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PETITION FOR PR08A TE and GRANT OF LETTERS
J' 'Ir... f., '/1
Estate of ~labl'l '.:. Buxton
also known as
No,
To:
Register of Wills for the
Deceased. County of ('lIl1lhnt"'l ~tl(l In the
Social Security No. 204 - 30- G Y 2 ~ Commonwenlth of Pennsylvania
The petition of the undersigned respectfully represents that:
Your petitioner(s), who is/arc 18 years of age or older an the execu1nr
in the last will of the above decedent, dated
and eodicil(s) dated Novembe r 28. 1 Y Y 5
~I"y (,
named
, 19.25-
Decendent was domiciled at death in Cumberland County, Pennsylvania, with
/1pr last family or principal residence at Church of Gm! NlIrsing Ilnmr>
ROT Nnr~h ll"nm'r>r C;t'rr>r>t', ('"r1is11' Pl'nn"l.T"~n;" ,,^,';I' .,,'.,t!!,....,.
(list Slf"'. number and muncipalilY)
(uatc relevant circumstances. e.l. renunciation. death or executor. etc.)
Decendent, then 101 y~ars of age, died AuClus t G.
at C:"rlislr>, Cl1mbr>rl"nd County. Pennsv1v"ni"
Except as follows. decedent did not marry, was not divorced and did not have a child born or adopted
after execution of the will offered for probate; was not the victim of a killing and was never adjudicated
incompetent:
Decendent at death owned propeny with estimated values as follows:
(If domiciled in Pa.) All personal propeny
(If not domiciled in Pa.) Personal propeny in Pennsylvania
(If not domiciled in Pa.) Personal propeny in County
Vnlue of real estate in Pennsylvania
situated as follows:
,1996
$ no.OOO.OO
$
$
$
WHEREFORE, petitioner(s) respectfully requesl(s) the probate of the last will and codicii(s)
presented herewith and the grant of letters t'"" t' "ID"n t'" rl'
(lesulInentatyj administration c.t.a.; administration d.b.n.c:.t.a.)
theron.
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Stephen Hinana
lO/South 14arket Square
. Harrisburq. PA 17101
OATH OF PERSONAL REPRESENTATIVE
COMMONWEALTH OF PENNSYLVANIA } ss
COUNTY OF -CIlMTlFRT ^Nn
The petitioner(s) above-named swear(s) or aflirm(s) that the statements in the foregoing petition are
true and correct to the best of the ~nowledge and belief of petitioner(s) and that as personal represen-
tative(s) of the above decedent petitioner(s) will well and truly administer the estate according to law.
Sworn to ~r affirme~ and subscribed { ~1E['~ 13.:::
before me Ihls i._.'. _ day of ~I ~.. .
.. ~-';).~ 19~ DY. ,'c. ./
'1>1" "6 l'_. :;:".., s~ .. "n"
? i.,,_ t' P, ',.. ,.\. Reliister
r'
No. ?1-ljC,-C,71
Estate of
~iilh(!l E.Bu>:t:nn
, Deceased
DECREE OF PROBATE AND GRANT- OF LETTERS
and Lelters
are hereby granted to
AND NOW ^IJGll~;'I' 2 7 19~, In consideration of the petition on
the reverse side hereof, satisfactory proof having been presented before me,
IT IS DECREED that the instrumem(s) dated ~l^ y C,. 19 q 4 W It.I" Nav. 2 R , 19 l) '> roc 1('1 L
described therein be admitted to probate and filed of record as the last will of
Mah"'l F:.Ruxtnn
'rOH t a man tc.1 rv
M"'llnn Hank
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, {. it '-<.. L)...' - .: ~l"'(ll,-L(i
Re&i.ler or ww/ (J
FEES
Probate, Lelters, Etc. ......... S200. 00
Shon Cenlficates( 5) ... .. .. ... S 1 'i . 0 0
cnd i~.i 1 S 10.50
KenUnC3.Con ................
X-P!I'l'.!!'l S IH. /)11
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TOTAL _ S248. 50
Filed ..... ..l\.I[GWi:'"..?~ ,~.'!~)5.........
.JQ..\M.e.~ O. flow~ ~(". ),771./;1.
ATIORNEY ISup. Ct. 1.0. No.)
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ADDRESS
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"'''pll 'WII.I.,'llIlXTllN.WII.
3Ensl lItH nub Wtslntntul
OF
MABEL E. BUXTON
I, MABEL E. BUXTON, of 3251 Butler Street, Harrisburg, Dauphin County,
Pennsylvania, being of sound and disposing mind, memory and understanding, do make,
publish and declare this as and for my Last Will and Testament, hereby revoking and
making void any and all former Wills, Codicils, or writings In the nature thereof, by me at
any time heretofore made.
FIRST: I hereby order and direct my Executor, hereinafter named, to
pay all my Just debts, funeral expenses, testamentary expenses and all Inheritance,
Estate, Transfer and Succession Taxes, as soon as may be conveniently done after my
death, out of my residuary estate.
SECOND: 1 make the following specific bequests:
A. I give the sum of Five Thousand ($5,000.00) Dollars to MR. AND
MRS. DANIEL M. RICKER, of 10B paxtang Avenue, Harrisburg, Pennsylvania 17111;
B. I give the sum of Five Thousand ($5,000.00) Dollars to DR. AND
MRS. HERBERT E. HALLIDAY, of 545 Wilson Street, Carlisle, Pennsylvania 17013;
C. I give the sum of Ten Thousand ($10,000.00) Dollars to MR. AND
MRS. RICHARD DOLAN, of 410 East Market Street, Williamstown, Pennsylvania 1709B; I
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COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
ss
I, MABEL E. BUXTON, Testatrix, whose name is signed to the attached or foregoing
Instrument, having been duly qualified according to law, do hereby acknowledge that J signed and
executed the Instrument as a First Codicil to my Last Will; 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 MABEL E. BUXTON, the Testatrix,
. '''~-th
this ~ U day of November, 1995, at Carlisle, Pennsylvania.
~ tl/cl.i ((! J3.-u..i-'CtJ7~l..
Mabel E. Buxton, Testatrix
L;}f"1 if, >~l~L~~
Notary u lie
NOTARIoIl.SEAI.
MERlENE MARHEVI(.t, Nell." 1'1llIi:
Cllillo, CuImoIIandColl1y, p~
lIyComm_E....&M8
2
\.
SUMMARY OF ACCOUNT
PAGES
PRINCIPAL
Receipts 3 $ 98,316.68
Net Gain on Sales or Disposition 4 3.60
$ 98,320.28
Less Disbursements:
Debts of Decedent 5 $ 77.56
Funeral Expenses 5 255.50
Administration - Misc. Exp. 5-6 423.16
Federal State & Local Taxes 6 10,327.48
Fees and Commissions 7 7.423.00 -18.506.70
Balance before Distributions $ 79,813.58
Distributions to Beneficiaries 8 -35.150.00
Principal Balance on Hand 9 $ 44,663.58
INCOME
Receipts 10-12 $ 3,380.89
Less Disbursements 13 -163.92
Balance before Distributions $ 3.216.97
Income Balance on Hand 14 $ 3,216.97
COMBINED BALANCE ON HAND
$
47,880.55
================
304-4bn pIs
- 2 -
PRINCIPAL RECEIPTS
INVENTORY FILED
Assets listed in INVENTORY per copy attached
$
95,643.86
SUBSEOUENT RECEIPTS
08/21/96 Deposits made by decedent in
checking account at Mellon Bank
acct. #112-202-5545 prior to death,
credited after date of death
$
10.45
08/21/96 The following is an after
discovered asset determined to be part
of the Estate: Jewelry
09/19/96 Proceeds received from Paine Webber
Acct. #36602
Value
Undetermined
2,662.37
TOTAL PRINCIPAL RECEIPTS
$
98,316.68
===============
304-4bn pIs
- 3 -
, .
DISBURSEMENTS OF PRINCIPAL (cont'd)
FORWARD
ADMINISTRATION - MISC. EXPENSES (cont'd)
$
383.16 $
Reoister of Wills. cost of
Drobate. filino fees. short
ctfs.. etc.
10/18/96
11/21/96
05/06/97
08/27/97
$
6.00
6.00
15.00
13.00
40.00
FEDERAL STATE & LOCAL TAXES
Reoister of Wills. Pa. inheritance
W
10/31/96
05/06/97
$
8,550.00
1.777.48
.'''''-~-~-'
333.06
423.16
10,327.48
FORWARD
$
11,083.70
304-4bn pIs
- 6 -
PRINCIPAL BALANCE ON HAND
CASH (AUTOMATICALLY INVESTED)
FIDUCIARY
VALUE AT ACQUISITION
10/31/97 VALUE
$ 44,663.58 $ 44,663.58
$ 44,663.58 $ 44,663.58
TOTAL PRINCIPAL BALANCE ON HAND
================ ================
Note: The above cash is currently
invested in Short Term
Obligations
,
,
304-4bn pIs
- 9 -
RECEIPTS OF INCOME (cont'dl
FORWARD
$
Miscellaneous (cont'dl
Interest on Income cash
balances and other various short Term
Demand Investments
(cont'dl
10/03/97
Interest on princioal
cash balances and other various Short
Term Demand Investments
09/05/96 $
10/03/96
11/05/96
12/05/96
01/06/97
02/05/97
03/05/97
04/03/97
05/05/97
06/04/97
07/03/97
08/05/97
09/04/97
FORWARD
$
304-4bn pIs
- 11 -
68.90 $
260.24
12.25
81.15
0.22
112.03
328.18
362.73
246.46
223.72
200.37
221.93
216.49
222.83
218.49
231. 74
231.09
2,816.28 $ 341.39
INCOME BALANCE ON HAND
CASH (AUTOMATICALLY INVESTED)
FIDUCIARY
VALUE AT ACQUISITION
10/31/97 VALUE
$ 3,216.97 $ 3,216.97
$ 3,216.97 $ 3,216.97
TOTAL INCOME BALANCE ON HAND
================ ================
Note: The above cash is currently
invested in Short Term
Obligations
304-4bn pls
- 14 -
. .
. .
. .
INCOME
Balance for Distribution $3,216.97
Beneficiary Share Amount
Mr. and Mrs. Daniel M. Ricker One-tenth 321.69
Dr. and Mrs. Herbert E. Halliday One-tenth 321.69
Mr. and Mrs. Richard Dolan One-tenth 321.69
Karin Wlestllng One-tenth 321.70
Michael Dolan One-tenth 321.70
Tracie Sully One-tenth 321.70
Betty Genovese One-tenth 321.70
The Church of God One-tenth 321.70
The Salvation Army One-tenth 321.70
Bethesda Mission One-tenth 321.70
. '
. .
COURT OF COMMON PLEAS OF CUMBERLAND COUNTY. PA.
ORPHANS' COURT DIVISION
NO. 1996-lXI671
FOR THE ESTATE OF MABEL E. BUXTON. DECEASED
(#J04-4BNI
SCHEDULE OF DISTRIBUTION
PRINCIPAL
Balance for Distribution
$44,663.58
Beneficiary Share Amount
Mr. and Mrs. Daniel M. Ricker One-tenth 4.466.36
Dr. and Mrs. Herbert E. Halliday One-tenth 4,466.38
Mr. and Mrs. Richard Dolan One-tenth 4,466.36
Karin Wiestllng One-tenth 4,468.36
Michael Dolan One-tenth 4.466.36
Tracie Sully One-tenth 4.466.36
Belly Genovese One-tenth 4,466.36
The Church of God One-tenth 4,466.36
The Salvation Army One-tenth 4,466.35
Bethesda Mission One-tenth 4,466.35
.
.
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.
. .
.
. .
INVENTORY FOR THE ESTATE OF
Mabel Buxton
Who Died on 08/06/96
~========================c==================================================ac
Mutual Funds
1,054.329 Units Franklin Penn Tax Free
Income Trust Fund; NoL.
@ 10.35
$
10,912.3~
10 Units Muni Sr 023 Inv Tr Fund
PAi N.L.
@ 361. 24
-.
12 Units Muni Sr 04B Inv Tr Fund
Multi st PAi N.L.
@ 1,027.49
1,688 Units Muniyield Penn Fundi NoLo
@ 14.125
47? Units Nuveen PA ~nvt Qual Muni
Fundi N.L.
@ 16.625
,
.i
!
66 Units Nuveen Sr 206 Tx Ex Uns
PA MtlYi NoL.
@ 43.41
Paine Webber Cash Fundi
@ 1.00
Miscellaneous
Balance in decedent's
Residence account
FORWARD
25.04
150.00
128.40
8.26
2,713.00
20.00
$ 67,103.53
Personal Property,
appraised @
Prescription refund from
Federal Employee Program
Refund from Bell Atlantic
Refund from Church of God Horne
Refund'of deposit for
telephone
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Nabal Buxton
Who Died on 08/06/96
.
. ,INVENTOR'l
. .
aaa=a=============a===Q========a=============================================c
FORWARD
$
67,103.53
~
Cash found in decedent's residence
Corestates Bank Savings
AICI 0034067295
Interest accrued .to 08/06/96
Mellon Bank Checking Alc
# 112-202-5545
Interest accrued to 08/06/96
-.
TOTAL PRINCIPAL RECEIPTS
$
===============
0" 0
- 2 -
,!},'-e -1.1,.)/- ?r'o - OW?I
COMMONWEALTH OF PENNSYLVANIA
OFFICE OF ATTORNEY GENERAL
MIKE FISHER
ATTORNEY GENERAL
January 7, 1998
Charitable Trusts and
Organizations Section
21 S. 12th Street, 3rd Floor
Philadelphia, PA 19107-3603
Telephone: (215) 560-2402
Fax: (215) 560-2202
James Do Flower, Jr., Esquire
Flower Morgenthal Flower & Lindsay
11 East High Street
Carlisle, PA 17013-3016
Re: Estate of Mabel E. Buxton, Deceased
Dear Mr. Flower:
Receipt is acknOWledged of your letter regarding the
charitable gifts in the above matter.
I have reviewed the Account and other materials submitted
and, on behalf of the Attorney General as parens patriae for
charities, would advise you that this Office is without objection
to confirmation of the Account as stated.
<"
l-'~;
yours,
, ..\
':.) ~ ;
Lawrence Barth
Deputy Attorney General
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Mellon Bank
I'll 110\ -;-"'~I!I
l'htl,ldl'lpIU;t, 1',\ 1!111I1 ';~!~I
May 5, 1997
Register of Wills
Cumberland County Courthouse
1 Courthouse Square
Carlisle PA 17013-3387
Re: Estate of Mabel E Buxton
Died 8-6-96
File No. 21-96-0671
Ladies and Gcntlemen:
As Executor of the above named estate, we file herewith 2 copies of the Pennsylvania
Inheritance Tax Return. Also, we have enclosed checks for the balance of inheritance tax
due, $1,777.48, and the $15.00 filing fec.
Please send us your oflicial receipt.
Very Tmly Yours,
~~c..-I ,b C;J(.JfL
Robert G Chase
Senior Estate Tax Oflicer
(215)553-0308
cc: Steven C Minana, Assistant Vice President
Mollon Prlvato Assot Managomont
III S4IlIlh MUlk,'1 SIIIU""
I'll BIlll. Wilt
1I11rrbhllf~, I'A 171mHIIIII
(iI7) :.!:ll.j.!lirIOHll't'
(717) :!:II.lir,llll ~)IX
October 17, 1996
Sue Krcn
Register of Wills
Cumberland County Courthouse
Room 102
One Courthouse Square
Carlisle, PA 17013
Dear Ms. Kren:
Enclosed plcase find a check payable to the Register of Wills in the amount of$6.00 for
two short certificates forthe Estate of Mabel E. Buxton, No. 1996-00671. Also enclosed
is self-addressed postage paid envelope to my attention for your convenience.
Thank you for your assistance,
Sincerely,
Martha H. Heil
Senior Trust Specialist
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tiff. Mellon Bank
Detach Ind Rltaln thl. Statement For Your necord. V!.!I
TRUST AND INVESTMENT DEPARTMENT CHECK NO: 0000096216
" .. ;
.1.."-;'_" ..~
304-4BN
Olte: 10/17/98
Amount: $6000
LEGAL COSTS PER STATEMENT OATEO 10/17/98
CHECK NUMBER 0??oo98218 PAYABLE
TO REGISTER OF WILLS
10/17/98
$8.00
MELLON BANK. N.A.
TRANSACTION NO. 01180
:i~lffi,!;:-3...~'\;2:n:rll;;-y!t-i1V:~,:~i:";,,:ir-~i;' :l1 :,:;.:.:: ~ir_-n__!" _-;O-'_:l .. :",~. t,il T:":-jT"__n.,;':J:':'i: i ~;.lt~'.~ r "-_i ~;~:n:'J.-r;;i 1:,-;, '_'i r-~I!'_11:~F-:;.i.V:iFjt;.;ir:-JlSB',::.T;i'r,,"':T\.E;:TISli-it',
37
'f.\-U~TMiJoll.~EGOTIABLE
MARTHA HElL
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',. ,l~'.'. f
,- '-f..,J- I
!" .
{ !
..\
r fa. f~
'oJ
:. ~... ~.. , )0
-<
'..
'1
of_ ..'
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.. ~ '.'\
~ 4', ~ .
..
.
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.' ,
"
f. '?-
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'j J
t'
"
\. " ~.
't. ~
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.._-'
-~.~-,..
to.- r.....
t. -\
.........-.
........~.
7=:
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~
.
I '. I; l 'j '/
INHERITANCE TAX RETURN ~~~~lm~~~FDH~MmR 12/31/91
RESIDENT DECEDENT POVERTY cnEDIT IS CLAIMED
ca....aNw'ALI"a"''''''''A''A (TO BE FILED IN DUPLICATE FILE NUMBER
U(IIAIUMUH or IltV(NU[ 21 1996
"AI""'I~~:;~.~~~~~:".on'" WITH REGISTER OF WILLS) COUNTY CODE YEAR
DECEDENrS NAME (LAST, FlnST, AND MIDDLE INITIAL) DECEDENrS COMPLETE ADDRESS
Buxton, M.loo1 E 801 North Hanover Street
SOCIAL SECURITY NUMDER DATE OF DEATH DATE OF DIRTH Cadisle PA 17013
DECEDENT 204 -30-6927 08/06/96 02/28/1095 CaUIlI CUmberland
lor Al'l'lICAULL/'UllVIVoNO 'I'UU"." NA"LILA". SOCIAL SECURITY NUMBER AMOUNT RECEIVED (SEE INSTRUCTIONS)
'1115' ANn MID JL[ INITIAL)
D 40. Futuro Inlofosl Comprom5o
(lor dalo. 01 doalh allor 12-12-02)
06. Decodont Dlod TostOlo 0 7. Decodent Mamtainod a Uving Trust
(Allach copy 01 Will) (AIIach copy 01 Tru,ll
ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
NAME COMPLETE MAILING ADDRESS
Mallon Bank N.A., Executor Attn: Robert G Chase
TELEPHONE NUMBER P.O. Box 7899 RM 193-0224
(215)553-0308 Philadel hia PA 19101
1, Roal EOIato (Schodulo A) ( 1 ) None
2. Slacks and Bonds (Schodulo B) ( 2 ) 64 , 058 . 83
3. ClosolV Hold Slock/PaMllorship Intoros' (Sch. C) ( 3 ) None
4. Mongago. and NOIOS Rocoivablo (Schodulo D) ( 4 ) None
5. Cash. Bank Doposlls & Mlscollanoous Porsonol (5) 31,585.03
Proporty (Schodulo E)
O. Jolnllv Ownod Proporty (Schodulo F)
7. Translors (Schodulo G) (Schodulo L)
O. Tolol Gross Assots (Iotal Unos 1-7)
9. Funeral Expansos, Administrativo Costs,
Miscollanoous Exponsos (Schodulo H)
10. DobIS, Mongago Uabllilios, Uons (Schodulo I)
11. Total Doductions (Iotal Unos 9 & 10)
12. Not Valuo 01 ESlato (Uno 0 minus Uno 11)
13. Charitablo and Govornmonlal BoquO.ls (Schodulo J)
14. Not Valuo Sub oct 10 Tax (Uno 12 minus Uno 13)
15. Spouul r,,,nsl,,, (for dAle, ot duth .lIer 6-30.94'. See
In'truthans tor Apphc.lble Pe,tentAge on Pol;e 2. {InClude
vollues trom Schedule K or Schedule M.I
16. Amount of Uno 14 taxablo at 6% ralo
(Includo valuos from Schodulo K or Schodulo M.)
17. Amount 01 Uno 14 taxablo at 15% ralo
(Includo valuos from Schodulo K or Schodulo M.)
18. Principal lax duo (Add tax Irom Unos 15, 16 and 17.)
19. Crodits 5pouUl Poverty Credll Prior Payments Discount
+ 8,550.00+ 450.00-
20. "Uno 191s . roalor than Uno 10, onlor tho dllloronco on Uno 20. This is Iho OVERPAYMENT.
A. Chock ho",1I au aro ro uoatfn a rotund cl our oVo a ont
21, If Uno 18 Is groalor than Uno 19, enler tho dlfferenco on Uno 21, This i31ho TAX DUE.
A. Enter tho Intorest on tho balanco duo on Uno 21A.
B. Enlo. tho lotol 01 Uno 21 and 21A on Uno 21B. This islho BALANCE DUE.
Mako Chock Po obla to: Roglstor 01 Will.. Agent
.. .. BE SURE TO ANSWER ALL QUESTIONS ON PAGE 2 AND TO RECHECK MATH" ..
Under penalties 01 porJury, I doclare that I have oxamined thIS roturn, includmg accompanYing schodulos and statemenls. and 10 the bosl of rrrf knowledge
and boliol, it Is truD, carroet and complete. I doclaro lhat all roal estalo has boon reporfed at tiUD markot value. Declaration 01 prcparer other than the personal
roprosontativQ is basod on alllnlormation 01 which preparor has any knowledgo.
SIQr4ATURE OF PERSONftESPON$lolE FOR Fl.llNG RETURN ADDRESS
oJIG/WI}(( fiLL/If
SIGNATURE OF PRE PARER OTHDfm~~~'EPRESENTATlVE
nU~T OFFICER
PA15001 NTF llllP9
ft (, '; f'
.fteV-UOO[Jl;II'-1J41
1. Original Return
CHECK
APPRO-
PRIATE
BLOCKS
o 4. UmJiod Eslolo
CORRES-
PONDENT
RECAPIT-
ULA TION
TAX
COMPUTA-
TION
ADDRESS
COPyright Forma SoftWAre Only, 1994 Nelco, Ine. N94PAoOl
f
C
0671
NUMBER
3. Remamder Rorurn
(lor d.lu ot dulh pllor to 12-13-121
o 5. Foderal Estale Tax Return Roqulrod
...Q.. O. Tala' Number 01 SaiD DopoSlt Boxos
( 6)
(7 )
None
None
(0 )
95,643.86
(9 )
7,923.66
(10)
77.56
(11)
(12)
(13)
8,001.22
87,642.64
15,792078
(14)
71,849.86
(15)
x .
=
(16)
o . 00 x .06 =
0.00
(17)
71,849.86 x .15 =
10,777.48
(IB)
10,777.48
Interost
(19)
(20)
9,000.00
(21)
(21A)
(21Bl
1,777.48
0.00
1,777.48
OAA'PR f 8 1997
DATE
0 >..
, .!
',", i-J
L"YJ
I
~.:
ro-
c:, . ~;\ - .)
0: .. GO
RE'J.!!lOlUtt4-11l1
COMMONW[ALTtl OF "[NN5YLVAN'A
INmRlTAN~[ TAil A[TUHN
IU:iIO[NT DCCEOENT
SCHEDULE B
STOCKS AND BONDS
ESTATE OF
FILE NUMBER
MaOOl E Buxton
(All property Jolntlv-owned with Right 01 Survivorship must be disclosed on Schedule F.)
ITEM
NO,
21-1996-0671
DESCRIPTION
VALUE AT DATE
OF DEATH
1 1,054.329 shs Franklin Penn Tax Free Income Trust Fund; N.L. @
10.35
10,912.31
2 1,688 shs MuniYield Penn Fund; N.L. @ 14.125
3 475 shs Nuveen Pa Invt Qual Muni Fd; N.L. @ 16.625
23,843.00
7,896,88
4 12 units Muni Sr 04B Inv Tr Fd Multi St Pal N.L. @ 1,027.49
12,329088
5 10 units Muni Sr 023 Inv Tr Fd PAl N.L. @ 361.24
6 66 units Nuveen Sr 206 Tx EX Una PA Mtly; N.L. @ 43.41
7 Paine Webber Cash Fund; N.L. @ 1.00
3,612.40
2,865.06
2,599.30
TOTAL (Also onlor on lino 2. ROCDpilulDllon)
(II mora spaco Is noodod, Insert additional shoots of sarno silO.)
$
64,058.83
PA15031 NTF 1212
Copyright Forms SoHwar. Only. 189" Nelco,lnc. N94PA031
CoroStalos Bank. N A
PO Do. 7616
P~!ladOlphla PA 19101.1i118
~
Octobcr 23. 1996
Core States
Bank
Manha H. Hcil
Scnior Trust Spccialist
Mcllon Privatc Assct Managcmcnt
10 South Markct Strcct
P.O. Box 1010
Harrisburg, PA 17108-1010
RE: Estate of: Mabel E. Buxton
Datc of Dcalh: August 6. 1996
Dear Manha Heil:
In response to your leltcr. please be advised that the deccdcnt hcld the following account(s) with our bank:
ACCOUNT #
ACCOUNT TITLE
DATE
OPENED
DATE
CLOSED PRINCIPAL
ACCR.
lliL
Savings 0034067295
Mabel E. Buxton
10/29/87
20,939.74
23.25
I trust that we have been of assistance to you in this mailer.
Sincerely,
CORESTATES BANK, N.A.
.J)ufl,n j{1bllle 1&
Brian K. Harvey
BHlhb/045
IN REPLY REFER TO:
REPORTING SERVICES
Fe 6-90-3-235
PO BOX 1102
READING. PA 19603
610-655-3353 .
9497112.94'
c:\...p) I \..ilb\",hitt .cBS
COMMONWEALTH OF PENNSYLVANIA
'.
COUNTY OF CUMBERLAND
ss
,
" MABEL E. BUXTON, Testatrix, whose name is signed to the attached or foregoing
Instrument, having been duly qualified according to law, do hereby acknowledge that J signed and
executed the instrument as a First Codicil to my Last Will; tt)at 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 MABEL E. BUXTON, the Testatrix,
~:~h
this
day of November, 1995, at Carlisle, Pennsylvania.
14 rJd F J3 .~C7Tt-
Mabel Eo Buxton, Testatrix
ln~ (f,br~L~J
Notary Pu he
NOTARIoIl.5EAL
MERlENE MARHEVI(.t, Nclttr NlI'c
Cllillo.CunatVdColl1y.p~
lIyCommilticnEmm&M8
2
c. ,.,.11 \\\1I.LSUltlXTON, Wll.
11LClst JlIill ClUD QrtStClUUnl
OF
MABEL E. BUXTON
I, MABEL E. BUXTON, of 3251 Butler Street, Harrisburg, Dauphin County,
Pennsylvania, being of sound and disposing mind, memory and understanding, do make,
publish and declare this as and for my Last Will and Testament, hereby revoking and
making void any and all former Wills, Codicils, or writings in the nature thereof, by me at
any time heretofore madeo
FIRST: I hereby order and direct my Executor, hereinafter named, to
pay all my just debts, funeral expenses, testamentary expenses and all Inheritance,
Estate, Transfer and Succession Taxes, as soon as may be conveniently done after my
death, out of my residuary estate,
SECOND: I make the following specific bequests:
A. I give the sum of Five Thousand ($5,000.00) Dollars to MR. AND
MRS. DANIEL M. RICKER, of 10B Paxlang Avenue, Harrisburg, Pennsylvania 17111;
B. I give the sum of Five Thousand ($5,000.00) Dollars to DR. AND
MRS. HERBERT E. HALUDAY, of 545 Wilson Street, Carlisle, Pennsylvania 17013;
C. I give the sum of Ten Thousand ($10,000.00) Dollars to MR. AND
MRS. RICHARD DOLAN, of 410 East Market Street, Williamstown, Pennsylvania 1709B;
j.
c. \WI'II\W1I....UIU1CTOH.WII.
D, I give the sum of Five Thousand ($5,000.00) Dollars to KARIN
WIESTLlNG, of P. O. Box 321. Herndon, Pennsylvania 17830;
E. I give the sum of Five Thousand ($5,000.00) Dollars to MICHAEL
DOLAN, of 410 East Market Street, Willlamstown, pennsylvania 17098.
THIRD: All the rest, residue and remainder of my estate I give to the
following in equal shares:
A. To MR. AND MRS. DANIEL M. RICKER, of 108 paxtang Avenue,
Harrisburg, Pennsylvania 17111;
Bo To DR. AND MRS. HERBERT HALLIDAY, of 545 Wilson Street,
Carlisle, Pennsylvania 17013;
Co To MR. AND MRS. RICHARD DOLAN, of 410 East Market Street,
Williamstown, pennsylvania 17098;
D. To KARIN WIESTLlNG, of Po O. Box 321, Herndon, Pennsylvania
17830;
Eo To MICHAEL DOLAN, of 410 East Market Street, Williamstown.
pennsylvania 17098;
F. To MR. AND MRS. JIM STOLL, of 1235 South 20th Street,
Harrisburg, pennsylvania.
Go To TRACIE SULLY, of 219 East Locust Street, Mechanicsburg,
Pennsylvania 17055.
2
0:'...11 IWlIJ.\UIUXTOtl. WlI.
H. To BETTY GENOVESE, of 7802 Selgrave Road, Baltimore, Maryland
21207,
I. To THE CHURCH OF GOD, 2733 Canby Street, Penbrook,
Pennsylvania.
J, To THE SALVATION ARMY, of 1122 Green Street, Harrisburg,
pennsylvania.
K. To BETHESDA MISSION, 611 Reily Street, Harrisburg, Pennsylvaniao
LASTLY: I nominate, constitute and appoint the MELLON BANK, of
Harrisburg, Pennsylvania, to be the Executor of this my Last Will and Testament. No
executor shall be required to file bond in this or any other jurisdiction,
IN WITNESS WHEREOF, I have hereunto set my hand and seel this
(-tu.
'M-u
. f. .._~.r t. (!, ~<+ {n'...-
Mabel E. Buxton
day of
,1994.
SIGNED, SEALED, PUBUSHED and
DECLARED In the presence of:
3
-......-..
1rv.IWII(.""
146896 COMMONWEALTH OF PENNSYLVANIA
DlPARTMENT Of REVENUE
OfFICIAL RECEIPT · PENNSYLVANIA INHERITANCE AND ESTATE TAX
'*
DNo.AA
RECEIVED FROM:
i
ACN
ASSESSMENT P:'
CONTROL ...
NUMBER
AMOUNT
MELLON BANK
10 SOUTH MARKET SQUARE
101
$1:1,5::>0.00
latDHII!
HARRISBURG, PA 17101
ESTATE INFORMATION:
~ FilE NUMBER
Y 21-1996-0671
1:'1 NAME OF DECEDENT (lAST)
~ BUXTON MABEL E
II DATE OF PAYMENT
B POSTMARK T
COUNTY
SSN 204-30-6927
(FIRST) (MI)
CUMBERLAND
DATE OF DEATH
j
i
11
REGISTER OF WILLS
m TOTAL AMOUNT PAID '8.000. 00
CW !
RECEIVED BY 'h'&; /IV /J.L. J " / ..:;>t'~'i
7 SIGiqy.. , I
MARY Co LEIJi s ~ J1;,IV AJ,/I'r:
REGISTER OF WILLS . :
REMARKS
MELLON BANK
SEAL
CHECK# 0000096558
. --- --- ----;------.-
~'
"
,
.
'j, .
......
-t
-'- --
---I -~ ..-.
._~~. - - , ,~
COMMm~W[AlTH or f1EUNSYlVANlA
DEPAIHM[NT or REVENUE
BUREAU OF INDIVIDUAL TAXES
OEPT 280601
ftAnnlSOUnG. PA 17128.0601
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
*~'
~
.. .
NO. AA211277
Il[V.1162 EX ftt'96)
RECEIVED FROM:
I
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
MELLON BANK N A
ATTNI ROBERT G CHASE
POBOX 7899 RM 193-0224
PHILADELPHIA, PA 19101
101
:$1, 777 . loa-
FOI.DtlER(
rOlD HfRE
ESTATE INFORMATION:
FilE NUMBER
-IQQI.d)1.71
NAME or DECEDENT ILASTI
q5N 2('''-3C1-1.<;I2-/
IrlRSTI
IMI}
-BUU.lJN MABE'IP E"
DATE OF PAYMENT ..".:
5/.08/9,::/ .
POSTMARK DATE / .'
S/.Ob~7' .
COUNTY
-CUl'IDEl'iLANn
DATE OF DEATH .~
"
,~ "",
"
,.~~
:
-
- .-
-' ::
TOTAL AMOUNT PAID
$1,777.48
-MAm C, lBNIS. Rf:lgfmer of Wills:
REMARKS MELLON BANK N A ..' .....
ATTN I HOBERT'G CHASE
SEAiJ:HECKII (0299a,,"""
lH.iJ _ ; ;..H ';-JF ',',,-ILL'=.)
RECEIVED BY
MARY C. LEWIS
REGISTER OF WILLS
.--------.--. --.-----.- -.- ._---
...- - - --.... _.. - ~ '" - ---~_.
....---.-- -----------,---'
" .
\' ",
~, .
~'
:'
....
,-
,
.---
- .".,..-
~ -' ~.
-....:
,
~ -._ .--.;o---""'.M.
;'"
)':....
/.5'_/;'7,-:/ - 7
BUREAU Of INDIVIDUAL TAKES
I ""'" I lANt I r,,~ 111111 ~III"
utllT. ,'110,,01
'I"WIII SIIIJIIG , II' Ill.'" 01,01
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
(~
(\. ...
...~ ',X; ~
~..."' ''L''/:
,'~~,'~~'.'f:;, '\"'~
r'r'~~,':.t
'.1:;'}.'.",'c.,,:,
II, ,.11'1"':11/)
MABEL
PA 19101
~-.---A;;~~nT-R-;'~i-tt;.d----~
-_",~.",,-,,_c=--c",c"_=-..;_"O....:..'--'_7.-;;.-o1
E
MAKE CMECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
CUT ALONG THIS LINE .. RETAIN LOWER PORTION FOR YOUR RECORDS .....
R-Eii:isi;j-EX.-AFP--ioj-:97i--NO;ricE--OF-i-NHER-iiAN-CE.Tiix-iipPRA-isEiiENT~--AL1-oWANiCE-o.R----_..._-_._----
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF BUXTON MABEL E FILE NOo 21 96-0671 ACN 101 DATE 08-18-97
If an assessment was issued previously, lines 14, 15 and/or 16. 17 and 18 will
reflect figures that include the total of ALL returns assessed to date.
ASSESSMENT OF TAX:
IS. Anount of line 14 at Spousal ~8t. CIS)
16. Anount of Line 14 taxable at Lineal/Class A rat. 116)
17. Anount of Lin. 14 taxable at Collateral/Class 8 rat. (17)
18. Principal Tax DUB
TAX CREDITS:
PAVHENT I
DATE
11-01-96
05-06-97
ImllCI Of INllIRI1AtlCl TAK
AflPRA15ll1lNT. ALlOWANC[ ON DISAllOWANCE
or IllDUCTIONS ^NO ASS[S5t1[NT or TAX
ROBERT G CHASE
MELLotl BANK NA
PO BOX 7899
PHILA
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
08-18-97
BUXTOtl
08-06-96
21 96-0671
CUMBERLAtlD
101
TAK RETURN WAS: I X I ACCEPTED AS FILED
CHANGED
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Real Estate lSchedule AJ (1)
2. Stocks and Bonds (Schedule OJ 121
3. Closely Held stock/Partnership Inter8st (Schedule CI (3)
4. Hortgages/Notes Receivable ISchedule DJ (4)
5, Cash/Bank Deposits/Hisc. Personal Property (Schedule EJ 15)
b. Jointly Owned Property (Schedule F>> (6)
7. Transfers (Schedule G) (7)
8. Total Assets
.00
64,058.83
.00
.00
3\, 585.03
.00
.00
C81
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Fun.,.al Expenses/Adm. Costs/Hisc. ExpensBs ISchedule HI (9)
10. Debts/Hortgage Liabilities/Liens (Schedule II lID)
11. Total Deductions
12. Net Value of Tax Return
13. Charitable/Governmental aequests (Schedule J)
14. Net Value of Est.t. Subject to Tax
7,923.66
77.56
1111
I1Z)
113)
114)
NOTE:
.00 K .00,
.00 K .06,
71,B49.86 K .15,
1181
RECEIPT
NUH8ER
AAI46896
AA21I277
DISCOONT I + I
INTEREST/PEN PAID C-)
450.00
.00
8,550.00
\,777.48
AHOUNT PAID
I TOTAL TAX CREDIT i
IBALANCE OF TAX DUEl
INTEREST AND PEN 0 i
TOTAL DUE !
NOTE: To insure prop."
credit to your account.
submit the upper portion
of this forM with your
tax paYlllent.
95,643.B6
R.nnl ??
87,642.64
15.792.78
71.849.86
.00
.00
10,777.48
10,777.48
10,777.48
.00
.00
.00
. IF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
IF TOTAL DOE IS LESS THAN $1, NO PAVHENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" I CR I, YOU HAV 8E DUE
A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS.)
I ~ r'.
~V
RESERYATIONI E.tatl' of dacldant. d11ng an or blfara Daca.bar IZ, lq8Z -- If any futura Int.re.t In the estat. I. tran.f.rr.d
In Po.s...lan or .nJay..nt to Cia.. a lcallataral) b.n.flclerl.. of the d.c.d.nt aft.r the .~plrfttlon of any I' tat. for
Ilfa or far y.ar., the CaMManw.alth h.r.by e_pr...ly r...rv.s thl right to apprals. and as.... transf.r Inharltanc. T....
at the lawful Cia.. B Icoll.t.ral) rat. on any luch future lntarlst.
PURPOSE OF
NOTtCEI
To fulfill the r.qulr..ant. of S.ctlan ZI40 01 tha Inh.rltanc. and [.tate Ta. Act, Act ZI of 1995. (72 P.S.
S.ctlon 9140).
PAYHEHTI
D.tach the tap portion of thl' Notlc. and sub.lt with your payft.nt to the Rlglstar of Will. print.d an tha r.v.r.. .Id..
--Halo.. ch.ck or ..on.y order payabl. to: REGISTER OF MILLS, AGENT
REfUND I CR):
A r.fund of . tax credit, which was not raquI,ted on the ra. Return, nay b. r.quI.t.d by co.pllting an HAPpllcatlon
far Rafund of P.nn.ylvanla Inheritance and [st.,. laxH IREY-13IS). Application. are avallabl. .t the Offlc.
of the R.gI.t.r of Willi, any of the Z1 Ravlnu. Ol.trlct Offlc.., or by calling the .p.clal 24-hour
an,warlne .arvlce nuaber. far 10rM' ord.rlngt In P.nnsylvanla 1-800-36Z-Z0S0, outs Ida P.nn.ylvanla and
within loc.l Harrisburg area 1717) 787-8094, TOOl (717) 77Z-ZZSZ (Hearing lepalred Only).
OIJECTIONSI
Any p.rty In lnt.ra.t not ..ti,'I.d with the ~ppralla.ant, .llowanc. or dl.allow.nc. 01 d.ductlon., or a"e...ent
of ta. I Including discount or Interest) a. shown on this Noticl .u.t obJact within .I.ty (60) day. of rlc.lpt of
this HoUu by:
--Mrltte" protllt to the PA Depart..nt 01 Revenue, Board of Appeals, Dept. 2810ZI, Harrhburg, PA 17126-10Z1, OR
--al.ctll" to have tha .attar d.tarllllln.d at audit of tha ,,,count of the parsonal reprasent.Uv., OR
--appa.1 to the Orphan.. Court.
AOHIN
ISlRAlIYE
CORRECTIOHSI
Factual arror. dl.cov.red on thl. ....,..ant .hould b. addre.s.d In MrltlnQ tOI PA O.p.rt.ent of R.vanu.,
Burlau of Individual I...., A'TNI Post A'I...~.nt Ravl'M Unit. nept. 280601, Harrl.burg, PA 17128-0601
Phon. (717) 787-6505. S.. page 5 01 the booklet "In.tructlon. for Inh.rltanc' Ta. Return for a RI.ldlnt
D.cadlnt" (REY-1501) for .n a.plan.tlon of .d.lnl.tratlvely corr.ct'ble error,.
DISCOUNTI
If .ny t.w due I. paid Mlthln thrl' (3) calandar eonths after the dec.d.nt', death, a flv. p.rc.nt (5%) discount of
thl t.. p.ld i. allowad,
PEHAl TV I
Th. IS~ tl. aan..ty non-participation p.nalty I. coaput.d on the tot.1 of the tax .nd Int.ra,t .....I.d, and not
paid balor. January 18, 1996, the flr.t day altar the .nd of the ta. aan..ty p.rlod. Thl. non-plrtlclp.tlon
p.nalty I. .ppaaleble In thl .... .ann.r and tn the the .a.. tt.. p.rlod a. you would appe.1 the ta. and Intar..t
thlt ha. ba.n .....s.d .. Indlc.t.d on thl. notice.
INTERESh
Intlre.t I. ch.rg.d b'Qlnnlng with flr.t day of d.llnqu.ncy, or nlna (9) aonth. and on. 11) d.y frOI the data of
d.ath, to the data of pay..nt. T.... which bec..e dellnqu.nt before Janu.ry 1, 1982 bl.r Inter..t at the rate of
.1. 16~) p.rcent per .nnuI Cllculatad .t I dally rat. of ,00016~. All ta.'1 which blc", d.llnquant on Ind .ftlr
January 1, 1982 will baar Int.re.t .t a r.t. which will v.ry Ira. c.tandar y.ar to c.lendar ye.r Mlth that rat.
announc.d by the PA Dap.rt..nt of Ravenue. The appllc.bla Inter..t r.t.. for 1982 throuoh 1997 .ra:
!!!! Intarast Aat. Dally Interast fActor !!!! Inte,..t Aata Dally tnt.,..t f.ctor
1982 20~ .0005108 1987 ., .0002101
1983 I.~ .000438 1988-1991 11~ .000301
1981, lU ,000301 1992 .~ .00OZ47
ms 13:< .D003S6 1993-1994 n .000192
1986 IO~ .00OZ74 199!t-1997 ., .000Z47
ulnterllt Is calculat.d .. folloM'1
INTEREST = BALANCE OF TAX UNPAID X NUNSER OF DAYS DELINQUENT X DAILY INTEREST FACTOR
-.Any Notlc. I..ued .It.r tha tax bacoa.. d.llnqu.nt will rafl.ct an Intarest calcul.tlon to fllt..n lIS) day.
beyond the d.ta 01 tha .....'..nt, If p.y"ent I. ..de .ftar the Intera.t cO'pUtatlon d.t. shown on tha
Hotlce, additional Int.ra.t lU.t b. calcul.tad,
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
A/CN 304.4BN
Vice President of Mellon Bank, N,Ao
1.
J
u:
S.C, Minana, Assistant
bein9 duly, sworn
.ccordin9 to I.w, d.pos.. and sayt th.t ho I s Executor
or tho Eslalo or Mabe IE. Bux ton
I.to or 801 No Hanover St, Carlisle , Cumberl.nd County, Po" d.c....d .nd that tho
within is an inventory modo by S. C, Mi nana , Ass t. VI ce Pr,g,ilient , the said Executor
of tho on lire esl.to of s.id decodent, consistin9 or all tho po"onal proporly .nd ,..1 ..tate, ncept ,..1 estate ouhide
tho Commonwe.lth of Ponntylvani.. .nd th.t tho fi9uros opposite ..ch item of the Inventory rep'..ent it't f.i, v.lue
.. 01 the d.to 01 decedont't death,
.,.-
,y/LJ",cN .nd subscribed bolore me,
JJu ~t/:.1 ~ 1d 19 91
'7laMJ/ !I ~(Lf!.It/
r (/
By
Ene"t., . Adminh',.,.,
\ '. I - .: ~, ;
," '" ~('I ;.1 ..It r 1,1\
1\ ,I, 1', .\", I
)
p ^' '11(, I
Add,...
Date 01 Death
6th
O.Y
Augus t
Moftlh
1996
Yu,
INSTRUCTIONS
I. An invontory must be Iilod within three montht .ft., .ppointment 01 pe"on~r,~pre..nt.tivo.
20 A supplement inventory mutt be liled within thirty d.ys 01 discovery 0; .ddiii~~~1 ....h.
3. Additional sh..t~ m.y bo attached.. to po"onalty 0' ,..Ity
4. Seo Articlo IV, Fiducia,i.. Act 0119490
>- .,;
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en I- '" 0 . '" c
en Z I- ..J U. l- e ~
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.... U. ..J :t:
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0 '" .... U
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Invenlory of Ihe real and perianal .slale of
Mabc 1 E, Bux ton
deella ud.
- -----.-
____= _ ______~=~~~=~=~~~~a _n=cn=_==_====c=~=~==U=~=DD=a==.a
~
$ 1
. .
Cash found in decedent's residence
Corestates Bank Savings
A/Cn 0034067295
Interest accrued to 08/06/96
Mellon Bank Checking A/C
# 112-202-5545
Interest accrued to 08/06/96
0,939 4
23 5
7,571 4
5 9
Mutual Funds
1,054.329 Units Franklin Penn Tax Free
Income Trust Fund; N.L.
@ 10035
I 0,912. 1
3,612 0
I
I
2,329 8
3,843 0
10 Units'Muni Sr 023 Inv Tr Fund
PA; NoL.
@ 361. 24
12 Units Muni Sr 04B Inv Tr Fund
Multi St PAl N.Lo'
@ 1,027,49
1,688 Units Muniyield Penn Fund; NoL.
@ 140125
475 Units Nuveen PA Invt Qual Muni
Fund; N.Lo
@ 16.625
7,896 8
66 Units Nuveen Sr 206 Tx Ex Uns
PA Mtly; NoL.
@. 43041
2,865 6
paine Webber cash Fund;
@ 1. 00
2,599 0
Miscellaneous
Balance in decedent's
Residence account
25 4
FORWARD
$
92,624 0
- 1 -
~. .....
INVENTORY F
aaa=aaaaaaaaDa=======aa==a===========================================a._aaaaaa
Mabel Buxton
Who Died on 08/06/96
FORWARD
$
92,624.20
Miscellaneous (cont'dl
Personal Property,
appraised @
150.00
Prescription refund from
Federal Employee Program
Refund from Bell Atlantic
128.40
8.26
Refund from Church of God Home
2,713.00
Refund of deposit for
telephone
20.00
TOTAL PRINCIPAL RECEIPTS
$
95,643.86
===============
- 2 -
----
, -
,
.' -..
t
vi
UNDER RULE 6. ~~
~_ -:J\_ ~ - \
c::.. :")U'(.-'c:l\\)
STATUS REPORT
Name of Decedenl: fu CI. b e\
Date of Death: <lIb Ic;t.
, '
will No. /tjqu - OtJ & '1/
~---,.._-_..."_._.....
Admin. NO.
---...,,--.....-
pursuant to Rule 6.12 ot the Supromo Court urphane'
Court Rules, 1 report the followinq wilh p-!lIpw:L to clI01ploLlun or
the administration of the above-captionad olltalul
1.
State whether administratiun of tho ollLaLH III compleLol
Yes -y- NO
2. If the answer is No, sLaLe Whlln Lho pursunal
representative reasonably believes that tho odministralion will be
complete :-----
3. If the answer to No.1 is Yes, otato Lho toliowingl
a. Did the perspnal reprellonLalivo lila a linal
account with the Court? Yes if No .
-- ----.--
b. The separate Orphans' Court No. (II any) for
the personal representative's account is:
c. Did t.he personal repres"nlalivo slate an I
account informally to the partll?S In intfHl'st'l Yos____ NO..L-
d. copies of rec<!iptS, rele/lSes, joinders /lnd
approvals of formal or informal accounts may bo filed w th the
cerk of the orphans' Court and IMY IJH ,1tLa had t reporl.
'1,/1 /
Date:
.3 /.Y /9i'
.
!....J
~ \,.' IV Q \ \\ I ,..,e. IV (', Ii V P
amo I loaoo typo'or printl
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C.l\,oll 1\ y:
vi "unlOn.!1 llepresentative
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lupros",nt4tiVO
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