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In Ihe Sodll/ S.'''I<rilY No. ./-2!I.:::-L~j21. COnlllHlIIWCnllll of I'enll'ylyooia The pClilloll of Ihc IIl1der,l~ned respeclflllly rellTC'ellls 111111: YOllr pelillonerl'), who Islllre I H yellrs of lI~e or older nlllhc eseCIIIJtl: IlIlhe hlSI will of Ihe nhuye dee,'dclll, dOled ~NMLLC:I- /2> alld eodicll(,) dlllcd _ c."UI., oJ ~Y"UI4, S'm.LT:J{____ a/so kill/WI< as ---'- named . 19f1L. (\HIl\' fI:Ie\'nnl \'jrclUmIAn\'C\, ,',ie, h'I\II11dllllnl11 \truth Ilf ,,'WClIlur. CIC.) Dcccndelll WlIS domicllcd III dClllh In ~L''J^J n COutUy.. Pennsylvania. with h e.1C. Ills I fllm~)' or PJinciplll rc,idencc III~.-L:i. W. /...OtlrH I!/l 51: GI9JU.L.:.-'-~'/:J , 1701:>' (Ii\l \lrl't'I,lltlllllu,'rmuJl1IlIlIdr:llil)') Dccel~clll,lhcn 7 8' yeurs of lIgc, died D: To 8EA.. ~ ,19 '15 lit /9.C.J..1.ll.~-1Il:'l.c.... , Execpt II' fnllow" dccedclll did nolmorry, WIlS nol ~Iyorccd and did not hoye a child born or adopled aftcr cxccllllon of Ihc will offcrcd for prohulc; Wll' nOllhe ylclim of a killing and wa' neyer adjudicated Incompclclll: DeccodclIl III dCUlh OWllcd propcrly wilh cMlmotcd yalucs u' follows: (If domlcllcd in I'a.) All pmonlll propcrlY S ;l, Dc:>. 00 C\ . \'0 (If 1101 domlcllcd in I'll.) Persollol propcrty III Pelln,ylvallia S (I f 1101 domlcllcd III I'll.) Persolllll propcrlY In Counly S Vulue of reul C!tilatc in Pcnn!rl.)'lvnniu S ,ilualed us follow,: '-10 tvE WHEREFORE, pClilioner(s) re'pcclfllll)' !:"!JIICSI!,) Ihc prohllle of the lasl will alld eodlcll(s) presclllcd hcrcwlth alld Ihe grnlll ol'1cllers TE: STA "'Etvrl'l Y Ihcmll. L c~~il.~:">1_~"'J.?'0.L_- G t ~ 0 .jyI--LJ:/./o ~.g t:,'i. W, I1~N{)C>fJ OI2Ir..Jg:. ~~ ~i1Y=/f 'z'W!t,15 i 70 I :} :;": a ;, \i1 OATH OF PERSONAL REPRESENTATIVE COMMONWEALTII OF I>ENNSYLV ANIA } l:lS COUNTY OF CUMBERLAND The pelillnncrlsl ahnye-namcd ",'carts) or affirmls) Ihallhc S1alemcnls illlhe foregoing pelilion arc Irlle and cnrrccl In Ihc hesl nf Ihe k,!nwlcdgc and helief of pctilloner(s) and Ihat a' porsonal represen- IIlIiyc(s) nf Ihc ahnyc dccedclIl pClillnncr(s) will well and Irllly udmllli>ler Ihc eslule accordlllg 10 law, Sworn 1\1. or afnr.mCJ am.1 suhscrihcd ~ J~'", .I...;:t;{, I!> ~;~e OI&~~ER-.- 13T~+. r~~~~j 1e tl-1 ~~ l' 11/ ~r;d"~~~ff.(~'Nt~'I'" 11/j((N;'~:-:t,/ . c ~ No. 21 - 95 - 775 Estate of EVEL YN M SMITH , Deceased DECREE OF PROBATE AND GRANT OF LETTERS AND NOW OCTOBER 18. 19~, In consideration of the petition on the reverse side hercof, satisfactory proof having been prescnted before me, IT IS DECREED Ihatthe Inmument(s) dated JANUARY 13. 1995 described therein be admitted to probate and filed of record as the laS! will of EVEL YN M SMITH and Lellers TESTAMENTARY are hereby granled 10 TOM SMITH FEES Probate, lellers, Etc. ......... S 235.00 Short Certlncates(5)........., S 15.00 Re1>undatlon ...,............ S X- ages S 9.00 JCP TOTAL _ S ,,;R'RR Flied .., 9.c;1Q~.EJ~ . J?...l ~~.5..,... ....... ~~~?~~<A u!_ RtllS/or or Will. MARY C. LEWIS ATTORNEY (Sup. CI, 1.0. No,) ADDRESS PHONE if- y.?t Q' \26-:-.,Id Called Executor on 10-19-95, tJw' 1 1)t'.11 Hq~lsll,lr Tht' Ol.jgill,d (l"I'lifll',Il(' \\ ill lx' tlln\ ,lIllt-tllt' 1111' SI;llC' Vil.lI Ht.lllld" 'HlIll' 1111 Pl'llIl.lllt'llI Illlll,l.!. WARNING: Ills Illegal 10 dupllcale Ihls copy by photostat or photograph. Ffl' for Ihb t'~'l'Cirif.lICI S:!.IH) 3103889 ---.-------N".;:--...---- -'-'- ~ . \~. .~\t . I'"~ "\' C .c > \t.: t~ ....J "'l 5\-.o~~ "(L'~' 'If \~Cl\l. .ar. . \ V'~\I" -Z.\\&:, I11l'il!'l Ib~:Y~~t~'n'!:'.~ . I.IKOlI nl'~iMhlr .______ .oCJJ--1\l.05 D.lle "'OI'UI\t>r lit' COMMONWULTH OF PENNSYLVANIA' DIPARTMINT OF HEALTH' VITAL RtCORDS CERTIFICATE OF' DEATH (Co,one,) -"'" . ...... "'... . .. .~ .. I. Feratle II Smith .~ cllii6 ~"tf00'; P a _0 .. ... " . . '_.0.._ Nov. 26. " -. , I.,,,,, "...__....._........, Carlisle ~":';;':::'-::':~'X:r /IOu. Own 1I0me DCctlll,.I.....'IoQ~.."""' ....... 1>1<<""'1 51S West Louther strest ~~\.a Car1ie1e.Penna. 1701) ~~~ .. ."'".,.....1'..__1"'1 Albert L. Nickey 01........1..-- omas W. Smi th u.....hnnBylvan a ''''f'_ Cumberland (......-....0.'_1 o M' ,l~ ....~_'........_.,..._,..c........ ....,.., " !""- .-1 October 2 1995 81~3 A. .. 'I. ........._...........~....._.--...._O\ ~........""_..,.,... """'_1.......'_-....... -....""",._. l.....,_I._........_ Occlulive Corona Arter Di.eole OUIfOlOl'l""U.I1(OUINC tAl Dl.It QOlJIA _COOl\( ...:cOIl OVtITOfCI'l.1"'C-OOjKOOJ(""~1 . M:I'U'" . ..........r_m tOWUTIQt,IO"UUII OfOUI'HT . """" ~o.,-., Q{ __ 0 o ~.........._ 0 ...... 0 c:...w_...---.... a ~O:.~"'-' tit II." Moo tI~JII~~~~~.,.._...,_"'OI_~-__~...P..........""__.....__nt ,...._.,..,.........'_...__....I~.l......._.._",....."....,....,.,.. ...".,.."... . . -- -- _0 ..0 .~.IoOC..II'.,.,IItCI.,.'IlC""............_Jt........__~-..........-tl_ ,....._.,""....-..._....._M...._,_._,.....__........_II_.._...ltl.. 'IltDrCALUU'IIf'l'lI'COIIO"'l'l O"""".......'_....,.........,.,""'''"t.llOll. IIlIll,epl!IIM...,tto.....,n "....,......,tI.....,,.,,........ ..."""'._1.1..... .._.....tn.. ......... ".............."......,...,,,,.......,...,,,,,,.,.........,...,............ .., IIIlitO\"U' ~ &ii.~ '''',h.__ IC:laIL'I~"1II,IlI1I.1I . 179-12-4)1) OoII'(lfOUI'H~OitI_: t. October 2, 1995 ._Ill H ___~_"-a""''''__ :::...0 ~-, -:~"=' --., Wid~w UII""Y I 11I_....__ .. - .... -, ".0"-'........"'..... Carlisle M. Raudabaugh e Pa. 1 01 . . Car1ie1e.Penney1vania o , " , . ~O~ ..0 --. -- -........ "11' ~I.....I...__--..._....... .....I.........'""~"_---.."''''' ......, .....", IM)II' """ ..... 0..0 ",....--,.-. ... Coroner l'I la~Oj(~p,,'_l o . Ill.. October 3. 1995 ....... 'OOIlI"OI,,"~~.o(.iiiio;pi.f.. I_IfI'."......'''., Michoel L. Norri" Coroner M 405 Fairway Drive Nil Hechnic.burR. rat 170S5 "1_,.._, .. . G, \"I'lS _. , ~i ...-. , i~.~,3.~';~~'.,::~:~t' :!'; ~J\'\ir~~~;~rTjf::'''":'!SC ~,:.'~' c.; ",~~~:;':J'~ltt~'~~!:1'~'J~~E'/~v,;~: :~~"i "~~r~!li~:~~' 21 - 95 - 775 : "', ' ' '" I~r ";' ,.; . 't h" . . .', '.' <' }f' ",;,,;,~/,;;t'l::.:,;tF'<' ,,>":,' . ;"" "oj' . .. . ';',1 , .~ - ':.~ :\"'-',;. , ,..i . "':;, -" _.,n ',:"".,,', _,,~,' '..' .', 'i".'.: . >,..1 "'.' . "";,, . ,,::-',; '.-::...,' i"> ":<'!"" ..., ,.;';;,' ". .. ...i ::' ',..' i':' ;~: .,', '. ,<, . ,,,', , ii,. C. . . .... ,,;. ,L' , . . , .,. ,:!: . ',. >,,'i)" F:.::';:: ;:}: . ,',"," ';:i' ""'.'., , '''': !,;~: :,' .',' ','.'-' ','::" ,: '. :t'.','.~~, / i- ; . ,~~,~_. , '.":, 'i:: _.' ;.... \ ; :', . - " q", . ...... ':. -',::,''',! ;.. OJ '.' ;. " . . ." :..' ',' C' . .,,:' .:i " . _' ';:: ,-" n ., :,;"" , ' ..,:'~:;:., ., "". . '_'~"',;". . lJ,";'\b ,T>.::: i'> ..', ):?;;!;; "',,> "i ':1 ':,j'f' :":::-;'..,.i .: ..:" '. f .. ,>...,. .:;',""";, ",,;,";", .':y:,'} ';": ' ",;i, ....'.."'C . .,,' :\' :" . ..., ';,' , .', '." . " , .:. , '" . i :t:~;:' . " ." . ., " ~" , .,"-' " l' :: .' .,' ...'. . n,>,.,~./' ,; : , . ,'::',;'.": . ..' ,'i.;,_.,~,.:: :;; :i, ii: '''','' :...:, .' , . , ; ,'::';' ,:,: . . "," ' :','in:'" . ',i';"'"':', ':';";'::';'00'.,;,'.'.: .' ...,.. i . ',: :~~::-, ~"~,'i ," :;C~;" < "0 . . ," ': :":: J, .'; :;'';' , , , , f". 21 - 95 - 775 LAST WILL AND TESTAMENT OF EVELYN M. SMITH I, EVELYN M. SMITH, of 515 Wesl Loulher Streel, Carlisle, Cumberland County, Pennsylvania, being of sound und disposing mind, memory and underslanding, do hereby make, publish and declare Ihis my Lasl Will and Teslument, hereby revoking und declaring void all Cormer Wills, Codicils, and teslumentary dispositions by me at uny lime heretoCore made, FIRST: I direct Ihc puyment out oC my eslule of all my just debts and Cuneral SECOND: I Inslruct my personnl represenlative 10 puy ull my eSlale and inheritance laxes, bolh State and Federal, arising from my laxable estate, THIRD: I give my five-diamond ring 10 my son, Don R. Smith. FOURTH: I give my one and one-hair earnl diamond ring 10 my daughter, Barbara Smilh, FIFTH: I give my gold- frumed pointing of Noel B, Smith, Sr. as u litlle boy to my doughier, Susan Adams, SIXTH: All of the resl, residue und remainder of my estate, holh real and personal, oC whulsoever kind and churueler, und wheresoever situale, I give, devise, and bequeath 10 my children in equal shores provided, however, Ihul if Don R. Smith has fulled 10 repay his $10,000 debt 10 me in full ul Ihe lime of my deuth, which is 10 be verified hy my personal representalive, then he is ineligible 10 receive nny money or properly under this clouse; however, Ihis will nol uffecl Ihe specific bequest of purngraph three. Furlher, if any beneficiary named in Ihis paragruph to receive my residuury estute fuils 10 survive me, Ihal beneficiary's living children sholl toke Ihul beneficiury's shore. If u beneficiary numed In Ihis paragraph to receive my residuary estate Cuils to survive me und leaves no living children of his or her own, the other surviving beneficluries numed in this parugruph to receive the expenses, Page t of 4 , residuary estate shall take the deeeased beneflelary's share In equal paris. In the event that any of sueh children of the said beneficiary or beneficiaries who might have predeceased me leave minor children, In such event I dlrecl that my personal representative shall hold the legacy, of principal and Income, for such minor beneficiary or beneficiaries In Irust for such minor or minors until such shall have attained the age of twenty-one years, At such time, my personal representative shall distribute the corpus of such trust to the beneficiary or beneficiaries, Prior to the final distribution of sold corpus of the trust, my personal representative shall have eomplete authority to make periodic distributions of the trust corpus to meet the financial needs and educational expenses of the beneficiary or beneficiaries as my personal representative shall see fit In the representative's sole discretion. SBVENTH: I name Tom Smith as my personal representative (exeeutor), to serve without bond, If he shall for any reason fail to qualify or cease to act as personal representative, I name Patty Denney as personal representative (also to serve without bond), instead. If she shall, for any reason. fail to qualify or cease to act as personal representative, I name Carrie Wedo as personal representative instead (also to serve without bond). EIGHTH: I hereby grant to my personal representative the following powers, in addition to all olher powers conferred on him by law, to be exercised as he deems to be in the best interests of my estate: 1) To retain any property or investments at discretion without liability for loss or depreciation resulting from such retention, 2) To invest and reinvest at discretion without restriction the so-called legal investments with the specific right to invest in common nnd preferred stocks. 3) To keep cash in bank uninvested if deemed advisable for the protection of principal. Page 2 of 4 \' and to lease real estale and any olher property. upon such terms and for such period as my 4) To manage. operale, repair, alter or Improve real eslate or olbcr properlY. BxecUlor dcems advluble, 5) To sell any real or personal propcrlY whlcb I may own at my deatb or wblcb may from lime 10 lime conslltute a part of my cslale, e\lber al public or private sale, for sucb prices and upon sucb terms as may scem proper. and 10 make, execule, acknowledge and deliver to Ihe purcbasers tbereof good and sufficient deeds of conveyance tberefore, and all assignments, transfers and otber legal Instrumenls eltber necessary or convenient for pU5slng tbe title and ownersblp Ibereof, freed and dlsebarged of alltruslS, wilbout lIab\l\ly on tbe part of sueb purebasers to see 10 the appllcallon of Ibe purcbase money, I I I \ \ ' . I j; \ . I, 1 BVBL'iN M, SMITH. tbe lestalrlx, sign my name 10 thl& Instrument tbls -IJ;.- /2; day of ),41/// AA. '/ 1995, 1 bereby declare Ibal I sign It w\lllngly, 6) To make dlslrlbutlon In kind. and that 1 exeeule it as my free and volunlary ael for Ibe purposes Ibereln expressed, ,;:tJ l'/~ " t.- ! ( G' . ,1',.dJ1,-'::" I (Signed) , We, Ihe wllnesses, sign our names to Ihls In&uumenl, and do hereby declare Ihal Ihe lestatrlx wll\lngly signed and executed this Inslrumenl as Ibe testatrix's Lasl W\II and Teslament, Bach of us, In Ihe presence of the teslalrlx, and in the presence of each olher, hereby sign Ihls Will as wllnesses 10 the leslalrlx's signing. WI'~"'" tf,,:lJfl}~ ~ . (/. , R"I"" '" ~/";~;(/'" _/J.< ~!I"d/.J ';iA4 /fJ. 1'l,17 Wllness #2: I~UtL.~, ...J./Il-I..O-'-.J A ..,Id", '" ,'';:I ~ ~ rh" ,Ale &uuL<-, r,,--, 1.1013 I ' Page 3 of 4 J-, CERTIFICATION OF NOTICE UNDER RULE 5.6 (Al Date of Death: Evelvn M. Smith October 2, 1995 Admin. No. Name of Decedent: Will No. 95-775 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 : ~ Address Barbara I. smith, 515 W. Louther st.. Carlisle, PA 17013 Sondra A. Rhoades, 46 E. Hiqh st., Carlisle. PA 17013 Linda K. Garber. 805 Countrv Club Rd., Camo Hill. PA 17011 Noel B. smith, Jr., 806 Coooer Circle, Carlisle, PA 17013 Steven O. smith, 54 E. Pomfret st.. Carlisle, PA 17013 Cynthia M. Koblish, 60 E. Pomfret st., Carlisle, PA 17013 Patricia S. Dennev, 10409 Hebard st., Kensinaton. MD 20895 Thomas W. smith, 24 W. Oakwood Dr. , Carlisle, PA 17013 Cathv S. McAdoo. 739 Sherwood Dr.. Carlisle, PA 17013 Susan M. Adams, 221 N. 24th st., Camo Hill, PA 17011 Don R. smith, 4 Weslev Dr., Carlisle, PA 17013 Carrie S. Wedo. 112 Montana Dr., Chadds Ford. PA 19317 Elizabeth A. smith, 121 E. Main st.. Shiremanstown. PA 17011 Notice has now been given to all persons entitled thereto under Rule 5.6(a) except None Date:~~e~ /r;;/~ . , 'm:) ~n \l ~~~~ "I; Name Edward L. Schorop. Esa. o;~: 6 \;' 61 :r ":>5. Address 36 South Hanover Street Carlisle. PA 17013 U Telephone (717l 243-3727 capacity: Personal Representative X Counsel for Personal Representative - _.. - '-" ".,. ,~. ,- . . , ----- ------..."..,....- --..-- ----- - - -- -------------.---------- K::<~:~r~~;:~'''(;y\~:.,!~~:,;xz.-:'~.,;~'y;,!-;':::.:";<,:,,;-"" . ':;,' .,',. ,'. ,'~ >A':l;:~AA,;.082433( ,COMMONWEALTH OF PENNSYLVANIA . D~~. ,': ;"<(1',1,;..: " \ :",' DIPARTMINTOPRIVINUI ' , '.- ". ., ,.. v" j" . '. . '. .,.- ,. ". '<'.- ;>-. ". '.-'1- :,., ...' r ,. ,', .' I., ._. '. '. , .' '. .. . .' . .' . .' .' . .., . . ~ ll";'ii,;,ilj.;~:': '. <t~';~OFFICIAI; RECEIPT. .PENNSYLVANIA INHERITANCE AND ESTATE TAX, . RECEIVED FROM: fJ ACN ASSESSMENT III CONTROL ... NUMBER AMOUNT TOM SMITH e4 W OAKWOOD DR 101 .9,000.00 CAR~ISLE, PA 17013 - lotD HII, ESTATE INFORMATION, !t fiLE NUMBER (II el-19915-07715 ~ NAME OF DECEDENT (LAST) iiI SMITH EVELVN M II DATE Of PAYMENT m POSTMARK DATE COUNTY SSN 179-1e-4313 (fiRST) (Mil CUMBERLAND DATE OF DEATH I I I I I /"~,'""""":,-_-~-'~..:""':C'_~"~_-'-__-- --.---<-........~.~,::~~.~,~,~.~.-.-- -- --'- --- ----.r-;-,"'7"~ '7""' ~-----I---:' REMARKS fa TOTAL AMOUNT PAID THOMAS W SMITH SEAL CHECK" 115 REGISTER OF WILLS .;' '" I " . " t ~ ' .r .~ . ...',...,....... ...~-~~...~- --.- r -, ,.-...-.........w. -r~ t...-~ -1-.:..., I : '.- "I' ..- '" --. .... ,_.-. ,---~ IUY.UOO Ut 11.11'1 ... >- ..oe.. ua:~ ...~u :cog ulEm ~ ~~~ I '5- (,II - 10 INHERITANCE TAX RETURN RESIDENT DECEDENT (TO BE FILED IN DUPLICATE WlTli REGISTER OF WILLS) t=:. - fOR DATl5 OF DEATH AnER 12/31191 CHECK HUE If A 5POU5AL POVERTY C~EDIT 15 CLAIMED 0 FILE NUMBER 15 ~ lil o COMMONW(AlfH Of P(NU!loYlVAr~IA DlPAR1MfNIOI Rlyltwl 01'1 7flOIoOI tl,AIl" ~ 1~1~"G!f'~1 ~ I '_._OM) I ClICllIlU '!. rlAMlltA!. .IIUI. "'Nil MlIIOIlIUlll"ll Smith, l>'\>eI II M. lOCI'" UCUIlIIYHU'Mill 21 - 'l5 COUNt v COOE ~ 0775 'tEAR N~M6E~ 179-12-4313 -.-- .- IlIUDWI"!. (OMrull AIlUIl!!.!. lO!I\. 04, lQ9 b. lImitod Ellal. [J 2. Supplemllnlal Relurn o 40. Fuluro Inlorolt CompromllO Ifor dote I 01 dllOlh aflor 12,12.02) DlCedont Diad TOIIolo IJ 7. Decadent Malnloinod 0 livino Trull IAlloch cop)' of Willi IAlloch copy of TrUll) ALL CORRESPONDENCE'AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO., ,! NAMI COMPUIl MAIliNG ADDII15o!. Edward L. Scho 36 South Hallover Street ",,,"01!NUM'" Carlisle, PA" 17013 243-3727 Orloinol Relurn J,>- ...ffi "'0 "'z 00 u~ . d ,"(' " ,:1; t .," , , :z: o 5 E ~ oe lil '" I. R.ol E,'ol. IS,h.dul. A) 2. Slockl and Bondi (Schedul. B) 3. ClolIl)' Hold Stock/Porlnorlhlp Inlor.11 (Schedule C) 4. Mortgog" and NaIll Receivable ISchedule OJ 5, Calh, Bonk Depollll & Milullaneoul Pllflonol Proporly IS,hodulo E) 6. Jolntl)' Ownlld Propllrl)' (Schedulo FJ 7. T,oo,lo.. IS,h.dul. G) (S,hedul. 1I B. Talol Groll AIIIIII (Iolallln" 1.71 9. Funllrol EltpllnlOl, Adminhl,otive COlli, MIscollaneoul bpenlel (Schedule HJ 10. Debll, Morlgoge llabilillel, lIonl (Schlldule I) 11. Tolol Deductionl (tolalllnel 9 & 10) 12. Not Value 01 Ellole (line 0 minullIne 1 II 13. Choriloble ond Govllrnmenlal Bequelll (Schlldule J) 14, Ne' Value Subjoclla Tolt 11Ino 12 mlnulllne 13) 15. Spoulol Tron,ferl (for dalol of dealh ollar 6.30.94) See Inllrucllc.nl for Af,plicoble Percentage on Reveflo Side. (Indude voluel rom Schodule K or Schodule M,) 16, Amounl of lIno 14 loltoblo 01 6% role (Include vohlel Irom Schodule K or Schodulll M.I 17. Amount 0' line 14 laltable 01 15% role (Indudll voluel from Schedulo K or Schedule M.) lB. PrlncipollOIt duo (Add tOk from line I IS, 16 and 17,1 19. C,edill Spoulol Povorl)' Credit Prior Parmonh + 9,000.00 11) n.nn 12) 0.00 (3) 0.00 (4) 16.275.00 IS) 197,655.29 Ib) 0.00 (7) 5.016.98 19) 13,900.53 (101_ 3.,408.13 (B) 218.947.27 :z: o !;i !; ~ .. o u (It I 17.308.66 (12) 201,638.61 (13) 0.00 IU) ><._1:1 0.00 X .061:1 12,098.31 x .15 1:1 0.00 (I B) 12,098.31 (19) 9,473,67 (201 0.00 (IS) (16) _ 20 t,JiJ!h.(i 1 (171 + Discounl 473,67 Inlorel! ~ >- 20. If line 1911 grooler Ihon Line 10, ontllr Iho differonce on lIn. 20, Thh is ,he OVERPAYMENT. aD 2,624.64 0.00 Chack ho,o if y.ou 0'0 ,oquolllno a rolund of your ovorpaymont.' (21) .. (21AI (216) 21. If lino 10 h !)roOlor Ihon lIno 19, onlor Iho diHoronca on lino 21. Thh Illho TAX DUE. A, Enlol the Inlerell on Iho bolonco duo on Lino 21 A. O. Enlor Ihololol 01 lIno 21 ond 21A on L1no 218. This Is Iha DALANCE DUE. Malee Chide Pavable tal Regllt.r 0' Willi, Agenl ~ ~ BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND TO RECHECK MATH ~ ~ ' " Under ponalti.. of perfury, I doclaro Ihot I hoye okamlnud Ihil rolurn, including accompanying IChedulol ond lIalomonll, ond 10 Iho ball of my knowledge and belillf, II II I,uo, corrocl and complelo. I docloro Ihol 011 roal o,lnle hOI boon ruporled 01 Iruo markol yolue. Doclaration of pteporor olhel Ihon tho perlonol reprannlolive II bOlad on olllnformolion of which proporor hOI ony knowlodgo. ~IC. UIl[ 0' PU~O" IUPOU!.IIl( I IIUtUi II IUI "DOllfU (lAU . 24 W. Oakwood Dr., Carlisle, PA 17013 3J.;:z..s-~ AODUU DAU 36 S. lIanover St., Carlisle, PA 17013 3/.'2S'rY.c . . Act #48 of 1994 provide. for the reduction of the tax rate. Imposed on the net value of transfers to or for the u.e of the .pou.e. The rates a. prescribed by !he statute will bel . 3% (.03) will be applicable for estate. of decedents dying on or after 7/1/94 and before 1/1/96 . 2% (.02) will be applicable for e.tate. of decedent. dying on or after 1/1/96 and before 1/1/97 . 1 % (.01) will be applicable for estate. of decedent. dying on or after 1/1/97 and before 1/1/98 e Spousal transfers occurring on or after 1/1/98 will be exempt from Inheritance tax. PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING A CHECK MARK (....) IN THE APPROPRIATE BLOCKS. YES NO 1. Old decedent make a transfer and: a. retain tho use or Income of tho property transferrod, ..........h........................................... x b, retain the right to designate who sholl use the properly Iransferrod or its Income, ....,.......... x X c. retain a reversionary interost; or ...............1................1......................1....111..............1....1 X d. receive tho promise for lifo of ollhor paymonts, bonofits or caroi ............101....01..1......11....01. 2. If death occurrod on or beforo Docembor 12, 1982, did dqcedenl within two yoars procedlng X death transfor proporly without recolvlng adoquote consldoralioni If death occurrod oftor Decombor 12, 1982, did decodont transfor proporty within one year of death without rocolvlng X adequate considoration'... ........ It.. .1.... .1....... .1....... ........ ..11.................. 'I..... ,II..., "I'. ........... 3, Old decedent own on 'In trust lor', bonk account at his or her death'........,............................. X IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. , , LAST WILL AND TESTAMENT OF EVELYN M. SMITH I, nVHLYN M, SMITII, oC 515 Wesl "uulher Slreel, Cnrlisle, CumherllllHl Couuly, Pennsylvnlllu, heillll oC 50nnllllllll disposinll mlllll, lIIemory nnll underslllllllillll. ,10 herehy mnke, publish anll declare Ihis my I.nsl Will nnd Teslamelll, herehy revukinll and ,Ieelnrlnc voill nil Cormer Wills, Codicils, nnd lestnmenlary dispositions hy me nl nny lime hereloCore mnde, FIRST: I direel Ihe pnymenl 0111 oC my eslnle oC nil my jusI ,Iehls mill Cuneral expenses. SECOND: I inslrucl my persannl represenlnlive 10 pny nil my eMnle and laherilnnce laxes, both Slale and Federnl, nrising Crom my taxnhle estate, THIRD: I give my five-,lillmolld rinc III my son, 01111 R, Smith, FOURTH: I give my one nnd one- hnlC enrnl dinmond ring to my dnughler, Bnrbara Smilh, FIFTH: I give my gold-Cramed pllinling oC Noel n, Smilh, Sr, ns II Iiule boy 10 my daughler, Susnn Adllms. SIXTII: All oC the resl, residue nnd remninder oC my eslnle, both renl nnd personnl, or whatsoever kind and character, and wheresoever situalc. I give, devise, untl bequelllh 10 my children in equnl shllres provided, however, Ihnl if Don R, Smith hilS fniled 10 rep"y his S10,OOO dehl 10 lIIe in Cull III Ihe lime oC my dellth, which is 10 he verified hy my personnl representntive, Ihen he is ineligihle to receive nny money or properly ullder Ihis ellluse; however, Ihis will nol IIrrect Ihe specific bequesl of pnrngrllph Ihree. Furlher, If lIoy beneficinry nnmed in Ihis pllrngrnph 10 receive my residuary eslnle Cnils 10 survive me,lhlll beneficillry's living children shllll IlIke Ihlll hcoeficillry's shllre, If n heneficinry unmed in Ihis paragrnph to receive my residullry estnte Cnils to survive me nlld lellves no living children oC his or her own, Ihe olher surviving beneficinries nllmed in Ihis pllrngrnph 10 receive Ihe Pllge 1 oC 4 " ,_:-"_ _....'.....,'__,~~'.._'...n ..... ;,~....o.-;.,,,...,._.--",,,,,. resldunry eMute shnll Inkc the dcccused heneficlury's shure In elllllll pllrls, In Ihe evelll thut ullY DC such children DC the snld beneficlnry or beneficiaries who mlllht hllvc predecensed me leave minor children, In such cvenl I direct 1111I1 my I'ersonul represenllltlve 5hull hold Ihe lellacy, or rrlnclrnl nnd Income, ror sllch minor heneficlnry or heneflclnrles in trusl ror such minor or minors until such shnll hnve allnined the aile DC twenty-one years, At such lime, my rersonal rcpresentativc sholl dlslrlbute the corpus DC such trllst 10 the heneficlary or beneficiaries, Prior to the Cinal dlstribullon or said corpus or the trllsl, my personnl represenlntive sholl hnve completc authority 10 make periodic distributions or the trllst corplls to meet the financlnl needs and cdueational expenses or the heneficlary or beneficlnries ns my personal represeotative shnll sec fit io the representlltive's sole discretion, SEVENTH: I nome Tnm Smith lIS my personul representntive (execlllor), 10 serve , \' without bond, H he sholl ror nny reason rnll to qualHy or cease to act os personal representative, I namc Potty Denney os personal representutive (also to serve without bond), instend. If she shall, ror nny reason, Call to qllullCy or cease to act us personul representntive, I nome Currie Wedo os personal represenlallve Insteud (tllso to serve withollt bond), mOUTH: I hereby Ilrunl to my personal rel'resenlullvc Ihe rollowlng powers, In uddltlon to nil other rowers conrerred on him by luw, to be exercised US he deellls to be In Ihe best Interests or my estate: 1) To retuln nny property or investments ut discretion with 0111 liability ror loss or deprcclutlon rcsllltlng Crom sllch relentlon, 2) To Invesl nnd reinvest nt discretion withollt restriction the so-called legnl , investments with the specific rillht to invest in common nnd preferred stocks, 3) To keep cush In blink uninvested Ir deemed advisllble rur Ihe proteclion DC principal. Pngc 2 or 4 .' ACKNOWLI!l)()I!MI!NT AND AFFIDAVIT COMMONWEALTH OF PENNSYLVANIA COUNTY OF 55 EVELYN M, SMITH, whose nnme is signed 10 Ihe uunched or Coregolng Inslrnment, having been duly qualified nccordlng to Inw, docs hereby ncknowledge Ihnl shc signed nnd exeeuled Ihe inslrumenl ns her Lnsl Will and Teslamenl; 111111 she signed il willingly; nnd Ihnt she signed it as her Cree and volunlnry ncl Cor Ihe purposes Ihereln expressed. We,lhe wilnesses whose nnmes nre signed lolhe nllnehed or Coregoing instrnmenl, hcing duly sworn nnd qunlified nceording In law, do depose nnd sny lhnl we were presenl nnd snw EVELYN M, SMITH sign and execute the instrument ns her Lnst Will nnd Testnment: Ihat EVELYN M,SMITli signed willingly nnd Ihnl she executed it ns her free nnd voluntnry nct for the purposes Iherein expressed; Ihnl ench of us in Ihe henring nnd sighl of the Teslntrlx signed Ihe Will as witnesses; and Ihnl to the besl of our knowledge the Teslatrlx wns nt lhnt time 18 or more yenrs of age, of sound mind nnd under no eonstrnint or undue Influence, (1) " I"" C,' .,..{:: /t;(t,:, l,~ ,';'/1 J.'i'I,,:7/'II,.t.~(.. I " I Teitnlrlx' ;&c.d''Il.f..(;( yJ ~,'ct,I^-,; , Witness /S:"J , / . ," , ,.;/:'/ . .,,/I'/r.< // I'{:\ ....... I or, .I.~';,rr,. I, ,o",'-J".,,- ,/ Wilness j Sworn or nffirmed to nnd ucknowledged nnd subscribed beforc me Ihis I ;T)~nday oC : !1\,\,(lil' \=,1995, , , . '. ..JC\.\\\.C1\..\..)j~, Un .l.f\O.\ Notnry Public ( __,0 NotJ,rc.'5J:'; 1bmmvL.H.",.,.,I'I::':t'/rullc Hanf~ll1. On..f..1in ':,:,,',-..:" MyConVlio:;k>, "'fl':,"':;"": 'J! --. Mml'4x:" pormytror:i:l ^,.x.e~i",,;i ~ Pnge 4 of 4 " , .' lJ^""'"N DII'C)"II HAN'" M"" "lu'.'-. ('IIMPAN\,. 11^"IU..IUIIUi. 1'1 NN't\'1 V^NI^ ~ of :: '." Landis Olllck to Scllorpp ,IAta No. "^., NlIme: Cvolyn M. Smith SSN: 17!l-12-4313 000: 10/02/!l5 Account No. 0023507195 05001223 ------------------- ---- - -------------- --- -..-- --- - ------- ---------------- Typo Choeldng Safe Deposit Oox ------------------------ ------------------------ ------------------------ Date Opened or Issued 04/03/07 09/22/95 ---------...--------,---....-- ------------ ------------ ------------------------ Date Closed or Matured 11/27/95 (Closed) Date of Death Oalance $2,960,95 Not Applicable PLUS Location: Date of Death Accrued Int. $31.72 Carlisle West Offica Joint OMlers (if any) 09/22/95 Date of Joint Oimership Special Comments: N/A Atldittonal Informat1un nvaihbln at $20.00 pel' hour, OnB hour mintmum. Dato Pnlpllred: February 14. 1996 Prepared by: Carolyn A, Barllebi Ie Customer Management Information Dept. (CMI) Telephone No, (717) 255-2054 F:ED,;::;::, 19')(, 3'2.11'1'1 II:',O~'" P,ld Facsimile Cover Sheet TO:~~ Company: Fax: 111 ~ ::t~:EL:..1'i~ FROM: Department: Routing: Extension: Debbie Howard Annuity Services-Special Markets 1255 5331 COMPANY: BUSINESS MEN'S ASSURANCE CO. 700 KARNES BLVD, P.O, BOX 419458 KANSAS CITY, MO 64108-3306 816-753-8000 800-234-1397 fax: 816-751-5530 Date ~ - d-J-. q ,b Pages { COMMENTS: ~ m ~-1. ..11 6/111/c c.~d;- " (/\...... "r () O,2~ Q.Q. -ae.C~cP. ~'t (n-J.,-' ~.- (,.10.' ,ljq~r2')& ~ ~~; :;Prn<<O$ ~ ~ rfY\. 'WJ.. .: !I !1'.#, ').cf Or ~ 1. p~ast c4tt li- YfOV\. l^.o~ ~ ~ ~~~~ /) ~~ce;y f7 ~ ~ 0".,.",'....0..";'.,."'.......-.."'..,.--" ,'''<'jLj'f~,;'H,''- 11I1 MOUNTZ IlWILIRS 'l'm'l YllllrS,,,-bl MIllllI'III' 'Ii. MIIIIIIII. Jalluary 10, 1!I!lG Evelyn M. smith C/O Thomas W. Smith 24 Wost Oakwood DrIve Ca!lisle, Pa, 17013 RE. Rstate hppralsal of Evelyn M. smith Dear Mr. smithl The following information is to description and value for the Collowing give items. you white (5 ) gold lady'S diamond band. This round brilliant cut diamonds which 3.05mm in diameter and have an weight oC .50 carat. These S-I-2 in clarity, II-I in color set. The shank has a plain bright 1.75 - 4mm wide. I. One 14K ring contains measure 2.73 approximate total dIamonds are S-I-1 and are four prong finIsh and measures pOo.OO 2. One band Is IOK white gold plain measures wedding band. . !Imm wide and 1'h I s weighs wedding .470 R. $ 5.00 3. One 1411 white gold antique uLyle diamond fauhioll rIng. Thiu ring conLaino (3) old mine cut dinmondu set horizontally in the center wIth one chipped end tJlamuntl. 'I'hosc diamonds mOl1suru 4.1 4.Glnffl ill diameter ,and have an approxImate totnl weight oC one carat. These diamonds are S-I-1 - I-l in clarity and O-J in color. There are (5) round sIngle cut diamonds and (II) diamond chips set around the center diamonds, Cour on each side. These diamonds measure l~:::~" ,\~.,. .......'11 a 1';:\ Norlh 11:IIlCll'l'r SII'l'l'I, C:trlisk', I'^ 170l,i . 717/..!'I.\"I'J,ICl. F,\:\ 717/2I,HI7H'; 'jij 1l0I,I':X I I I I l IlvUIIII. ""' . SCHEDULE H FUNERAL EXPENSES, ADMINISTRATIVE COSTS AND MISCEllANEOUS EXPENSES Ploasa P,lnt ,,-r Typ'o FI E NUMBER CQMMONWfAUH 01 ,[NN!oYlVANIA INIIUIIANCIIAlllllUIN In~D[N' DlelDINt STATE OF Smith, Evelyn M. ITEM NUMBER A, 1. 2. 3. B, 2, 4, C, 1. 2, 3, 4, 5, 6, 7. a, 21-95-0775 DESCRIPTION AMOUNT Funoral Exponso.. ing Brothors Ho's - reception catering rge's Flowers 6,957.00 927.50 201. 40 1, Admlnlstrallvo Cast.. P.nonol R.pr..enlatly. Comml..lan. Social Security Numb.r of P.nanol R.pr..enloIlY.: Veor Comml..lon. paid 3, Allorn.y F... ells, Black & Schorpp Family Exemption Clalmonl Add,... of Clolmonl 01 d.c.d.nl'. d.alh slre.1 Addr... Rolollan.hlp 5,000.00 City 5101. Zip Cado Probal. Fe.. advanced by Landis, Black & Schorpp serve for closinq Ilcallanooul ExpenlDlr Thomas W. Smith, reimburse for Register of Wills fee. 14.00 350.00 264.00 40.00 6.89 52.04 40.00 47.70 I I L CUmborland,Law Journal, executor's notice Dauphin Deposit, invoice Evening Sentinel, executor's notice J\merican Red Cross, donation of household furnishings appraisal foo, Mountz Jewelers, appraisal fee TOTAL (AI.o .nlor an IIno 9. R.capitulatian) (If mar. spac. Is n..d.d, In sort addltlanal.h.... of soma size,) S 13,900.53 i r' , J: . U'tllllll, 11.11' ~' ,9"ll'.Jd" 1l.'l)l'SH' COMMOHWI"ltll 0' PfU,,'''VA,.IA ItUlll.JA"U IAIIIIUIU IUIOINI PIClOIHI , SCHl:DULE I _I DEDTS OF DECEDENT, MORTGAGE LIADLITIES AND LIENS PI.'!~_so P,I_~I or !ypo ,__ _ FILE NUMUER 21-95-0775 ESTATE OF Smith, Evelyn M. ITEM DESCRIPTION AMOUNT NUMDER I. Dr. Robertson, dental bill 465.00 , 2. Good's Fumituro, final invoice 516.62 3. Bon Ton, invoice 154 . 67 4. M&T Universal Card, invoice 100.00 5. Bon Ton, final invoice 168.20 6. AT&T Universal Card, final invoice 1,405.44 7. Carlisle Hospital, unreimbursed medical expense 73.20 8. OOn R. Smith, outstanding rent 525.00 ,I ( I , I I , TOTAL (Aho onlor on IIno 10, Rocapllulallan) 'If lIIoro IpOCO illlOfluod, inaorl odcJilional dlools 01 JORlO sizo.} S 3,408.13 Smith, Evelyn M. FILE NUM8ER 21-95-0775 I I I 'ly.1JUUtI1,'1J . COMMOHWIAII" 0' ,'HNlnYANIA IHHllnANn .All.nUIN 'UIOIHIOICIOIHI SCHEDULE J BENEFICIARIES ESTATE OF ITEM NUM8ER NAME AND AODRESS OF 8ENEFICIARY RELATIONSHIP AMOUNT OR SHARE OF ESTATE A. Taxable BequIIHI I. See attached list ITEM NUM8ER NAME AND ADDRESS OF 8ENEFICIARY AMOUNT OR SHARE OF ESTATE 8. Charllablo and Governmental Duquelhl I, TOTAL CHARITA8LE AND GOVERNMENTAL 8EQUESTS (Aho ontoc on lino 13, Rocopllutollon) 5 (If mora .pan II n..dld, In'lrt addltlonollh.... of lam. Ilz.J . NAME SOCIAL SECURITY IU<:LA TIONSIIIJ> NO. I. Barbarn I. Smith 204-30-8978 Duughter Specific bequest plus 515 W, Louther St, 1/13 residue Carlisle, PA 17013 2, Sondrn A, Rhoades 161-32-569\ Daughter 1/] 3 residue 46 E, High St. Carlisle,l'A 17013 3. Linda K. Garber ] 72-32-0092 Daughter ]/13 residue 80S Country Club Rd, CnrnpHiII,PA 170\1 4, Noel B. Smith, Jr, 192-30-4984 Son 1/]3 residue 806 Copper Circle Carlisle, PA 17013 5, Steven 0, Smith 204-30-77] 6 Son 1/13 residue 54 E, Pomfret St. Carlisle, PA ]7013 6. Cynthia M, Koblish 165-38-1795 Daughter 11131 residue 60 E, PomlTet St. Carlisle, PA 170]3 7, Patricia S, Denney 210-40-1954 Daughter 1/131 residue 10409 Hebard St. Kensington, MD 20895 8, Thomas W. Smith 182-46-4405 Son 1/131 residue 24 W, Oakwood Dr, Carlisle, PA 17013 9, Cathy S, McAdoo 198-44-8765 Daughter 1/131 residuc 739 Sherwood Dr, Carlisle, PA 17013 10, Susan M, Adams 173-50-0200 Daughter Specific bequest plus 221 N, 24th St. 1/13 residue Camp Hill, PA 17011 11. Don R. Smith 181-50-9633 Son Specific bequest plus 4 Wesley Dr, 1/13 residue Carlisle, PA 17]03 12, Carrie S, Wedo 182-50-3] 85 Daughter 1/13 residue 112 Montana Dr, Chadds Ford, PA 13, EliZllbeth A. Smith 183-52-6329 Daughter 1/131 residue 121 E, Main St. Shirenmnstown. PA 1701] - -. ~_......-- .., ...... . ..._~_ _,_. __ ~.'".~._ - ..._ .. _..>, .... _.__ _,_ .o__ <...... ._. .._ __._._ "__0" RECEIVED FROM, i ACN ASSESSMENT I!' CONTROL 1;1 NUMBER AMOUNT EDWARD L SCHROPP Ese 3b S HANOVER STREET 101 .I!,bI!4.0" SEAL THOMAS W SMITH C/O EDWARD L SCHROPP CHECK" ..5 ESt! m TOTAL AMOUNT PAID .e, be.. . b4 DO () '., ';' RECEIVED Byvla,i..:; C ,/>(I"<!-o)/""'I/ ,/ $lONAlU.. ) ',' MARV c. LEWIS "Of ;-; ;/; ..' REGISTER OF WILLS /;;,.f-,- " / I I i 'OlD H"j ,i I 1 I I j I i , 1 i CARLISLE, PA 17013 ESTATE INfORMATION, m IL MIER III e 1-1995-0775 ~ NAME Of DECEDENT lLAST) ~ SMITH EVELVN M II DATE Of PAYMENT II POSTMARK DATE COUNTY SSN 179-1 e-/t:313 IflRST) IMII CUMBERLAND DATE Of DEATH REMARKS REGISTER OF WILLS , ,\ . <Do: ,~ , .. . I '" ~ " t., \' ", ~, . .t " '-....'..-. . --.~ ,..,. ........~AI -~ __~"iI -<4::'" ! ) -'.. .. - -~.. .'. ,- -" ~,-- , v ':;-0/-10 REV-1547 EX AFP 112095* COHHDNWUlllt Of PENNSYLVANIA DEPA~'"[N' OF REVENUE BUREAU Of INDIVIDUAL l'X[S OEPJ. ZlOnl HARRISBURC. PA 11121-06DI ACN NO lICE OF INHERITANCE TAX APPRAISENI'NT. ALLOWANCE DR DISALLOWANCE OF DEDUCTIONS AND ASSESSNENT OF TAX DATE FILE NO. 10-02-95 COUNTY CUMBERLAND NOTE. TO INSURE PROPER CREDIT TO YOUR ACCOUNT. SUBNIT THE UPPER FDRTIDN OF THIS FDRN WITH YOUR TAX PAYNENT TO THE REGISTER OF WILLS, NAKE CHECK PAYABLE TO "REGISTER OF WILLS. AGENT" REMIT PAYMENT TO: EDWARD L 5CHORrr f5~ 36 S HANOVER 51' CARLISLE PA 17U13 (I .<---' 101 07-08-96 REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 Allount R...ltt.d CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS .... iiE'V':is4i-EX--iiFi;-ri'z-:9sY-iloricEo-oF-YNHEifii'ANCE-i:AX-iiPPRiiisEHEil:r;-iii.i:oW;'HCE-ijli--------mmm DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF SMITH EVELYN M FILE NO. 21 95-0775 ACN 101 DATE 07-08-96 TAX RETURN WAS. C XI ACCEPTED AS FILED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ONI ORIGINAL RETURN 1. R.al ed.t. (Schedule A) (1) 2. Stock. and Bond. (Schedule BJ (2) 3. Clo..ly Hald stock/Partnership Int.r..t (Schedule C) ISI 4. "artg.gal/Not.. RacIlvablD (Schadule DJ 141 S. C..h/Oank Depolita/HI.c. Parlonal Property (Schedul. E) IS) 6. Jointly Owned Property ISchedule F) (6) 7. Tranafara (Schedule 0) 171 B. Total A...t. APPROVED DEDUCTIONS AND EXEMPTIONS I 9. Funaral E~p.n..a/Ad". Coata/Hiac. EMp.n... CSch.dul. H) (9) 10. D.bt./Hortg.ge liabiliti.s/Li.ns CSchedul. I) CI0) 11. Totel Deductions 12. Net Velu. of reK Return 15. Charitable/Governnentel Bequ..ts CSchedule J) 14. Net Valua of E.tat. Subject to raK I CHANGED ,00 ,DO ,00 16,275,00 197,655,29 ,DO 5.016,98 leI 13.900,53 3.408,13 Clll 1121 1151 1141 218.947.27 17,3nR ~~ 201.638.61 ,DO 201,638,61 NOTE I 14, 15 and/or 16, 17 and 18 will returns assessed to date. If an assessment was issued previOUSly, lines reflect figures that include the total of ALL ASSESSMENT OF TAXI IS. Anount of Lin. 14 at Spou.el 16. Anount of Lin. 14 taxebl. .t 17. Amount of Lin. 14 taMable at lB. Principal TaK Du. rat- Lin.el/Cla.. A r.t. Collat.rel/Cle.. 8 rat. USI UbI 1171 TAX CREDITS I PAYNENT DATE 12-21-95 03-25-96 RECEIPT NUNBER AAD82433 AA1l2657 DISCOUNT 1+1 INTEREST C - I 473,68 ,DO ,00 X ,DO. 201,638,61 X ,06. ,DO K ,15. CUI ANOUNT PAID 9.000,00 2.624,64 TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE ,DO 12.098,31 ,DO 12.098,31 12.098,32 ,OICR ,DO ,OlCR . IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST, IF TOTAL DUE IS LESS THAN 'I. NO PAYNENT IS REQUIRED, IF TOTAL DUE IS REFLECTED AS A "CREDIT" ICRI. YOU NAY BE DUE A REFUND, SEE REVERSE SIDE OF THIS FORN FOR INSTRUCTIDNS,) ${~:j \ci~: I ~ t~~. ~I~'" r.' ~ ~:. SZ'j ~1~'1 '~l -;"1 :fq Ct,~ ft-i'"<') ") X~:! ~~~~:!l ,,'J "I <'~l ;)H ~f,i 1.:'1 f'=) ',5,\ f~l ~~;j ;:;i I t'l 'J ;_:1 ~' I '~d 'f~ :'J ~;j :/J Jj4 lJ1 ~1 ~1 ::'j ~~i' -"': I ;t j il ~I '" I""l I~'" - r. :1 a.: 0 ~ lXl ... ,., c>: (-.. ." I,J ~j~ ./ d ^ ,., cr _:,j ~'.J _/'('J ! -, " ~ ,~ '" 'I. ~ ~t ~; ,) a..;..,. ~~ __0 ~ ~ E Ie: 08 e: RfURYATlDHI Elt,t.. ., decedent. dvJna on or bl'or. Dlcl.ber 12, 19.2 _. If enw lutur. lnt.r..t In the ..t.t, 1, tr~'f.rred In pO.....lon or enJov-~t to CII,. . (coll,t.r.l) b~'Jcl.rl.. 0' thl d.c.d~t .'t'r thl I.plr,tlon of eny ..t.t. 'or 11'. or for ~'.r., thl C~..lth her~v Iwpr..'lv r...rve. the right to appr,I.. and ...... trenl", Inherltinel 'IX" It thl l~ful CI... . (colll'.r,l) rete on any luch lutur. Int.r..t. PURPOSE Of' NOTla. To fulfill thl r.qulr..ent. of Slctlon 2141 of thl J~rlt~. and E.t.t. T.. Act, Act II 0' 1"1. 71 P.S. .'C1tJon IUD. PAMH'Tr Det~h the top pCl~tlon of thl. Hotlc. and .ub.lt with vou~ P'v.ent to the R.gl.t.~ of Will. p~lnted on the ~ev'r.e ,Ide. --"ske check or ,one, order ps"bl. to, REGISTER OF HILLB, AGENT All p'~snt. recelv.d .hlll flr.t b. ~ll.d to sn_ Intere.t which 'ev b. due with .ny r..alnder .ppll.d to the t... A refund of . tax credit, which wa. not reque.t'd on the Ta. Aeturn. .av be r.queated by co.pl.tlna en "ApplIcation for A.fund of PennlVlvWlSa Inh.rltanc. and E.t.te T.." (AEY.UU). AppllcaUon. are ,vIllable at the OffiCI of the R.gl.t.r of Will., any of thl 2S Revenu. Dlltrlct O'flc.i. or bV c.lllnl tha lpeclal 14-hour enlver1na ..rvlce nu.b.r. fo~ 'or.. ord.rlnll In P.nnlvlvanl. l-IDD-S61-IDS', out.1d. Penn.vlvanla end within loc.l Harrl,burg ar.. (717) 71'-1094. TDD' (717) 772-2151 (Ha.rlng lapalred Onlv). REFUND (tA) r DB.JECTlONS, Any party In Intar..t not ..tl.f1.d w1th the appral.a.snt. allowanc. or dl.allowanc. of deduct1on., or a'I".aent of tax (lnclUdlng dl.count or Intlr..t) .. .hewn on thl, Not1ca au.t Object within II.tv (6.) daYI of rlc.1pt of this NoUca bv' ADttIN ISTRAJlVE CORRECTIONS I "'wrlttan prot..t to Uti PA D,p.rt.ant of Ravenul. loard of App,.", D.pt. 281021, Hurhburg, Pi UUI-UII, OR -..I.cUon to h.y. thl aaUar d.tar.lned .t aucHt 0' the .ccount of the p.r.onal tlpr...nhUv., OR -.epp.al to tha Orphenl" Court. DISCOUNTr Factu.l .rror. dl.cov.red on thl. .......ent .hould ba .ddr....d In writing tal Pi D.,.rt.ant 0' Rayenul. Bur.ty 0' Ind1vldual T...., ATTN, Po.t A.......nt R~vl.w unit, D.pt. 280601, Hlrrl.burg, PA 17111-0601 Phon, (717) 7'7.6505. Sa. p.g. S 0' thl bookl.t Rln.tructlon. for Inh.rltanc. Ta. A.turn for. R..ldant Dac.Jant" (REY-15Dl) for an e.planltlon 0' Id.lnl.tr.tly.lv corrlctabla Irror.. If anv tl. due I. paid within thr.. (J) cII.Mdar aonth. a't.r tha d'c.dantl. dllth, a 'Iv. p.rc'nt (IX) dl.count 0' tha ta. paid II Illow.d. Th. 15X tax -.ne.tv non.p.rtlclpatlon panaltv I. coaput.d on th. tot.1 0' the tax end Int.r..t .......d. end not paJd be'or. Januarv 11# 1996, the 'Ir.t d.y .,t.r the end 0' th. t.. a~.tv p.rlod. Thl. non.p.rtJclp.tJon p~ltv I. appealable In the .... .ann.r and In tha the .... tla. p.rlod .. YOU would app.al tha ta. end Int.r..t th.t h.. baan .......d .. Indlc.t.d on thl. not Ie.. PENALTY I INTEREST I Int.ra.t I. charg.d beginning with 'Ir.t dlY 0' d.)lnqu~ey, or nln. (,) aonth. and on. (1) day froe the data of d..th, to the d.t. of pa~ent. TI... which bac... delinquent b.for. Janu.ry I, l'.Z ba.r Int.ra.t .t the r.t. of .1. C6U pareant par.,...,..,. calculated at a dalh rata 0' .000164. AU ta.1I which bu... d.Unquant on and aft.r Janu.ry I, 19'2 wJII b..r Int.r..t .t . rat. which will vary 'roe cal.nd.r ve.r to calendar va'r with th.t r.t. announced by the Pi Dap.rt..nt of Alvenue. Tha .ppllcabl. Int,r..t r.ta. for 1912 through 1996 .rll U!! Intare.t R.t. D.I hi Int.r..t FlclDr !!!! Int.r..t A.ta D.lly Intar..t F.ctor 1912 rDX .000541 19.7 'X . GODl47 19n lOX . G004S1 1981.1991 lIX .GOOSDl I'.. lIX .00OSOI 1991 'X .0001'7 1915 UX .0OGS56 1995.I'" 7X .00Dl92 1916 I'X .OOOZ" 1''''-19'' 'X .000147 ..Intlra.t II calcuhtect II 'oHowlI INTEREST. BALANCE DF TAX UNPAID X NUNaER OF DAYa DELINQUENT X DAILY INTEREST FACTOR ..An, Notice 1..UId a't.r the tax baco... d.llnquent will r.'l.et an Int.r..t c.lcul.tlon to fl'ta~ (11) daV' b.yand thl data of the ........,.t. If p.pant h aed. .ftar the 1nt.r..t coaputaUon data shown on thl Notlca, add1tlonal 1nt.r..t au.t ba calcul.tad. . STATUS REPORT UNDER RULE 6.12 Name of Decedent I Ge!'"~ Y..v /,?;1,' .s:;:;,,...,;;r-,,.y- Date of Death I c::;::l.C~E~ ..::?; 1~:7S- will No. t?);-'js:- - 0 77..s- Admin. No. Pursuant to Rule 6.12 of the supreme Court Orphans' Court Rules, I report the following with respect to completion of the administration of the above-captioned estate: " 1. State whether administration of the estate is complete I Yes)( No 2. If the answer is No, state when the personal representative reallonably balieves that the administration will be complete I 3. If the answer to No. 1 is Yes, state the followingl 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 iSI c, Did the personal representative state an account informally to the parties in interest? Yes X No d. Copies of receipts, releases, joinders and approvals of formal or informal accounts may be filed with the Cerk of the Orphans' Court and may be attached to this report. ~~/ S gnat.ure 6~o L" ..5C...../~.;9<=' Name (Please type or print) 36 .s: ~~"""FR S7', ~..ec.......s-.:::'~~ '//'0-'.5 Address Datel ?~/..s--% (7/7) ,;?~.s- 3'7;;;' )> Tel. No. (MAHlrmf/AM3) Capacity: Personal Representative ~counsel for personal representative """""~'~""""""~-""''',"",'~i''''''i-''''#~''\';f''.-''~~''''-''-'-'-''' ~'.,.....,.~--.-_~,~. ,. "......,.".-.......'N.............-,".....'..,...,....._..m'.,..'-"'.""....,"'....,.,<.'-.~.'" ,.,_