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HomeMy WebLinkAbout96-00443 ~ ~ h . Ii-€' ~ '. . rrrr.- . ,. . ~ ' . PETITION FOIt PIWHATE and GltANT OF LETTEItS I(,lil-vqc:-;o cQl-Yf.p- 483 10: 1:\'1111' flf E (,. (;.tH~" IL "I\11k,,0,,""'" .-- u . Ikn'II\('II. Socilll.','"'''''''' "'0. .~S-\'~./:I-.:.;A"J t" J. 1(1'~I'lcI 01 Will, 101 Ihc ('Ollllty 01' C>_,t'.\\"'\:_L..I\~..lD in the l'OmllHI1l\H'ahh "I I'run,yh'ania rhe pl'lilHm \11" till.' UlHkl,i~ll\.'d fl'\l'l'\.'tfll!ly 11'1"1"""llh thai: YO\lI IWlil,itllu:I(,I. \\110 j.. 0111.,' I~ Yl',I1\ 01 i1.~!l:,OI IIldl'l an thl'.l'\l'l'IIl':/~ in Ihl' 1'''1 ,,"II 01 Ihc aioo' c ,b'I'dl'nl, dalcd ~ I (lll- ~ lr I'FI'" and \.'odidlt...) dOlled .' --~- _ ...______ named .u.....---, \9:1.1- ..-~--- I'I.lh' ,dl'\.1I11 ~1l~'11111't,1lI~',", l',~~ l\lllllll'l.lllllTl, Ik.tll1ll' ,'\,'(111111, l'h:.1 Ik":l'lldl.'lIl \\iI'" dOl1lh..'lkd al dc.tlh 111 l~ l~:l' \1' t../~c h ,~\ \"';) ~ rOlllllY. pCI111\ylvanii). with h.eJ~ \"" ranlll~ ",pdl,,"P,11 Ic,idc",c al /Ilj- NOL'fl{ ~eR. _Vq,~.! C If 11(1 fiJI-/...: .l?q _, ,?o Il. --' . - . - - - tll" 'll~'d. lllllllbn .lId ,'Hllhlp.tlI1" \le~l1lknt.1.hcn~ .1fl ./c'''' 01 a~c, dicd -I ',.JJ ~A-5' _:2.. e. - ,19!JiL-, al rO/tt:'S (___>>"1: _f'Jr)(L~/N ()- t()~'1 _u"__ I'\.:cpl a, r.,lIo,,', Ik,:,',knl did nOIIll,n 'Y. '\iI' n,,1 di\\u.:cd and did n"l havc a child hurn or "duplCd aflcI cw,ulio" ollhc "ill "Iflolcd rOlpll'\1:IIC; '\i" 1l01lhc ,klilll "I a killin~ alld \\"" IIcvcr "djudkalcd inl,:IlI1'I'l'll'I11: _____._.... -_.-- ----- _m_~__~_' .--------- Dl'(l'lHknl at Ul'ltlh O\\I1I.'U properlY \\ith ""..Iimatcd \alm.... a' follow': (If dnl11i\:ikd in POl.) All pl,,'r..nnal pWpl.'ll~ (If lUll unl11kikd III POl.) PCT..onal property in PCllIl..yl\'al1ia (1I1111t lloll1idlcd ill Pa.) IIc,,,ol1,,1 propl.'rty ill County "ahll' III n..'al c..101Il.' ill 1'1'111l,yhania/1. fV ~ ,ilUatc.:d a.. h\lhm..: . __ ._... 'I) L s eo ,!2C'0 :=___ s s L -------.-......------- ---.. ,..-.---"-"'-------' _.._-~~_..- \\ II1:RU'OKI.. pCliliollCrl'l IC'I1C<lIIlII~ [cquc'It,) Ihc p",halc "I Ihc la,1 \\'i11 "lid codicil(,) 1'I1."l'111\.'U hl.'ll.'\\l1h and Ihl..' ~rant of klll'l' ..J L!.;] })Il', Lh.\"1 ltP--Y.-- t ;l"l,lm~lll,ll ~. ,1\11111\11,11 ,,1\,lll ~'.1_;l.; adlllllli\llalinn d.h.n.I,.".1.a.) t hl.'U' II. .,- ,W~jl~~~' i~1~~~r~)t tf(;~14SolJTIl '31(11.- "." A,tl-'N~T,'NI b'K .;!);lO" '7();;/c/ '51- ",ec..'f ~~ - . ;- ; _..._-------_._-~- ..-... ----------- OATil OF PEltSONAL ItEPltESENTATIVE (,O:\I:\IO:--;\\'I-:AI.TII OF 1'1.::--;:--;S\'l.\'A:--;IA COl"n OF <.'..L\'\\"~C IpllJ.i1.>___. I j' :-;:-; 1 hl'l'l.'tllillIlCIl\) ;tbo\~'""al1\l'd '\\l'tlll"') \11 aflill1\("') lhill Ihl' 'latl'lI1c:nh in thl' fOl\.'going petition arc tllIl' .llId ~'llIll'd III lhl' hl....t \lllhl' hl\tl\\kd~l' ami bdid l,r petiliol1l.t(,) and that a"'l1l'r~onal fl..'I'lrc...en- lall\cl,) "llh,' 011..1\1' "IW,klll pelili""CII" "ill \\ciJ~~ 11111) adlllilli'~I.I;!l~aIC~"'dillg In la\\'. S"..,,, '" 0' alii'lllc,l alld ,"\",.111....1 l~t->- /2. . J'-. _"':.kl1L '" I'~~~l'"' ":1'UUf, /J 3RfJD, \./?~ 01 ~\ HC>\Jl;rlThII! IC. IhJl-t..Gi~J~. ~. 11< :IA</ ,,'ttl....(cl f:<<:' '/J7r....JJ..r.., ;1./ -~='-'~==--= ~ MARY C. LEWIS II"CIIII" l 0 ~ IlAc - 0 .~---- - Nil. 21 - 96 - 44] Estute III' ELEANOR G ItALLOCK . Deceused DEClum OF I)ROnATE AND GRANT OF LETTERS AND NOW JUNE 5, PI. 96 _, in co",idcraliun uf Ihc PCliliun un Ihe rcver,e sidc hercuf. ,ali,faclOry prouf h,,,'ing hcclI PIC'CIIICd hcfurc me. IT IS DECREED Ihal Ihe inmnmenl(') dmcIL_.__IieJUL23 ...J..9Ll de,cribed Ihercin bc admilled IU prubalc and filcd of record a' Ihc la'l ",iI\uf ELEANOR G HALLOCK TESTAMENTARY HOUGHTON ROSS HALLOCK .JR alld LCllcrs are hercby grnlllcd III )J;Zvu 1- rJ)/!, U~[) (] M J ~(1n.~ (L,. . ''U. R,ghlc,"r'\\,iII' f(Ja MARY C. LEWIS FEES Probalc, Lcllcrs. Ele. ......... Shorl CCrlificalc,(2) .......... ~:.IJ>ua"g~~iUn ................ JCP $.2OD.JlO_ $_6..0.0- $ $ 6.00 -5-;1>0- TOTAL _. $"*1-7-,00-- . . . . . . . ~~.N~ . ?'" .1. ~?6. . . . . . . . . . . . . . o\nORNH (Slip. Co. 1.11. No.1 .-\III1RI'SS Filed !'1I0NE 'D 't".( ~ r;: 'J " ~ C.L '<:' " a.. , 'I' z :.::J " (., U "J "" t: (\)0:: 0:: p, .5!! :l UU Mailed letters and order to Executor on 5-6-96. 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'cunIfY..a,"YIIC1ANI"..-~""~~......._..........,_I",~""",,,"""""""dl,.<I'i.....,..nlll v......."..,~...._..........MI...........I.......-.......... ....... .... ......... ............. " "'. lit PlAClOfIfUUA"",_W",.IlI.-.*"""oI"&'l -w.e -'" I'ol- ..1 ... " .,...,c. a "' _AHOCUll'"..a'"'SlQAHI....'_.........au.rog,.......oJ..."...."'...~.l~~ v........"..,................~II.."""...M.~pIICII.............c..-(.I~-..ll.II.. ..... ... SIO"IAl~1AHOll1l[OfctX' A I}l,,, fJrJtdlJ. ~-f' IIC[NSlNIJUIllA o.hIlGNlD!.......' [lI,.....1 L1l!L~l1U.n.I..'~a l ..... I" ^ ~- - 2 - "'....( AMJ~,fOl: l'lA$(JtolWtIOC9"'",n,r,CAU'iol Of p(AJH "~"",,,..~r,,. '" or.y ~. tV-lTUf/Ij Ilti) n hb III \W rLJIIt- I~ 11 Cu..\ O...U.lD,u....,lloI'-1 'MU)lCA&.llJ.MlMIM:CNWNIA 0.. the..... crI..~ IIIdIOf",,,.tI,.,toft."'ft'IJ opWotI. dlll"occuflld"lt'II 'MM, d.ll.'" plItl.1I'Id ..,.10"" tlUNll1 and '1&.---..11..................................................................,...................,................ AlQlSllUJ1l'.SlQNRURI ANO~ /7 j,},I.,J,/,1\ .. ~,~ 21 - 96 - 443 I I (')(') \ C(F" -n :ui\? =1 -'; l'. .' 0, ,!\O l .' ,""l n i= " ;', z .' , I ') W . . fJ . ' , -0 -' . i..i b (j; :0'- N ,::> ....::1 ~ W .;>: ..... ~... ..~ ? 1 - 96 - 443 l,~~'l '"Tll \,_' " ,.,'," c. ; _.1 ,;,:~, ~ ':. . . .'Ll: (1",.. I, l_L,',::r:,. ....ilC(,j:, ( ,:"t~. (I:" "l.p~'i~ :l:'~t ~t!Ltc of r(;1::r:.'~} ~/'\~l~ '~'J '. ( j;c)"r; ':. , '1, .~: . . ((;J '1. C Lh ~ E to b ( :r.:' 1 '\,~t . ....., ,', ~ .L: '1.~--'~: _E'E'trl.:~.(~it, ;.e rb,'. rovol:L::" :11J \"I'~]lR :l.na eodi{;~_1.G to ','.'l~j~ ~:C:-'i"ct.('.:"o:'c :.'t'.!( :';" :~.(;. ?T:-.S:~: I ~:.~1'(-ct. C!i'lt ~:,:J 'r:" .:,1~~t ::'(:_JLr '.l.rl'~ f~.ln('r~ll C:'~P('~12(-E 1)( f\:11,;1 ~!': r,GCn 'I ~t~'l' ::::" c1E-'~th ;"1.E pl':\Ctica:,]c. C;~ C'C ',"" '\]] ~~.. the 1"'(: t. t ~.,(,!? (, 1(- ':_~ 1'C;I,':1.';-I:1E'1" or eEt~~CJ '..'hc:tLc' l"'t~:.J "'c:'~or;'~!. O~' ::' :':C~.", t";:(!'(<:o(~v(r ::-, tu~).tL...l J 0';,"' ,,:!:' c::~ I c~j c ~C] Z(~.: ':~,;'Jlj ['c::rEr: ('--~J i-:hethel" acq'JlpcJ ;jE:'O~'C O)~ 'l:-'t.C'l- t;,( exec :t~C:i of t,.~[1 : 1J1, and any ::_~l'O'~E~,.t~.. to \,..:: ': ell j O>"'.:'.~' hI? c-nt i tl c(~ ~; li1('7 t'I,E- of 1!:Y Ctc'l,th, t.o, L't,LC1' i,..t:; '1' ',. lll~t:"([': ~"'!:tch T :.,'\Y ;:"t1;c 'n thE' €Et'~t.C of '1:::r O~:.I~l" 11Ct'Sf):1, t :;C': q::l !i!' '\n:~ !,rr.~~el't~,. OV€!"' \".'Lich ! :~::l:;' l:'_!.,;(; '1. rc','C!~ oJ' Q!lro~ :ltmcrlt. 01' T'O\"'l P of t.t?~t,:un€nt1.r",r (~~~:r'o~,~.tj---n, ! !-.0~"('h:~ ~-~V€, ;i(V~r:f: 'l.iLi lJc-:'JC::tth t.o :::' l~,'r"'n: cL~J.~r(-~1 to be eel E; '!'\']:' be t,.:cc n U',cr:. ~::-~:-~: At tiJr 1.';"( 0;' ~L( l:,:ceut!r,:1"j (If' tll'~; i,:.':' ~1'il1 J ;'.;' J' \'} n (.'1:" J 1'C:1 ,\},( C"',;.,'lC :.C.:.~ ~.;r" J G~C?:-:'.l',,::: "':,\iJ;'J~.s, ~:'.: .:l:.'.:.~"~ ~,.. l.\,", ~l.l1~' ,- \: ;:.5 ..;l:..~;;..~'EIl; ,,/\1] Cl.~"~. ...,. " I) CERTIFICATION OF NOTICE UNDER RlJlJE 5.6 ( a) Name of Decedent: EiJ.l:JG"" r ":Lr,~.':o:.{ (~ . Date of Death: M:IY ;)11,1 Q9fl Will No. 1996 - 0044:> Admin. No, 'q Qf.; - Of! t1..-~ 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 Sentember :;, 1996 Name HOlll',hton :<0'" E"llock,.Tr. Address Kennett, Dunclln !i,l]loc,: Geoffrey GNi(i in :',l:lloc~k I r,:.IJ. 4f)7111. JOutt: :~I;th -it. t h!'l: n!.~()n, VH o:')"n.. Jt.rne~l Bcrryh i 11 !~!~11ocr: :)?6;'S ?ri"~~lt.()n Lrln~). (:entf'~ Vnl1rP/, Pi.. l.qn:~~ 6h:~P Loc:;:~~in Emu! Drive. 3:)rin~r 'ltz '1?:~?q :~ t:rl;.':'lo:';f>r PI rk"':IJ'/. il~~t"'10rt. CT O~j..;..r) Notice has now been given to all persons entitled thereto under Rule 5.6(a). ~ Date: Sentcmber 3<, 1936 'I " l- I. ~., S'- tJ;: s&~" Address Name l:o'whton;t. L',lloc,:, .Tr. 'nJ IJ 4f/llJ~ JO!lth :)6th .. ..,)... J..~l i fl,.to n, Vi" ":':-:00 Telephone ( 70:-) ~;;1-:'Fl6t, Capacity: x .I Personal Representative Counsel for personal representative . -".\.111\11111...111 . Itl liE I IW'j'A'I'E OF I,:I.IWKJU (0. IIAI.ln~J\ I,A'I'E lW '1'111': 1l0UOUUII OF CN>IJ> III 1.1, , CLlNIII:UI/\NIl COUll'I'Y, I'IW/IIlYJNAlllA I'~;'J,^,I'E NO. 21-!Jr,-,14 J IN 'l'lm COUIl'I' OF COMMON PLEAS OF WUlEIU.J\ND mLlN'l'Y , PENNSYLVANIA OIlPIIANS' COUR'r DIVISION JlligJ..l!1., RELEASE AND WAIVER OF ACCOUNTING .. KNOW ALL HEll BY TilES::: l'RESEIlTS, that I,Geoffrey G. HallOCk, being one of tho bonoficiaries under the will of ELEIINOR G. H1ILLCX:K, do hereby acknowledgu th/lt 1 hnve received /Ill sums of money and property due me , by virtue of the death of F.LEI\N()R G. II1ILI1X:K , in full satisfaction and settlement of all of my rights and claims under lbOOI:/her estate. I further declare, intending to be legally bound, that I hereby waive my right to require the filing of a First and Final Account and Proposed Schedule of Distribution in any Court of Common Pleas having jurisdiction over the same, and I acknowledge that I have had an opportunity to examine copies of the books and records of the said estate, and I agree to_.the final dis~~ibution of the estate without further formalities, and with the same 'force and effect as if a First and Final Account and P~oposed Distribution had been filed in a Court of Common Pleas of Pennsylvania having jurisdiction over the same and duly audited and confirmed. AND TIIEREFORE, I,Geoffrey G. Hallocl; do by these presents, remise, roleaso, quitclaim and forever discharge thQ Executor, his heirs, Succussors and assigns, from the acts of the Executor as aforesaid, ,and of Ilnd from all actions, suits, payments, accounts, reckonings, , f ,I \ " . claims, and demands whatsoever, for or by reason thereof, or any other act, matter, cause or thing whatsoever, and I do hereby consent to the discharge of the said Executor. IN WITNESS WHEREOF, I have hereunto set my hand and seal the ;?~t1J day of F'phn,,,,'Y , 1997 " a,70l 7nllAuJ 7r..l'J. witness ~__ I " I) '_') ) ." , , J___ ,. ~. r '__'. 7;... /'....,.. , ......,>, ~.)... . --p~),_-^---, : NAME- Geoffrey G. Hallock, M.D. . . COMMONWEALTH OF PENNSYLVANIA: X.Ju~/L-- " 55: COUNTY OF On this, the d. L/- th day of f drU'-VLy-- , 199? , before me a Notary Public, the undersigned officer, personally appeared Geaf.frei ~.~~!:itc..~o me (or satisfactorily proven) to be the person whose name is subscribed to the within instrument and acknowledged that he executed the' same for the purposes therein contained. IN WITNESS WHEREOF, I have hereunto set my hand and seal the day and year first above written. &vn >>U''z.~ 't?,-c.cL Notary Public -2- tJolminl 5nal Ann M:I/i., Mini. NotAry PubliC CoOrj)f":blj~~ !:tHi' tf.:'IlIQh COIJnty ~,'l Ct'lII,n1,l,"'\~JI br-rr:!". /0011118.1999 }A;,tLaor """'tiMlrvw""~""''''''' nl r iol;l:l(1"l ut. \rel \ 1 (am. rul ... IN RE: ESTATE OF ELEIINOR G. HALLOCK LATE OF THE BOROUGH OF CAMP HILL , CUMBERIJ\ND COUNTY, PENNSYLVANIA ESTATE NO. 21-96-443 IN TilE COURT OF COMMON PLEAS OF ctJMBERIJ\ND COUNTY , PENNSYLVANIA ORPHANS' COURT DIVISION RECEIPT. RELEASE AND WAIVER OF ACCOUNTING KNOW ALL MEN BY THESE PRESENTS, that I, H.R.Hallock, Jr. , being one of the beneficiaries under the will of ELEIINOR G. HJ\LLOCK, do hereby acknowledge that I have received all sums of money and property due me by virtue of the death of ELEIINOR G. HJ\LI.CCK , in full satisfaction and settlement of all of my rights and claims under Xxkx/her estate. I further declare, intending to be legally bound, that I hereby waive my right to require the filing of a First and Final Account and Proposed Schedule of Distribution in any Court of Common Pleas having jurisdiction over the same, and I acknowledge that I have had an opportunity to examine copies of the books and records of the s~ic estate, and I agree to the final distribution of the estate without further formalities, and with the same force and effect as if a First and Final Account and Proposed Distribution had been filed in a Court of Common Pleas of Pennsylvania having jurisdiction over the same and duly audited and confirmed. AND THEREFORE, I, H.R.Hallock, Jr. , do by these presents, remise, release, ~~i.t~l~~m and forcv~:, ,~}.sctarga t~.- Executor, his l:sj'~~~1 successors and assigns, from the acts of the Executor as aforeseid, and of and from all actions, suits, payments, accounts, reckonings, ..l\ul' 1101..1 n1 IN RE: ESTNfE OF ELE1\NOR G. III\LLOCK LATE OF TilE DOROUGH OF CAMI' lULL , CUMJ3ERLIIND COUNTY, PENNSYLVANIA E5~TE NO. 21-96-443 IN TilE COURT OF COMMON PLEAS OF CUMDERLI\ND roUNT'i , PENNSYLVANIA ORPIIANS' COUR'f DIVISION RECEIPT. RELEASE AND WAIVER OF ACCOUNTING' ./ KNOW ALL MEN B'l THESE PRESENTS, that I, Jaxres B. Hallock , being one of the beneficiaries under the will of ELEl'INOR G. Hl\LlJXK' do hereby acknowledge that I have received all sums of money and property due me , by virtue of the death of ELEANOR G. Hl\LlJXK , in full satisfaction and settlement of all of my rights and claims under~/her estate. I further declare, intending to be legally bound, that I hereby waive my right to require the filing of a First and Final Account and proposed Schedule of Distribution in any Court of Common Pleas having jurisdiction over the same, and I acknowledge that I have had an opportunity to examine copies of the books and records of the said estate, and I agree to~.the final dis~;ibution of the estate without ..' further formalities, and with the same'force and effect as if a First " and Final Account and p~op'osed Distribution had been filed in a Court of Common pleas of pennsylvania having jurisdiction over the same and duly audited and confirmed. AND THEREFORE, I, Jarres B. Hallock, do by these presents, remise, release, quitclaim and forever discharge thr: Executor, his heirs, successors and assigns, from the acts of the Executor as aforesaid, and of and from all actions, suits, payments, accounts, reckonings, ., -. ~-- '" -- ut\nl\Uana.rol ./ IN RE: ESTATE OF ELFJ\NOR G. HALL<X:K LATE OF THE BOROUGH OF CAMP HILL , CUMBERLI\ND COUNTY, PENNSYLVANIA ESTATE NO. 21-96-443 IN THE COURT OF COMMON PLEAS OF CUMBERLI\ND roUNTY , PENNSYLVANIA ORPIUlliS' COURT DIVISION RECEIPT, RELEASE AND WAIVER OF ACCOUNTING KNOW ALL MEN BY THESE PRESENTS, that I, Kenneth D. Hallock, being one of the beneficiaries under the will of ELEANOR G. HALL<X:K, do hereby acknowledge that I have received all sums of money and property due me , by virtue of the death of ELEANOR G. IlALIJXK , in full satisfaction and settlement of all of my rights and claims under~/her estate. I further declare, intending to be legally bound, that I hereby waive my right to require the filing of a First and Final Account and Proposed Schedule of Distribution in any Court of Common Pleas having jurisdiction over the same, and I acknowledge that I have had an opportunity to examine copies of the books and records of the said estate, and I agree tO~,the final dis~~ibution of the estate without further formalities, and with the same 'force and effect as if a First and Final Account and p~oposed Distribution had been filed in a Court of Common Pleas of Pennsylvania having jurisdiction over the same and duly audited and confirmed. AND THEREFORE, I, Kenneth D. Hallock do by these presents, remise, release, quitclaim and forever discharge the, Executor, his heir.s, successors and assigns, from the acts of the Executor as aforesaid, and of and from all actions, suits, payments, accounts, reckonings, " claima, and demanda whatsoever, for or by reason thereof, or any other act, matter, cause or thing whatsoever, and I do hereby consent to the discharge of the said Executor. IN WITNESS WHEREOF, f/4. )'( day of Februarv I have hereunto set my hand and seal the , 1997. ~ LI2~.Jf'vn "lfltness ~;.4;lO&/{L-- NAME Kenneth D. Hallock t' . . . STATE OF TEXAS 55 : COUNTY OF f"I"v ~ lM.>M ,",l.. '/ , On this, the ?.,-tLday of F' c........u;r , 1997, before officer, personally appeared me a Notary Public, the undersigned , knc',':u to me (or satisfactorily proven) to be the person whose name is subscribed to the within instrument and acknowledged that he executed the same for the purposes therein contained. IN WITNESS WHEREOF, I have hereunto set my hand and seal the day and year first above written. ';:'.c-;h?_-:=~,,~;.,~-,-----~~pv::;v...;'il eP,'I"'~ MIClfAELD. WIU.J:"~'\Sj:,~ Notal)' PUbflC, &Ute c.f ! (;...;~ My CommiSsion EJ(ri:t'5 , NOVEMBER 25 1,~ -~.... , "'~"'I.>.v';,~ I). pi,,,,:;;.,,.~.r Notary Public -2- Il(V1!>OOO.I,q.&1 w ~ ~~cn ,-,,,,.. w"'-' :<;00 ,-,"'~ ..", .. '" I . . ., 15"- lOCo - ~t ,fOR OATIS OF DIAIH AnlR 12/31191 CHICKHIRI ,IF A SPOUSAL 'I POVlAty CRlDIlIS CLAIMID 1 I Fill NUMBIR I "1 COUNI'i' CODE \'JUllfljl.. (O"fPlt AJ.lO~I.'I' . 0 r l' S t iI r k I f~ a I l II C t' It It" r 71l1l \~allllll Illll.llllll Hllll<\ Carli,..)..., PA 171l1'l-'lhIJI) C"""'(CUUlhCC1UIIU'" ,,' --,.....--~-- ,ouu'" "" '''" l\tl"':'~("O"~________,__ II~:~~:~(\ .....).tG..,... COMMONW[AUH Of PINN!:I'HVAUIA OfPARTMfNT Of NIVltwl OEPI 280601 HA.RRI!lBU~_G.. PA "~2~ ObC1 I OfCfDlNT'!l NAMf ILA~T. III~' Atm l,l1[J(lll Itl11+A11 INHERITANCE TAX RETURN RESIDENT DECEDENT (TO BE FILED IN DUPLICATE WITH REGISTER OF WILLS) 1)11 YEAR 1I1,ld NUMBER ~ z w o w '-' w o IIALLO(:K, ELEANllH (;. ~ocIATlliuiiiyt~-U-M-Biit--_n -.- - - \UAII 01 OIAT" \tlATI 01 !1~1I1 555-12-2'lH2 S-2H-QIl Q-17-17 ".....""" w.." ;";,"',,,; ".., ,," ..,,,,,',. '"'' "",' !")(lM \lCU''''''''O''' 00 1. Original Return ] 2. SupplomenTal Return o 4. limiled E'lale [] 40 Fulufe Inlere,t Compromi,e liar dale' of dealh alter 12.12.821 [Xl 6. Decedenl Died Te'lale [] 7. Decedent Mainlained n living T ru,1 (Attach copy 01 Willi IAnach copy 01 Tru511 ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO. Remainder Return liar dale' 01 dealh prior 1012.13.82) Federal Ellal" To. Relurn Required r ] 3 115 Jl B T 010\ Numbef 01 Sofe Deposit 80...05 ,~ "'z Ww "'0 "'z tl~ COMPlE H MAtLl'lG AOOII(~!l .671A SOIlLh 36lh Stroot ~rl i ngloll, VA 22206-1725 __ .,~=~ =~=~~~'oo==,lO, (1) NONE (2)"NO.NE (J),NON.E. (41 NONE (5 )_~J!l' 3~').5) _~.IJ ,~ NAME H. H. lIallock. Jr. l(I(PHONE NUMBtA L202 I l)42-05(JH \C~ --.1 z o ;: :5 => ~ 0:: '" '-' w '" 1. Real e'lole (Schedule A) 2. sfoc~, and Bond. (Schedule 81 3. Cl05ely Held Sloc~/Porlnenhip Inlefel' (Schedule q 4. Mortgoge5 and Nole\ Receivable (Schedule 0) 5. C01h, Bank Oepolil5 & Mi5cellaneouI Perianal Property (Schedule E) 6. Joinlly Owned Property (Schedule F) 7. Iranll... ISchedule G)ISchedule II 9. TOlol Gran Aneh {lolallinel 1.71 9. Funeral Expen5lu. Admini51rolive Com. Miscellaneo..., E.pensel (Schedule H) 10. Debit. Mortgage liabililie5. lien, (Schedule I) 11. Total Deductions (totolline, Q & 10) 12. Net Value of Eslale (line 8 minU5 line 11) 13. Charitable and Governmentol 8equelh (Schedule JI 14. Net Value Subiect 10 Tax (line 12 minu\ line 131 15. Spou5al Tran,fen {for dale' of dealh aher 6.30.94) See In,lruetionl for Ar,plicoble Percentage on Revene Side. (Indude value, rom Schedule K or Schedule M.l 16. Amount of line 14 taxable at 6% role (Indude value, horn Schedule K or Schedule M.) 17. Amount of line 14 taxable at 15% role (Include values from Schedule K or Schedule M.) 18. Principal tax due {Add tax from lines 15, 16 and 17.) 19. Credits Spousal Poverly Credil Prior Payments -~._-----~--_._-_.- + + :.u , \,J -'! 16)~_NONl,-____ 17) .-$_.4 ~J,. 58,3..19_ :... t.) 1 B I _I~_..l11_L94 2.1..2 (9) _$..13 ,2!1..(t..2tL___ (101. $-. --5'L1..13 ----. (II) __$_13_..293...41 (l21_~__U4.149.31 (131 .Jillt:lJL___- (14) S 1!4, 149.31 (151 __.__X._._..= (16) S 114,14<),31 x .06 = _$_. __ !l LIi 4 B .Jl..CJ._ ~ _ .__ (17) ,__,.__X .15 = z o ;:: '" ~ " .. lE o '-' >< '" ~ Di"ount Inlere,1 (I B) S .0,848.90------ (lQI .-------- (20) .-.-.--- 1211 $ 6,B4H.96 (21A) (21BI S 6. 8/d3. 96 20. II Une 19 j, greater than line 18. enler the difference on line 20. Thi5 j, Ihe OVERPAYMENT. a O'''':T11,..[.H,.I'''I'I'.'U'.(.J'IIIJ'IIII:~fll"l'l":"r.lI':'J"TI.I'I.'l'J'U~'~"I.111 21. If line 18 is greater thon line 19, enler the difference on line 21. This i5 the TAX DUE. A. Enler Ihe inlere5t on lho balance due on line 21 A 8. Enter the tOlal of line 21 and 21A on line 218. Thi5 i, Ihe BALANCE DUE. Mah Chick Payobl. 10: R.gl'te~ o~. Willi, Agent _"'n__ ~ ~ BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SiDE ANO-TO-RECiiECKMATH ~...c. -------- Under penaltie, 01 perjury. 1 doclare lhat 1 hove ollomined this return. including accompanying Hhedulcs and 51alemenh. and 10 lht' bt'I' 01 my ~nowlcdge and beliel, it is true, correct and complele. I declare ,hol all real e\loh) hen been reported nltrue mar~el value Declaration 01 preporer o!hcr than thl' p.."onal representative is ba5ed on 011 informalion 01 which preparer hm any ~nowledge :G~^o:~~t'lJZ~(i:\,,"G'''U''i-~'~r;117'tA S. ';r.th St.. l\rlin~\L()n, VA 222011 ~:~\I. 27~,-;;~l)Z~ ~,6L"l~f omlt, OTI111 I'OAN IlPtl~HjTATI"'1 "Dr'~l~" I'AII 1I'o11Wllli UITI \ SCHEDULE E CASH, BANK DEPOSITS AND MISCELLANEOUS PERSONAL PROPERTY \- ,,~:J~~I\ _...'tj1u; COMMONWlAUH Of 'lNHSVlVANIA INHIIITANCI fAX .nUIN IU10lNf DICIDINf Ploa,o PrI!'t or Typo FilE NUMBER 21 (lh-041.3 ESTATE OF 1\1,I;ANOR G. HALI.OCt: (AU pfOplfty lolntlY.oOWned with the Right of SUfvlvouhlp mull be diu loud ~h.dule F) VALUE AT DATE OF DEATH ITEM NUMBER DESCRIPTION A. LIQUID ASSI;TS 91. h9 $ $ 5,958.81 1. Cosh 2. Checking AccoUllt No. 1013-3HhO (Stlltemellt Attllched Douphill Deposit Bonk and Trust CompllllY 3045 Market Street Camp lIi11, PA 17011 3. Certificates of Deposit (See Attached Copies) Dauphin Deposit Balik (Address above) $ 40,160.66 $ 1,079.81 $ 25,415.11 Certificate No. 8100049831 (Interest MOllthly) Certificate No. 8t00056161 (Interest Monthly) Certificate No. 8140131482 (Interest at Maturity) B. RECEIPTS $ 1,000.00 1. Refund 011 dowllpayment to Nursillg 1I0me (Green Ridge Village, Newville, PA) $ 138.05 2. Internal Revellue Servious (Adjusted Refund Received on 1995 Income Taxes (U.S.)) $ 352.65 3. Refulld on Cancelled lIealth Insurallce Policy (Capital Blue Cross/Pellllsy1vania Blue Shield) $ 503.62 4. Refulld of Prepaid Charges for Nursillg 1I0me (Forest Park lIealth Cellter) $ 273.83 5. Other Refullded Receivables C. MISCELLANEOUS PROPI;RTY I. Clothing $ $ $ 449.45 100.00 430.00 (a) Sold 011 COllsigllment (Rag Patch Boutique) (b) COllsiglled Items Unsold (I;stimated Value) (c) DOllated to Charity by COllsigllmellt Shop (Contillued Next Page) TOTAL (Aba onlor on Ii no 5, Roca i1ulatian) S (Attach additional 8YJ" )( \1" ,heels if mote 'pate i\ needed.) ll~lMlII.IJlT) SCHEDULE E CASH, BANK DEPOSITS AND MISCELLANEOUS PERSONAL PROPERTY Ploa.o Print or T 0 filE NUMBER 21<J!J-0443 rfj~ COMMONWfAlfH Of PENN~ytVANIA INHEIITANCI TAX IUUIN US1DENT DECEDENT ESTATE Of I\I.EANOR G. IIALI.OCK (All propert., lolntl.,-owned with the Right of Survlvor.hlp mu.t be dl.clo.ed on Schedule f) VALUE AT DATE OF DEATH ITEM NUMBER DESCRIPTION C. (C IIt'd) 2. 1I0usehold Goods alld Furllishillgs (a) Lamp and other Small Items Sold Directly to Purchaser (b) Sold at Auction (lIaar's IlIc.) $ $ 75.00 505.55 3. Miscellaneous Valuables (Books, Prillts, Jewelry, Art alld Decorative Objects) (a) Asian Art and Decorative Objects sold $ 770.00 Directly to Purchaser (b) Sold on COllsignment (Collsignmellt Gallery, $ 585.30 Camp lIill, pA) (c) Unsold Items Remaining on Consigllmellt $ 400.00 (Estimated Value) 4. Property in Decedent's possession (Forest Park Health Center) (a) Miscellaneous Clothing (Estimated Value) (b) Charm Bracelet alld Few Items of Costume Jewelry (Estimated Value) (c) Personal Effects $ $ 50.00 20.00 -0- .." , ." TOTAL (AI.o ontor on Ii no 5, Rocap1tulation) S < (Altach additional BY," )( 11" ,heets if more .pate i. ne.ded.) ..,Fli.\lli.\lIQlJl,lllQlJl,llJl,llli.\lJQlJl.\lJ/.ll.ll.llJ/.ll.ll.ll 810004983-1 ," j(.\I""'l<.>/j(.\Il<.>/IQ/J<.lI\<-"\<-"lI.)Ij(;,Ij(.\I\t:,/1 .-- NON:NEGOTIAIILE I Nor~ TnANSrEnAIILE @DAUPHIN DEPOSIT BANK -- CE~T;;ICATE OF DEPOSIT.. ~~.~_~VANIA' DEPOSIlOIJtSI ElEANOR G. (WJ1XJ< 555~12:~~~?,~_ '-'".'1''' ....~.. AOOIJESS 114 NOVENBER DR., # 5 'lA'; [JU'OS.T[Utfll",S IJA"K CANP HIll, PA 17011 OAUPHIN 40000 :!,-, '~, 0 0 {--~,., MEMReR .Dle TEL 730-9301 D E.I' 0 S ; l I,.: 0: .~, " ~. " $140,000.00 @DAUPHIN DEPOSIT BANK ~~~.~VANIA' OEPOSITOIJISI ELFANOR G. HAllOCK AOORESS 114 NOVENBER DR., AYf.# 5 OOIP HIll, PA 17011 MEMBER'DleTEL 730-9301 ISSUE I[HM OF DATE CERTIFICATE ; I 05/31/94 27 months ~ 0 SINGLE MATURlTV CeRTIfiCATE E 2 XI AUTOMATICAllY REN[WAlll[ C[RnnCATt ~ ISSUE T[FlM or DATE CERTlFlCATL: ; 05/18/94 27 months * \ 0 SINGLE MATURITY CEIHlflCATE E I 9 ! KJ AUTOMAtICALLY Il[t4(WAt!ll Cnl1lnCAl[ > I ~ MAlURlTV ItJITIAL DATE It~l[n[ST rlAl[ ------ 08/31/96 5.25% snAtK11 IVI'[ 014 827 l~"WLST "AiMlE 0 MAIL CHECK :(XW1IHIH.'t 0 S[MI.At~NLJAlLV 0 CAPITALIZED {J OUAIHCPLY g ~:~~f~~~~~T't' X>::REOIT AGel NO 1 n-111R6.::0- nrm t.~PtlorJ AMOUNT ",,,,,,,nl7[o ~ I't.M~~ I flnsl ~-;I(ilj.\1lJlH _ __ l~l _ _L~ a~ooo~qa~m~. q I: 50 ~ smODOO': ,.____:1 NON-NEGOTIABLE I NON TRANSFERABLE CERTIFICATE OF DEPOSIT 810005616-1 555-12-2382 l&".""l"~.".'" ,."..,.., .....~., $11,000.00 ~ HA', D[POSITEO It,,! THIS BAtJK MAlUllllY I If~111:\1 ~l---- ____I~.'ll,l..T I't.YAOll 0 MI\lL CHECK DAlE ~~~~~_~~lll.\~ j 'll'nfl!"'V 0 Sf;MI.AUfllJALlV l7'I CAPITALIZED j 1.--'. 0 AWJUAllV N 08/18/96 5.25% lJ ()"AnTl n" XXATI.IMUnnV 0 CnEDll ACCT "0 BIlAtJGlt ! I'd [ n[Il[Mf'llor~ AMOutH . O~~;::.~::oo,~~!~':;:~~o 5" I ~i~~S~4 . ."- " ;'::.:::. . ' "\' ~ ~ ~ !z 0 J: :J !:: 0 ~ :2 <t -' <t ;:: II: W 11: II: W :J a: ~ :;) ~ C) z ijj (!) II: Vi W w :2 w w 12 b -' ~ 1Il a. :J 0 (,) :0 w tz :;) o ~ w ~ o W II: :J ~ Z C) Vi II: W :2 o ti :J U W II: :J ~ Z (!) Vi w w >- 9 a. w :2 ~ o ::;~'":.~. ,: ,.,.S'.: .~-n.. t- ~ o ::; <t w a: :J ~ Z C) Vi a: w :0 12 1Il :J U w a: ::J ~ ~ (!) iii w w >- o -' a. ::; w ~'-. . z o ;:: a. ::; w o w a: -' =" ~ li: lftw , ~ z (!) - -- II: ~ f"1 ti w :J ~ U 0 '-"" Fidelity A Investments' New Account Profile September 08, 1995, ;" ~f--l!. ?,(~: U.' !~ ( C.s, \ _ Cu.lomer Acco~ull1ber, . '; ':. "r; -,i~ Tt091544tt - {,till/I": I 'c, ,. _,', '/ ~j\J 'iLJi\-, ,/.., .-;-L)~/.'('~. f , This form summarize. lhe illformatiol1 we have 011 lIIe about your accoun!. Please review it cmefully alld, iI allY accounl ownerohip informalioll is Inaccurale, make changes 011 the Correcllolls 10 Your Accounl COUPOII provided or coli Mutual Fund Account Asslslllnce at 800.544.6666, Account OwnershIp .kwlt N.lm. ELEANOR G HALLOCK H R HALLOCK JR ,!;o,:.u/~'I1,1J,,'1Ttoe, 555.12.2382 450.68.0405 o.l~e 01 at'" . -,... 4671 A SOUTH 36TH ST ARLINGTON VA 22206 [U'l"'g '''01'1. 202.942.0568 COlJflt'yolC"....OI'IA~p U.SA U'S.A~ D.I,,~OO'!. r\ 703.931-2864 (J ": ' . A'IlI' tndlclll. any COfl'etlOnl on ttle Couechonllo Your AccounllOlm mc~ded ",.tt IhI. '~e" Accourc Prol.e Account SetuD Account Number Type of Ownership Dividends and Capital Gains Checkwrillno MoneyLine Bank Wire Aulamatlc Accounl Builder Syslematic Withdrawal Plan Fldelllv Cash Reserves 055.0519432942 Jolnl WROS Reinvest all divide lids and copilal !lains in my accoun!. If elecled, you will receive your checkbook within 3 weeks, II elected, effective wilhin 20 days. II elecled, available immediately. If elected, effeclive Within 20 days. If elecled, you con make periodic wllhdrawals from your accoun!. . - . . . . - - . . - . . . - . - - . - - . - - - . - - - . - - . . - - . - . - - - . ~ - - - - . - - - . . . - - - . . - . - - - . - . . . - - - - . . . - - . . . Correcllons to Your Account SocialSecurityfTax 10 Number: Dale of Birth: All owners must sign lhls coupon if changes are required. LW W LLLU W W W . Jolnl Name: SoclalSecurityfTax 10 Number: Dale of Birth: LWWLLLU WWW Address: Fidelity Oiltributor. CorporOltion 095090e 0002 01003469 City: Slale: Zip: W Ul..liJ Dayllme Phone: ls1 Citizenship: LW LLLJ LLLU LlLLULJ Evemng Phone: 211d Clllzel1sh,p 11_,,,,,,,: LW LLLJ LLLU LlLLULJ Owner's SlglMture 2nd Owner's Signature I' App"':\bIe) : I I I I 1.1111,1.1...1.1111I11.11111.1111,1111.11.,1.111.11,1111..1.11 FIDELITY INVESTMENTS PO 80X 770001 CINCINNATI OH 45277-0002 11111111il7 . i , ; , . i I 1 i I I ! ., ~ 6 ! ~ 5 oS C .~ li :! II;; 1:: o Q, CII a: .. c CII E .. 1/1 CII > C - <0 '" '" - 11>' - ~ ::! ~~~ CO.... <0 ~~~ "'666 "000 iJcococo 8 }j .!!l .. ::I 0'" 8 .!llij .~ ~c: eX cll:8 ." ~g ~& Eo.E .. 8- ClUC~ ~~!~~ <0 '" '" - <0- - ~ ~ ~ j ~ w l- ll: <1)<0 8 jE~ -Ja:f.ON </..,M< :r:lI:jE> Cl8:JZ II:-JO~ O</.<I)Cl ~:r:~i!; ...Ja:,....~ w:r~ct - - - ... ... .... ~ ... '" o ... l- oa c :s I&. - Cll :s .. :s ~ Q. :r rJl a: o > :;; a: :J rJl U. o ~ J: !:2 a: :; ~ . .! ! J N II> N o '" ... a: -, ~ o o ..J ..J < J: a: J: o Z < ~ o o ..J ..J ~ Cl a: o z < W ..J W ! 'c d: 1 ~ co '" u> ... ... ... ~ I 1/1 CI E o U I: - 0'" - c: ... " !!:!2 a ,~ 1-0 ......OCQC) NOO),.. NcDcD~' 11>-... M."!. ... "'M _ 11>' II> ... ~ <0 - "II> ~ ".. ~~ ~... lVa E:l E.. ~o ~: Cl) III :I:J lU ca en 'a f: II ..>.!!.-3 c g>>; ,S !: :I '- ~ llJ D'I o 2 -t; CJ) c U 'en:; a:a u"s:..cc: croo;>oow i~ ~ .'" "l 0- ... U:ii ." s:, ~ ~ '" N ... '" N ~ '" - II> ~ II> o .. " 2: " .. " II: ..c III .. .. 1:0 '- ~ '1:1- o~ Xu:: l~ '" ~.. ~ -. M ~~ I:l ~5 .... .n ... !~ - 'i_ "f >.. N ~_ II> ~5 C'1.. J;Z ... 01 0 ~- !:! !=i_ d ~ II 0 I. :!! 0", . _M 51:!.. - II> '8 'C 8- . ;S 2;- '$ 11 ~ = 'i . '" c :g .e ~ g s " I .! III - .- Cll .. CII Q c o .- .. U Cll III C ~ .. .. ~ ~ .:= Q.I u ~ C\I - 11:"... - '" ." .eN c: .. M tf 8~ ~ rfj :II ~.U:o I :! ! .. N N II> M. ;z ... N '0 .. a ~ s j "'0'" "f!:!"! 0<0<0 M_.. NNN ... . M . j I. 8 cE 0000 ~C!C!C! .............,... ... j 0000 .....cnOcn C\fC'fqc.q NOCDCD ll)M.....,... MNNN ;Z- <?- - -0_ .. 0 .. " .. " ~ .. ~ '- 'tJ.- 0'1 II) 'iij Q.I c:1I:n.1I: '2 lU dl .5 E iJ E Cl8"8 "c:..c c: 00_0_ ~ (0""''''''0 T-M"'M t?0l~~ " Ily"UII.ll.Jl 9:..1~'~ ~WII~ SCHEDULE II FIINEHA!. EXPENSES, AllflINISTH,\TIVE COSTS ANIl ,HlSCI::LLANIWUS I::XI'!iliSI':S_ Ploa.aPrln'ar~y~-" FILE NUMBER 21 (lll-O/./,:l (OIolIolQl......IAllHOf ",,14\11._11'/1. I,.HI'I,,,,.(I ,...,llll/1I1 '1\1(JIIlIIlHIOlt,1 ---c ---' ESTATE OF ELEANOH G. IIA!.!.OCK ----....-----..------------ - --_.' --._._.._.._--_.-._._-_.-_.~. .. .__.._ n__.___.____ .---...------------ ITEM NUMBER DESCRIPTION AMOUNT --_.---- -..---------- A. Fllnerlll EXpCIISCH: s 6,218.00 1. Hyers-lInrncr Fllncrnl lIomc, Inc. 6,596.60 2. IIl1rrisbllrg Cemetery Assoclntioll (IlIterment, lIack Care and Elldowment) s II. Admillistrativc Costs: 1. PersOllnl Represcntative CommissiollS Social Sccurity Numbcr of I'ersollal Hepreselltativcs: Year Commision Paid 2. Attorney Fees 3. Family Exemption Claimant Address of Claimant Street Address City Rclatiollship at decedent's death Statc Zip Code 4. Probate Fees Register of Wills (Cllmberlalld County) $ 217.00 C. Hiscellaneous Expellses: 1,6.28 1. Hailing Costs S $ S 65.00 31. 92 2. Telefax and Photo C~pyillg 3. Typing 20.48 4. LOllg Ilistallce I'holle Charges $ 5. Register of Wills (Rules of Orphalls' Court) s 5.00 .-- - .._-- -......- ". -- ._- -_.~- TOTAL (Aho enter on line 9. Recapitulation) S_I~,-200. 28 {II mom spoct! j, needed. insert addi'ional ~hee's of some ,izld , \. '1'l1\lll1'i'lIIll~:ioloi"(J. 1)<, .' (\ .. .~ (OIrll....ONWI..thIOI PHlN\ll'''''''''. lNtll'ltAN(lIU'l!UIU '''lOIft! 01C10m1 \ SCHEDULE I \ DEBTS OF DECEDENT, l MORTGAGE LIABILITIES AND LIENS J Ploa.. "Print !'Ir T_yp. FILE NUMBER 219(,-0443 -- --.....-----......-. ESTATE OF ELEANOR G. "ALLOCK -----.---------------- ._--_.__.__._--------_._-----------_.~---- AMOUNT ITEM NUMBER DESCRIPTION -- --- $ 303.50 1. HediclIl Expellses $ 102.52 2. Prescriptioll Drugs $ 115.66 3. Internol Revellue Service (Adjusted Amount Due on 1994 IlIcome Tnx) 4. Reimbursemellt for Purchase of Persollol Items (". R. "allock, Jr.) $ 71.45 TorAL (Also enler on I;ne 10. Recopilulolionl (" more space is needed, insert addifional sheets of some size.} $ 593. t 3 IY'/(( '/ BUREAU OF INDIVIDUAL TAXES INIl[RIUNC[ I". DIVISION Drpr. :.ObOl ItARAISBURC, PA 1l1"..ObDI COHHONWEALTH OF PENNSYLVANIA DEPARTHENT OF REVENUE NOTICE OF INNERITANCE TAX APPRAISEHENT. ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSHENT OF TAX H R HALLOCK JR 4671A S 36TH ST ARLINGTON DATE ESTATE OF DATE OF DEATH FILE NUHBER COUNTY ACN 05-12-97 IlALLOCK 05-28-96 21 96-0443 CUMBERLAND 101 VA 22206 Anount Renltt.d *' .1t.1'" 1111' IU-", ELEANOR G MAKE CHECK PAYABLE AND REHIT PAYHENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ RiV:i5('-i"Eif-AFi;-io:f:97Y"N(jTicEUliF--iNHEiiiTAtiCE-~r"AX"'A"PPRiiisE'ilENi'-;-AL'i.-liWAtiCE-olimmmu------ DISALLOWANCE OF DEDUCTIONS AND ASSESSHENT OF TAX ESTATE OF HALLOCK ELEANOR G FILE NO. 21 96-0443 ACN 101 DATE 05-12-97 APPROVED DEDUCTIONS AND EXEHPTIONS: 13,200.28 9. Funeral ExpensBs/Adn. Costs/Hisc. Expenses (Schedule H) (9) 10. Debts/Hartgogo UoblllUos/Uens (Schodule II 1101 593.13 11. Total Deductions (11) 12. N.t Value of Tax R.turn (12) 13. Charitable/Governnent.l aequasts (Schedule J) (13) 14. Not Voluo of Estoto Subjoct to To. 1141 NOTE: If an assessment was issued previously, lines 14, 15 and/or 16, 17 and 18 will reflect figures that include the total of ~ returns assessed to date. ASSESSHENT OF TAX: 15. Anount of lin. 14 at Spousal 1&. Anount of line 14 taxable at 17. Anount of line 14 taxabl. at 18. Principal Tax DUB TAX RETURN WAS: (X I ACCEPTED AS FILED CHANGED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. R..I Est.t. (Schedule Al 2. Stocks and Bonds (Schedule B) 3. Closely Hald stock/Partnership Interest ISchedule CJ 4. Hortgagas/Notes Receivable ISchadule DJ 5. Cash/Bank Daposits/Hisc. Parsonal Property ISchedule EJ 6. Jointly Owned Property (Schedule F) 7. Transfars ISchadule GJ 8. Total Assets III (21 (31 141 151 1&1 171 .00 .00 .00 .00 78.359.53 .00 49 ,583.19 IBI rat. Lineal/Class A rat. Collataral/Class B rate .00 114.149.31 .00 X .00= X .06= X .15= 1181 lISl 11&1 1171 TAX CREDITS: PAYHENT DATE 02-28-97 DISCOUNT (+1 INTEREST/PEN PAID I-I .00 RECEIPT NUHBER AA185224 AHOUNT PAID 6.848.96 TOTAL TAX CREDIT BALANCE OF TAX DUEl INTEREST AND PEN. TOTAL DUE NOTE: To insura propar cr.dit to your account, subnit the uppar portion of this forn with your tax paynant. 127.942.72 B.H3 41 114,149.31 .00 114.149,31 .00 6.848.96 ,00 6,848.96 6,848.96 .00 ,00 ,00 . IF PAID AFTER DATE INDICATED. SEE REVERSE FOR CALCULATIDN OF ADDITIONAL INTEREST. IF TOTAL DUE IS LESS THAN $1. ND PAYHENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" ICRI, YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS,I ., ,', ,-! ~'-' RESERVATION: [,tat.. of dec.dant. dying on or b.'ot. oac..bar 11, l~aZ .. If any lutur. Int.r..t In the a.tat. I. tran.f.rrad In pOlle,.lon or enJoy..nt to Cia.. B (collelarnll baneflclarle. of the dacadant aftar the a.pit.tlon of any ..tat. for Ilf. or for y..r., the Co..onwa.llh hateby ..pr..sly t...tva. the right to 8ppral.. and .1'." tran.f.r Inherltanca 'a... at the lawful Clal. 8 lcollatarall rata on any such future Int.r..t. PURPOSE OF HOTICE: PAV"EHT I REFUND (CRJI OBJECTIONS: ADMIN ISTRATI\lE CORREClIONS: DISCOUNT: PENAllY; INTEREST: 10 fulfill the requlr...nt. of Sactlon 11~O of the Inheritance and [,tat. la. Act, Act 11 of l~qS. (71 P.S. Section 914tOJ. O.tach the too portion of thl. Natle. and tubalt with your pay.ent to the P.glst.r of Wills prlnt.d on the r.v.rs. sid.. "Halo. ch.ck or eon.y ord.r paYllbl. tal REGISTER or MILLS, AGENT A r.fund of a tax cr.dlt, which was not r.quast.d on the Yax R.turn, .ay ba r.qu..t.d by co.pl.ting an ~Appllc.tlon for R.fund of P.nnsylvanla Inh.rltanc. and [.tat. 'a.~ (R[Y-151!1. Applications ar. avall.bl. at the Offlca of the R.gllt.r of Willi, IIny of the Zl R.v.nu. Ol.trlct Offlc.., or by calling the .p.cial Z4'hour 8n.warlng .arvlc. nu.b.r. for for.. ordarlng: In P.nn.ylvanla 1'800'162'Z050, outlld. p.nn.ylvanla end within local Harrllburg ar.a (111) 181-8094, IDDI (111) 11l-2lS2 (Haarlng I.palr.d Only). Any party In Int.ra.t not satl,fl.d with the .ppral....nt. allowanc. or dJ,allowanc. of d.ductlon.. or .I......nt of ta. (Including discount or Int.r'ltl G' shown on thl. Notlc. 'Ult objact within .I.ty (60) day. of r.c.lpt of this Notice by: "wrltt.n prot..t to the PA Oapllrt.ant of Rev.nu., Board of App.als. Dapt. Z81021. Harrisburg, PA I1IZ8'1021. OR "al.ctlon to have the .attar d.taraln.d at .udlt of the account of the par.onal r.pr...ntatlv.. OR '-app.al to tha Orphans" Court. Factual arror. dlscovar.d on thl. 1I.......nt should b. addr....d In writing tal PA D.part..nt of A.v.nu.. Bur.au of Individual Ta.as, ATTNI POlt Ass.....nt R.vl.w Unit, Dapt. 280601, Harrl.burg. PA 111:8-0601 Phon. (711) 187-650S. Sa. page \ of the bookl.t -In.tructlon. for Inh.ritanc. 'ax Raturn for a R..id.nt D.c.d.nt- (AEY'1501) for an ..plan.tlon 0' .d.Inl.tratlv.ly corr.ctabla .rror.. If any tax due I. paid within thr.. (51 cal.ndar eonths a,ter the d.c.dant'. d.ath. a flv. p.rc.nt IS~) discount of the tax paid I. .llowad. Yha IS~ tax aana.ty non'partlclpatlon p.nalty I. coeput.d on the total of the ta. and Int.r.st ....s..d. .nd not p.ld b.fore J.nuary 18, 1996. the flr.t day .ftar the .nd of the tax a.n..ty p.rlod. 'hi. non-participation p.nalty I. apP'alabl. In the .fta. .annar and In the the sae. tl.. p.rlod a. YOU would app.al the tax and Int.r..t that ha. be.n .......d a. Indicat.d on this not Ie.. Intar..t Is charged baglnnlng with flr.t day of dallnquency. or nln. (9) eonthi and on. (I) dfty froe thl data of d.ath. to the data of ply.lnt. fa.ls which bac.ea dallnqu.nt b.for. January I. 1982 baar Int.r..t .t the rat. of .Ix (6~) perc.nt par nnnue calcul.tld at a dally rat. of .000164. All ta.a. which blcn.a dlllnqu.nt on and aftar Janu.ry 1, 1982 will blar Inter..t at II rat, which will vary fro. clIlandar year to cal.ndar yaar with th.t r.t. .nnouncad by tha PA D.part.ent of Ravonu.. Ih. appllcabl. Inl.r.,t r.t.s for 198Z through 1991 .r.: ~ tnhrnt Alii. Dally Intarnt FAclor ~ Inl.r.st RAI. Dlllly Inhrllt F'lIclor 1982 ZU .000548 19111 9l .000Z41 19U 16;( .000438 1988-1991 III .000101 19114 11" .000501 199Z .~ .000Z41 1911S In .OOOJ~6 1995-1994 ,~ .000192 1986 lU .000Z14 199~-1991 "' .000Z41 --tnt.re.t Is calcul.ted .. follow.: INTEREST = BALANCE or TAX UNPAID X NUNBER or DAYS DELINQUENT X DAILY INTEREST rACTOR ~-Any Notlc. 1,lu.d after thl ta. bacoea. d.linqu.nt will r"I.ct an Int.r..t c.lcul.tlon to flll..n (I~) d.y. b.yond the dote of thl a.sa.se.nt. II pay.ant is ..d. IIftar the Int.ra.t cOIPutatlon data shown on the Notice, Addltlon.1 Int.rest eust b. calcul.ted. In aUllt.., T' ~ophone: L ~ ...., :.. .... ',' _ .....a-.a:... ii&Hmtl l"..~l/.." I UEQUf.STED $16)0 --+ - " ' - ~.." POST OFFICE TO ADDRESSEE 1-x~ "f(EMS~ .------. I I , I I I I ih.. ~I;':J.~,:":' j"'. '. , _TlONAI. SHaPMENTB 0Nt. Y >'.1, ..". ,.. .41 i " f , I , , I I I I 0____ -. o ~.dM Cul1DmI fl:wq .., """""""'-may ..- See NJ 273 ancI IntemlDon&! Mal ~ WA,IV(R or SIGt4ATUfl[ lOoole~bC Only) I ....,\" oolr~ery 10 be ",..1l'0 ...."tloul Obla,mnq Tho M~n..1lur~ althe itt1<.1,t'~\l'o Ot!ho UlMrt'5~I'O !lllq!'"! I" In lt~ Judgement nlthl' d(lh~ory omplOyco, Tho ftrl.clo can be let! lfl a s~(;uro lix"ll{m) and I dUIl'ouzo IIII' dl'h~f)I.,. Cml\loy'H! 10 S''I" Ihallho 'h.pm...nt ....as dl'l'~ercd .,nd ul1oJl"Sldnd tha! fT10 s,gn,llu", 01 Tho OOb~Pry ..mployt'o w.11 COf1Slltu!o ~a'K1 ploof 01 dchcry NO DElIV(R", - . W!'FH.Hm HOIIOA,,,, C"'I.""...!,.r;.I....lI . ILAnn 1I11'>~J4 For Pickup or Tracking Call 1-800-222-1811 ,.- ...--.-.........-- .......-...~ _--fl..T..~" STATUS REPORT UNDER RULE 6.12 Name of Decedent: Eleanor- G. Hallock Date of Death: /olav 28, 1996 Will No. 1996-00443 Admin. No. 2196-0443 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: Yes X No 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: 3, If the answer to No.1 is Yes, state the following: a. Did the personal representative file a final account with the Court? Yes No X ()() . Cr.". 1(1 b, The separate Orphans' Court No;' (l.f any) the personal representative's account is: :::1 for, c. account informally ~ Did the personal representative stat~ an to the parties in interest? Yes X wNo :1 d, Copies of receipts, releases, joinders and ". \.. approvals of formal or informal accounts may be filed w~h the-- Cerk of the Orphans' Court and may be attached to this report. ~t\r\ ,I \(JLl(l~ Signature ' Date: February 20, 1997 " R_ HCll1ork. ,1r. Name (Please type or print) 4671A S. 36th St., Arlinqton, VA 22206 Address ( 202) 942-0568 Tel. No, Capacity: X Personal Representative (MAli: rmfl AM3) Counsel for personal representative