PMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. r" .- j;-,. u: P\ :.:\ '~ ::l 00 ,.,~__~~.~.it>?,::1~",p"':~'1"1~1,~::~5jr-t';~':;2\. ,"'..:'_~; ,. '" ;.-- . \ j'..;;:;...........;.._....-."-;:.~ . '1Iy.1I0) U. I\JIII * COMM~NWM~H D. tl~~'l\l"NI' I 1\MN~'o'tcloM "'ATia; -----.--,-.= =,",=~==-~=~-~'-'="==""'-"='=""'- =cc," ""--,.,,,,,-- ='ir'NliMiiIR~~'=="='~'~"'~==="'"'" Roy E. Harshbarger ,P,oporty lolntly.ownod with Righi 0' Survlvonhlp mu.t bo dllclolld on Schodulo PI All ,,01111010 .hould bo "po,'od 01 '01. mo.hl uoluo which I. dohnod o.lho prlco 01 which proporty would bo o.changod bolwoon a willing buy.. and a willing .011.., nolth.. bolng campollod 10 bu a. .011, bolh haying "a.onablo ~nawlod.o 0' tho "Ioyant 'acl.. ITEM NUMBER SCHEDULE A REAL ESTATE r I I DESCRIPTION VALUE AT DATE OF DEATH $64,681.88 1. Real estate known and numbered as 107 Herman Avenue lemoyne, PA 17043 See attached settlement sheet TOTAL Also enter on IIn. 1, R.ca Itulotlon (II mare spac. ;1 n..d.d, insert additional Ihe"1 o( sam. lize.) S 64,681.88 "ltt.1I1 IIl1nllfUe' t nllU IwaUClllltlM ^, seT"mlll' Slnlemelll .".,.,aJI&"" I".U.,,"-"I 1041;'1 111M ",""'''' ~,r.:.l."':::-'" OWtJ'~~!"f I B.... . .A .,"""..... -\TI:;c;;----\-t..;;;;l;:;r;;;,;.;;;---- I. (iJ c_.v... 1.10u~(:r,', thl. ~l.l' ~"""'" ,.~.., t.... """'If'" II .ft..1 ""1,..,,,, ,,"t AIII'II11U J'fIIII.....i " 11I1 ""1"",,.1 ,,''''I ." 111...". ,.,,,., "",A,I .",.,.,.,' ",., ,"I...UI,l, Ill, """'" tII" '" ,t.,,,.. "n/",,,,,,,,,._.-I,,,...,,.,,u...1 ",".,''', 1.."'J,li/'."'" c.ttUTlI c::..~~ffi?J RIlOlYlRI 13 001." 4JO.ORO AMOutfTDUlT !IILLERI 70 '20.88 ~L.. l~"'_'-'I.'l., lql.,.....!/!...Il_I....~~ ll;l.\<"!ilII~~l;'ll1 ~1:t<f,Qloin~~ Im11l'i\'iiIIlllli"'H'~I~..'iIlill1l', ,,~lIIl}:olA';~W~r ilt~ii11Vn'10'r. ,l\!!.'l!'. ,.._ . ,5~:..R.dtlt".lll~'l(.)"''.!~~tt~I!!!J!l..__. 1'-_ iaW~~ ~ (jlllmf,j(i.'\1illt'AM\ii'i;"''''ljQlftie#I~If!~~ .,\iiliilWAiiWIAiI 50~"'yrrDt"'II!"1J!~lt}!U.t~ ~~~;/,d ~1'l1"~"$j$i .Oilrl~iiW.~I.raO!.~~..,jl,~~lffi11:g[~ i/$.tjj!fi~~~~"'1 101 SOJ. . r'l""-~:'."'''''' "''''.' =.""'''-......= ="""",_"",e-..' I...""""""-"""""_=""-...."W""""""""""'~, """:i:l!",~l(-'; lAI r_tm:m~w: ~j~~~.H ~~tl'1'..:et.. ~oa:t::',1;::'~~j(~~~l.~=ro"~..\r.i:i ~.,,~.,t lot. '09, ADIUI1MVr1. FOn utfrAtD DV 'ULl.1l1 ADJUITM'EHIS rOR 1n:M' U~'.uD BY nu.KK, l1Q!.t:I!,1I . II- _. . . '1~2!'~t'" ,'t .- gtm.l!i... f>>J..-.,"'.., ~1.i/ii =-,..;.iiiaJ.7i.ilMi:! WI~IoltlIiii$'""",,~~~ ~€"jlf.I ~J".'.I\~~~_~<t ~"'~!m"'. t. rmm.~~~l';~ I. . ~~~~.WWit'?; 214. ta . "14, . 10 Illl'l"YJ.~~.,.=!f!!'!~am~i'lI~.ffill?~~~'i\'.a:;Fli~j)fIi-.!I!!!fif~ i.w....-~""-'--- .,.'.--- -'~m___~ ,.J!!w,. ""'''''''..-''''=''''.~~''''' .=~..... .:i1"'!i~~~!':ltC:;tIIL-~-:--: .. r ~l.t.a........-...\ ~ttn=ae:: 1;'rJn1.n':~~:JNmU~tAf.:n:t~!G'i:J~ q,."""":i'nw~..;:;gOij 2'. "11. ..~. ~.. ~!.... .'U, .~:'.'f~~~t=- . 'M"':a nfl. TOT^L rAIU UY/WM 12', TOTAL Itl:IJUCTlONI . JORROWIRI 10 OOO~oo IHAMOUl'lTDU.Rt.LMI 5 831.00 mr.?1"~li!.o!~I.lI!1!<.A-=.CJiJ1J1Jl!' ........1,~f,W,I!!'. ,t2!tll~~?~..-"'-o!!!!Js.ltV~. .19 m... lul"llIfr.:.........llIT~~1iOill~ ,V;lr,<JlJ: i _ _~l.,ui! ,ll ....i.liiii'io1:r~ra."rn1rimimf~/i.\ ii!iilJ~~~1 1Il. cAIn rrn,.oUlI 0 J\1) .UMOWU, ~,OO!il.8' .U.c.un ,I!1TOJf O,IloU) RU.n, 64,GB!.8I 11\10,10,". rAO! 1 '1-' 'auu... I....,"..~I 1<41.." "I" ",PJd~1 , , '0,111111,00. rAm "I.II~I .uu(mu'. .. .,.110,00 .._-- ---------------- ~.' .,'. :iii/ .,n:;. . ~l\t1 .~ 45,00 -,QI.l6~ 1400 10 BErn ...................:'::1\01 ;.t11M--:."U::-'::'.. '.Anoa,_'].U'''~ - - "'il: o=r., ~. ="r.!!EE...--.,;;,.-.,--. ... .n ~h,T .--t'~~~~w~~~~,,,.,.~E7. ~ :.a!=;'.i.'J,r~ .. . .. . " " i.\'!Ll\l1!lr~' ;;;r.;;;;i'!F.'J!!! ...._11 au ,,. M .", JrJI, S"",,, ''*III.IIt. m .f"tf"'1Q ...'".....'E?............lwW....._...__.............--~ .....ur...J....._II"""tI..ln.o.l~._ c:n-" --..............oW\ot'-- ............_____......."""..~ ~L .... 0'/01/15 ..- rl-/ A.J?" c V ./)}/J, _ --.!!./OI/" r . oJ fi&f'>:."'rfi".(J{ff.'rriJ'TE .~__ 0"011" - , ..... --~ Dwr 'I n..IftM,'..........a-........... ....-- ..1_...--......-...._I....~_..~Z~~ ATED. ]Il~; A;..J" I'. . & ---llLJlI/.. ./ ) , MOIl Iol__A_.' .All _lilt t < ;f < 1 .. " , .- , r- -, if~ :? . IIVUOIU'UIPI 5CHIDULlE CASH, lANK DIPOSITS AND MISCILLANIOUS PIRSONAL PROPIRTY * c""'t.?~tA\"~'mvlU'HI' Plio,. Print or T . Roy E. Harshbargor IAN -'V 1ol.llyoow..4 ..1110 lho .'Ihl 01 ,"",I....hl, ",.,1 ... 41......4 .. l.h.4... '1 N~~R DISCRIPTION VAWI AT DATI 0' DIATH 1. Dauphin Deposit account number 41472762 2. Dauphin Deposit account number 94256691 3. Carpenter's pension fund 4. Auto insurance refund $1970.77 18,745.16 2,000.00 5. Beverly Enterprise refund 6. Professional Hospice - Medicine Refund 203.00 956.56 642.74 170.00 7. Coin collection I a. Silver Coins - $60.00 b. Kennedy half-dollars and centennial quarters - $30.00 c. Canadian money - $3.00 d. Silver certificates - $7.00 e. Barr dollars - $60.00 f. Two-Dollar Bills - $8.00 g. Wheat pennies - $2.00 8 certificates of deposit $77,000.00 8. (Attach additional 8~" )C 11" .h.... If more 'pac. I. n..d.d.) ROY E. IIARSHBARGER ITIM NUMIIIR A. 'un.ral '.p.n.... 1. B. Admlnllt.atlv. CO.tll 1. ""nonal Rep",sentatiYII Comml..lans Social Security Number 01 ""nanal Repres.nlallve, Vear Camml..lans paid 2. A"arney Fees 3. family e"..mption Claimant None RelationshIp Add",.. 01 ClaImant at docedent's death St",..t Add",.. Clty Slale Zip Code 4. Probate Fe..s C. Mls..llanlaul Exp.n.... 1. Mileage for Co-executrix 2. Postage 3. Copies 4. Telephone calls S. 6. 7. 8. ._'YIII1I1.I'''1 -!'iJ. COMMONWIALtH O' PlNNnWANIA IHHunANCI 'AX .,'UIN ."lorN' DlelO HI SCHEDULE H 'UNERAL EXPENSES, ADMINISTRATIVE COSTS AND MISCELLANEOUS EXPENSES PI. a.. Print 0' T . DESCRIPTION AMOUNT $1,000.00 $5,000'.00 279.00 80.00 lO.OO 2.52 25.70 TOTAL (Also enler on IIno 9. Recapllulotion) (If more .pac. I. n..d.d, In..rt addlllonal .h..'. 01 sam. .1...) $ 6397.22 . ~.~. . . '''''"'''1'''' '* (()lIlMOHWUIHt Of 'IHH'''''IU~'' IH'IUUA...c. 'A. '"U'H 'UIOIHIDIClOIH. SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES AND LIENS PI. a.. Print ar T . Roy E. Harehbarger ITIM NUMIIR DISCRIPTION AMOUNT 1. Bell Atlantic 2. PAWC 3. PP&L 4. Kelly Services 5. Foot Care Center 6. Pharmacy Corp of America $89.49 15.39 19.21 2442.00 8.65 1024.80 TOTAL {Also enl., on line 10, Recopllulotlonl (II more .pace is n..d.el, ins.rt oele/ilional sh..ts ollome size.) $ 3,599.54 ..." Ulltlt 11"1 ~~ (O",,"ONwUl'M Of ,hm'tlVANIA I""II"'"U tAllnUI" '''I"HI DU:I~~H! SCHEDULE J BENEFICIARIES Roy E. ITIM NUMBIR lIarehbarger NAMI AND ADDRISS O' IIINI.ICIARY RILATlONSHIP AMOUNT OR SHARI O' ISTATI IITATI o' .ILI NUMBIR A. Ta...abl. 8.qulllu 1. See attached ITEM NUMBER NAME AND ADDRESS OF BENEFICIARY AMOUNT OR SHARE OF ESTATE B. Charitable and Gavernmenlal Bequests! 1. TOTAL CHARITABLE AND GOVERNMENTAL BEQUESTS IAI.o enter on line 13. Recopllulollon)' S (If more .pace 11 n..d.d, Ins.rt additional ,h..ts of .am. ,In) .. . SCHEDULE J BENEFICIARIES NAME AND ADDRESS OF BENEFICIARY RELAT!ONSHI~ AMOUNT OR SHARE OF ESTATE 1/5 of net estate Harold E. Harshbarger 506 Westmoreland Avenue Enola PA 17025 Brother Velda M. Stuck PO Box 52 Granville PA 17029 sister 1/5 of net estate 1/5 of net estate 1/5 of net estate 1/5 of net estate $1,000.00 Levada A. Parchey RD 2 Box 141-P McVey town PA 17051 Sister Desna P. Wagaman 1298 Lowther Road Camp Hill PA 17011 Jay R. Harshbarger RD 2 Box 141-N McVey town PA 17051 Beverly Spade RD 1 Box 134 A Thompsontown PA 17094 Sister Brother Niece Donald Murray RD 1 Box 134 C Thompsontown PA 17094 Dale Spade, Jr. RD 1 Box 134 A Thompsontown PA 17094 Bonnie Frick RD 1 Box 134 C Thompsontown PA 17094 Debra Nealman RD 1 Honey Grove PA 17035 Richard Maxwell 105 Herman Avenue Lemoyne, PA 17042 Nephew $1,000.00 Nephew $5,000.00 Niece $1,000.00 Niece $1,000 Neighbor Lawn mower, Ladder I \. " LAST WILL AND TESTAMENT I, ROY E, IIARSHBARGER, of 107 Herman Avenue, Lemoyne, County of CUmberland, Pennsylvania, do hereby make, publish, and declare this to be my LAST WILL AND TESTAMENT, revoking any and all prior wills and codicils, in manner following, that is to say, FIRST, that I direct that my Personal Representative shall pay all of my just debts and funeral eXpenses as soon as this shall be practicable. SECOND, that upon my death I give and bequeath the following cash gifts to the beneficiaries indicated: a. I give and bequeath the sum of Five Thousand Dollars ($5,000.00) to my nephew DALE SPADE, JR. b. I give and bequeath the sum of One Thousand Dollars ($1,000.00) to each of the following nieces and nephews: DEBBIE NEALMAN, DONALD MURRAY, BONNIE FRICK, and BEVERLY SPADE. THIRD, that I give and bequeath my lawn mower and my extension ladder to my neighbor RICHARD MAXWELL. FOURTH, that I give, devise, and bequeath all of the rest, residue, and remainder of my estate, real, personal, and mixed, to be divided equally among my brothers and sisters: VELDA STUCK, DESNA WAGAMAN, LEVADA PARCHEY, HAROLD E. HARSHBARGER, and JAY RAY HARSHBARGER, per stirpes; that is, if any of my brothers or sisters has predeceased me, then I direct that the share of said predecp.ased sibling shall pass instead to his or her surviving children, in equal shares. FIFTH, that I direct that all inheritance taxes and other assessments against my estate shall be paid as administrative expenses out of the residue of my estate. SIXTH, that I hereby appoint LEVANDA PARCHEY and BETTY SPEECE as the Co-Executrices of my Estate. Their fee for their services shall be the sum of Five Hundred Dollars ($500.00) each. I direct that my Personal Representative shall not be required to post bond in this or in any other jurisdiction. IN WITNESS WHEREOF, I have hereunto set my hand and seal this eighth day of March, 1995. i ;"fy~..e/&"A~ W#~1~rL~~j!-m- /?kJ:.' Z~. WITNESS , ,- . AFFIDAVIT COMMONWEALTH OF PENNSYLVANIA COUNTY OF DAUPHIN WE, CHARLES E. PETRIE and JOHN R. BOSTWICK III, the witnesses whose names are signed to the attached or foregoing instrument, being duly qualified according to law, do depose and say that we were present and saw testator sign and execute the instrument as his LAST WILL AND TESTAMENT; that ROY E. HARSHBARGER signed willingly and that he executed it as his free and voluntary act for the purposes therein expressed; that each of us in the hearing and sight of the testator signed the will as witnesses; and that to the best of our knowledge the testator was at that time 18 or more years of age, of sound mind and under no constraint or undue influence. Sworn or affirmed to and subscribed before me by CHARLES E. PETRIE and JOHN R. BOSTWICK III, witnesses, this eighth day of March, 1995. #J1d~-~~~ /".t.M ~ r /~ WITNESS ~@/ (d. rlr!if/) N AR UB IC NOTARIAL SEAL KELLY R PETRIE, Notary Publlo PaJlIJng Ooro. DilUl:hln Counry M C(}mmtS'l!~n c'(oiro. .Jnn. 27 1 . , CERTIFICATION OF NOTICE UNDER RULE 5,6(a) Name of Decedent: Roy E. Harshbarger Date of Death: auguR" , ~. , QQIi. Will No. 1 qgS_00629 Admin. No. To the Registera I certify that notice of beneficial interest required by Rule 5.6(a) of the Orphans' Court ~ules was served on or mailed to the following beneficiaries of the above-captioned estate on SRpt.Rmh..r 11. 1 q9S : ~ Address See attached list Notice has now been given to all persons entitled thereto under Rule 5.6(a) except None If'; r"L..-L.. E.~ Signature Date: September 11, 1995 Name Charles E. Petrie I' Address 3528 Brisban street Harrisburg, PA 17111 , ;~ cIl<- . .-'\ , ~) uO Telephone(711 561-1939 Capacity: Personal Representative Counsel for personal representative x . ,~ .~ t'l . Benetioiaries ot the Estate ot Roy E. Harshbarger HAROLD E. HARSHBARGER 506 WESTMORELAND AVENUE ENOLA, PA 17025 VELDA M. STUCK PO BOX 52 GRANVILLE, PA 17029 LEVADA A. PARCHEY RD 2 BOX 141-P McVEYTOWN PA 17051 BEVERLY SPADE RD 1 BOX 134 A THOMPSONTOWN, PA 17094 DONALD MURRAY RD 1 BOX 134 C THOMPSONTOWN, PA 17094 DALE SPADE, _ JR. RD 1 BOX 134 A THOMPSONTOWN, PA 17094 RICHARD MAXWELL 105 HERMAN AVENUE LEMOYNE, PA 17043 DESNA P. WAGAMAN 1298 LOWTHER ROAD CAMP HILL, PA 17011 JAYR. HARSHBARGER RD 2 BOX 141-N McVEY TOWN PA 17051 BONNIE FRICK RD 1 BOX 134 C THOMPSONTOWN, PA 17094 DEBRA NEALMAN RD 1 HONEY GROVE, PA 17035 . J /.1) - 5/' 0 RIlV-1547 EX AFP 112-95* CCWtOHWUIIII or flfNNUl VANIA DIP"'","' or RlYfHUI IURUU or INDIVIDUAl lun o(PI. 1ID61l tlARltIIlURO, Pi "1r'"OUI ACN 101 NOTICE Of INHERITANCE TAR APPRAISENENT. ALLOWANCE OR DISALLOWANCE Of DEDUCTIONS AND ASSESSNENT Of TAM DAT! 03-11-96 FILE NO. DATI OF DEATH 08-13-95 COUNTY CUMBERLAND NOlE I TO INSUNE PROPER CREDIT TO YOUN ACCOUHT, SUBNIT THE UPPER PORTION Of TIllS fONN WITH YOUR lAR PAYNENT TO THE NEOISlER Of WILLS. HAkE CHECk PAYABLE TO "REOISTER Of WillS, AOENT" REMIT PAYMENT TOI CHARLES E PETRIE 3528 BRISBAN ST HBG PA 17111 REGISTER DF WILLS CUMBERLAND CD COURT HOUSE CARLISLE, PA 17013 A.aunt R..ltt.d CUT ALONG THIS LINE ... RETAIN LOWER PORTION FOR YOUR RECORDS ~ R"ili: iS4T EX"AFi.--m-:9sY"NoTicE--Iij:niiiHEifii'iiN'ci-Tjiin-PPR'Ii iSEHENT-;-Ai.i:liwANCi-cfR'-----m-m----- DISALLOWANCE OF DEDUCTIONS AND ASSESSHENT OF TAX ESTATE OF HARSHBARGER RDY E FUE NO. 21 95-0629 ACN 101 DATE 03-11-96 TAM RETURN WAS I I X I ACCEPTED AS rILED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ONI ORIGINAL RETURN 1. R..I Eabi. (Schedul. A) (l) 2. Stock. land Bondi (Schedule 81 (2) S. Clo..ly Hald Stock/P.~tn.r.hlp Inta,...t (Schedule C) (5) 4. "orlaag.a/Not.. Receivable (Schedul. 0) (4) S. C..h/Bank Deposih/Hilc. Parlon.l Property (Schedul. E) IS) 6. Jointly Owned Property (Schedule F) (6) 7. Transfara (Schedule 0) (7) 8. Tot.l A...t. APPROVED DEDUCTIONS AND EXEHPTIONSI 9. Funeral Exp.n.a./Ad.. Coat./Hl.c. Expana.. (Schadul. H) (9) 10. D.bt./Hortg.g. Llabl11tl../Ll.n. ISch.du1. I) (10) 11. Tob1 D.ductlon. 12. H.t V.lu. of T.x R.turn 13. Charlt.b1./Covarn.ant.1 8equa.t. ISchadu1. JJ 14. H.t Va1u. of E.t.ta Subjaot to Tax I CHANGED 64 .681.88 .00 .00 .00 101.688.23 .00 .00 eSI 166.370.11 6,397.22 3.599.54 1111 1121 (13) (141 q.qq~ 7~ 156.373.35 .00 156.373.35 NOTE I l4, 15 and,or 16, 17 and 18 will returns assessed to date. If an assessment was issued previoUSly, lines reflect figures thet include the totel of ALL ASSESSHENT OF TAXI 15. A.aunt of llna 14 at Spau..l rat. ClS) 16. A.aunt of Lina 14 taxabl. .t Lln..l/Cl... A rata (16) 17. A.aunt of Lina 14 taxabl. at Co11.taral/Cla.. 8 r.t. 117) 18. Principal Tax Dua TAX CREDITS I PAYHENT DATE 11-13-95 RECEIPT HUHBER AA082309 DISCOUNT e'l INTEREST e-I 1,172.80 .OOR'OO. .00 K.06. 156.373.35 R.15. (181 .00 .00 23,456.00 23,456.00 AHOUNT PAID 22,283.20 TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST TOTAL DUE 23,456.00 .00 .00 .00 . IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. IF TDTAL DUE IS LESS THAN .1. NO PAYNENT IS REQUIRED. If TOTAL DUE IS REFLECTED AS A "CREDIT" ICRI. YDU HAY SE DUE A REFUND. SEE REVERSE SIDE OF THIS FORK fOR INSTRUCTIOHS.I :i () RESERVATIDHI E.t,t.. of decedent. dying on Dr b.for. D.c.ab.r 12, 1'12 -- If ~v 'utur. Int.r..t In the ..t.t. I. tr~"'rr.d In po.....lon or .nJoy-.nt to CI... . (coll.t.r.l) ban.flel.rl.. 0' thl dlcld.nt .ft.r the ..plr.tlon of ~v ..t.t. for llf. or for vaar., tha Co..onwaalth harabv a.pra..lv ra..rv.. the right to .ppr.I.. and ...... tran,'.r I~rlt~. T.... at thl l.wful CI... I Ccoll.t.ral) rat. on anv .uch future Int.r..t. PIJRPOS( OF NOTICE I To fulfill the r.qulraaant. of Section 2140 of the Inh.rltanc. and E.tat. Ta. Act, Act 22 of 19'1. 12 P.S. S.ctlon 2140. PAY~NTI D.tach the top portion of thl. Notlc. and .ubalt with vour p.y.ant to the R.al.t.r of Will. prlnt.d on the r.v.r.a .Id.. ..".... ch.ck or aoney ordar plvabl. tal REGISTER OF MILLS, AGENT All p.yeanta racalv.d .hall flr.t b. appllld to any Int.r..t Which ..v b. due with any r..alnd.r .ppll.d to the t... REFUND (CR)I A r.fund 0' at.. cr'dlt, which w.. not requa.t.d on the T.. R.turn, ..y b. r.qu..t.d bV co~l.tlna an "Appllc.tlon for R.fund of Penn.ylvanl. Inh.rltane. and E.tet. T.." CREV-ISlS). Appllc.tlon. er. avall.bl. .t the D'flc. of the R.al.t.r of Will., any 0' the 25 R.v.nu. DI.trlct O'fle.., or by ellllng the .p.elel 24.hour an.w.rlng ..rvlc. nu-b.r. for 'or.. ord.rlnal In P.nn'vlvanle 1-100-562-2050, out.ld. Penn.vlvanl. and within loe.l H.rrl.bura .r.. C717J 717.1094, TOOl (717) 772-2Z5Z CH..rlna I.p.lrld unlv). OBJECTIONS, Any p.rty In Int.r..t not ..tl.fled with thl .ppr.I....nt, Illowanc. Dr dl..llowanca 0' d.ductlon., or ......eent of ta. (Including dl.count or Int.r..tJ .. .hown on thl. Notle. au.t obJ.ct within .I.ty (60) d.y. of rac.lpt of this Notlc. by, --wrltt.n protl.t to the PA D.p.rt..nt 0' R.vanu., laIrd of App..l., Dlpt. ZII021, Harrlsbura, PA 17IZI-1021, OR --al.ctlon to hlv, thl .att.r d.tlr.lned It ludlt of the account 0' thl p.r.on.1 r.pra.antatlv., OR --app..l to the Orphans' Court. ADttIN ISTRATlVE CORRECTIONS. INTEREST I Factual Irror. dl.cov.r.d on thl. ........nt .hould b. .ddr....d In wrltlna tal PA D.p.rtlant 0' R.v~, lur.eu of Indlvldu.1 T...s, ATTNI po.t A"I....nt R.vllw Unit, Olpt. Z10601, H.rrl.burg, PA 17121.0601 Phone (711) 117-6505. S.. paal J of thl bookl.t "In.tructlons 'or Inherltane. T.. R.turn 'or. R.sldant Dlc.dlnt" (REV-1501) for an ..planatlon 0' ad.lnl.tretlvlly eorr.etabl. .rrors. I' any ta. due I. p.ld within thr.. CS) CII.ndar lonths I,t.r the d.c.d.nt.. d.ath, . 'Iv. Plrc.nt (5~) dl.eount 0' the tl. paid I. .110w.d. Int.r..t I. charg.d blalnnlng with 'Ir.t day 0' d.llnqu.ncy, or nlnl (9) ~onth. and on. el) d.y 'ro. the date of d..th, to the d.t. of pav-.nt. TaXI' which b.c... d.llnquent b,'ora January 1, 1'82 b..~ Intlr..t It the rat. 0' .1. ('X) parcant p.r ~ calcul.t.d at . dally rete 0' .000164. All t.... which b.ca.. d.llnquent on and aft.~ Janu.rv 1, 1'12 will b.ar Int.r..t at . rat. which wIll very fro~ callnd.r YI.r to cal.nd.r Y"~ with th.t rat. announe.d by the PA Dlpart..nt of Rlv,nu.. ThI .ppllcabl. Int.r..t r.t.. 'or 1982 through 199' ar.. DISCOUNTI v..~ Inter..t R.t. D.lly Int.r.st F.ctor ~ Intlre.t R.t. D.llY Inter..t Factor 1912 lOX .OOOSU 1'17 'X .a00247 1915 lOX .000451 1918-1991 I1X .000501 1914 I1X .On5Ot 1'92 'X .000247 1915 15X .000556 1995-1994 1X .aOO192 1916 lOX .000274 1995-1996 'X .aOOZ41 nlntar..t I. calcul.t.d a. fol1ow.. INTEREST . BALANCE OF TAX UNPAID X NU"BER OF DAYS DELINQUENT X DAILY INTEREST FACTDR ".Any Hotlc. Inu.d .fter the taM bacu.. dlllnqu.nt wIll rafl.et en Inter..t calculation to flft.en CIS) d.y. b.Vond the dlt. 0' thl ..5.....nt. I' p.~~.nt II ~.d. eft.r the Int.r..t co.putltlon d.t. .hown on the Motlca, additional Inter..t MI.t b. calculltad. STATUS REPORT UNDER RULE 6.12 Name of Decedent I ROY E. IIARSIInARGF.R ~v 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 I 1. State whether administration of the estate is complete I Yes X No " 3. If the answer to No. 1 is Yes, state the fOllowingl a. Did the personal r~resentative file a final account with the Court? Yes No . b, The separate Orphans' Court No. (if any) for the personal representative's account iSI 'c. Did the personal representative ~te 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. - Datel NnvRmhi..'-':ll. 1995 . -- - c:_ ,r'~c~ Signat.ure Date of Deathl R/11/Ql\ Will No. "..,11 -'7s ---. t.:n Admin. No. 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete I r'1 Charles E. Petrie Name (Please, type or print) 3528 Brisban Street Harrisbura. PA 17111 Address -- (':' \ 'J .~. 0:.... In P' i~ ?3 Ut.> (7l7) 561-1939 Te l. No.. Capacity: Personal Representative X Counsel for personal representative (MAHlrmf/AM3)