Loading...
HomeMy WebLinkAbout96-00675 .. Oath of Personal Representative Commonwea"h of Pennsylvania County of Cumberland 1M Pet~loner above-named swears and a<<irms thai the statements In the foregoing petition are true and correct to the best of the knowledge and bellet 01 petitioner and that, as personal representative 01 the Decedent, Pet~loner will well and truly administer thD estate according to law. Sworn to and affirmed and subscribed before me thls';C "Iday of (?~ /J/~~ / No, :1 \ - Iqql.o - 1./7 5 Estate 01 Victoria M, Blatt, Deceased Dale of Death: AUQust 17. 1996 Social Secur~y No: 209-12-6710 AND NOW, August 2B~h1996, in consideration of the Petition on the reverse side hereon, satisfactory proof having been presented before me, IT IS DECREED that Letters X Testamentary of Administration, CTA d.b,n,c.t,; pendente lite; durenle ebsentia; durante mlneritale are hereby granted to Charles M. Blatt. Jr. in the above estate and that the instrument(s) dated Julv 29, 1996 described in the Petition be admitted to probate and filed of record as the last Will of Decedent. FEES Letters........................... $ 200.00 Short Certificate(s).......... $ ReR&rfu~Mion.................. $ Affidavit ( )................. $ Extra Pages ( )............ $ Codicil.......................... $ JCP Fee........................ $ Inventory....................... $ Other............................ $ 18.00 ld:88 -n :.; r~; no c -:- ;(l 5.00 8 t-,,"\ Attorney: DONN L SNYDER a-. 1.0. No: 06858 ~.~ Post Office Box 741, 315 N..Front St. Harrisburg, PA 17108-0741 (717) 236-9377 TOTAL............... $ 236.00 Form RW.' Page 2 012 (Dauphin County) . , Register of Wills of Dauphin County, Pennsylvania EstatD 01 Victoria M. Blatt PETITION FOR GRANT OF LETIERS No. J. I -I q q to - {p '7 5 Deceased Social Secur~y No, 200-12-6nO Charles M. Blatt, Jr., Pelltloner, who Is 18 yealS a' aga or older, applies 'or: (COMPLETE 'A' OR "D' BELOW:) .& A, Probate and Grant 01 Letters and avers that Pet~loner Is the Executor named In the Last Will and Testament 01 the Decedent. See Renunciation 01 Virginia M. Deasey, attached. Slate relevanl circumstances. e,g., renunciation. death a' executor. etc. Except as 'allows, Decedent did not many. was not divorced, and did not have a child born or adopted alter execution a' the documents offered 'or probate; was not the victim a' a killing and was never edjudlcated Incompetent: !;J B. Grant 01 Letters 01 Administration (d.b.n.c,t.a.: pendente lite; durante absentle; durente mlnorllate) Pet~ioner(s) after a proper search hast have ascertained that Decedent ieft no Will and was survived by the lollowlng spouse (II any) and heirs: I Name Relationship Residence I (CUMPU: II: IN ALL CASl:s:) AttaCh additIOnal s~eets II necessary, Decedent was domiciled at death In Cumberland County, Pennsylvania, w~h her last lamily or principal residence at 1312 Oak Lane. New Cumberland. Pennsylvania. (list street. number and munlclpellty) Decedent. then 71 years 01 age, died August 17. 1996 at 1312 Oak Lane, New Cumberland, Pennsylvania. Decedent at death owned property with estimated values as 'allows: (If domiciled In PAl All personal property . .. , . . . , . .. , . . .. . , .. , , . .. . , .. . . . $ (I' not domiciled In PAl Personal property In Pennsylvania ,.. . . . . . , . , , , . . , . . , . . . " $ (If nol domiciled In PAl Personal property In County ",...".....",...,......,' $ Valua a' real estate In Pennsylvania, . . . . , . . . , . .. . , , , . . . .. . . . , . . .. . . . , . , , .. , , . , , . . , , . , , $ Total ..."...."....",..."."",.""",..,...,.,......,......,',..,., $ Real Estate situated as follows: 1312 Oak Lane, New Cumbarlend. Pennsvlvenla 15,000,00 80,000.00 95,000,00 Where'ore. Petltloner(s) respectfully raquest(s) the probata o'lhe last Will and Codicll(s) presented with Ihis Petition and the grenl a' letters In the approprlete 'arm to the undelSlgned: Typed or prlntad neolle and residence Charles M. Blatt. Jr., 3221 Highland Circle. Manhattan, KS S6503 Signature ~,A:'-I .# ~ J5-/~:4-/~ I I II I I I I I "II 1,,\. Illed WIII1 IIll'.l\ Till' ,.., 10) ~tllil) Ih.lllllt, 11I1.III11,ltl111l 11"11 I~l\llll'l ~"I'\\( \ "'I'It. Il,!l1 .1111111,1:111.' U'l" 11,1'"'1 'I. I J 1\I\,dl{q';''>lLll Tht'IIII,l-:llJ.dl('llllll.llt \\dll;,'llll\\,Il,lt.\IIJdll "Lilt VlI.dHII"I.I..111I11I h>lI'l'IIII.IlI(i1lldlll.l~ WARNING: 1115 Illegal 10 duplicale this copy by photostat (lr ph olograph. '.,_.... . ""' , 1 ..I.~,tj & , ._, /./ " , /.',1' /i.vl'u:~ J";l'- C?'.vn, i., 0 }llHf ,.....-...... /'.~\~\1!l WJ'f:;X, Il'.'~/ ~', "\~~' ~ ;31- .. , \"" . I.). . \~ ... ~ .. 'lil'"" ~" , .". ~' " ~ .?LA(EHl U\~;.'f,.( -...;q'~.!h!'f/!!!!"'" I'H.d Hn'.l''I1 I ,II I U' hi! till' \1 IIltll III 3782(;07 A1IG 2 n 1~95 t':ll 1),lll' . I ~....;n1 I i I COIlIlONWEALTH Of PENNSVLVANIA' DEPARTIlENT Of HEALTH' VITAL RECORDS CERTIFICATE OF DEATH NAWlOI DlaDlHf 'I'" WIIUI.L_ ., Victoria M. Blatt Ol' I. female ''''"'U'''''''''''' K)C1Al KC\lflltl' IoMAtll" ., 209 - 12 - 6770 0"'1 DrllLll........ 01.._. ,Aug. 17, 1996 71 ,. 0oll1 01 IIIITH lWOO..O"....' July 31, ....,......alC#,1O'd s...o:tfO'..."ecu_" Erie, Pa. PUa 01 DlR...o-......._- __........____ "''''01'' ~..D I~D .....~~_r P'. /::r., ~IO AOI.........." 1llN000k/SlHIQo9IOU lilY .. COUfIllY 01' c.RH art. tcRl.1'M' 01 DUIM .......p1ft11l.......~....tnd~1 Ma:' "--"............ WNI .. ......' White Cumberland New Cumberland e DlQDVfT.MAUC)AOOl'll..lSr....~ ....I"COIIt 1)12 Oak Lane New Cumberland, Pa. 1'7070 ,. HiltC....HAUlI,...~ Lil Harold R. heeler ...~ie:"tr.ihatt Jr. ~o~e~orNCAD) 'HlIDl'ClDlKfIVlIII" U'AIU.IIO'~' .....0 -W. .. OIC101Nl" 10lCAI1ON u.uww..wUl....... .... ""'_. w-... wi \ro1ll,'lr"" ............""".. .....~---,..,.... ,.. ... - .... Cumberland .....,.., uml =-=.. New Cumberland won."',,,,,,,,!?. YcUI ~..,,,.... ,lnle Marie Cnapln ~lf!S1>T.:r.r'dncWrta'rfflrnan, Kansas . 1fl.0 ................. ... OlClOlNT" ":1_ ",""HCC - ~-- u...... Pa. ORIEOIOISI'OIfTlOH ~0.,."'1 21. 1996 LCtO'f 00 L Loc;:.qlOH.~ ,,.... . st lIarrisburg Cemetery I<WII AHO AtlM(SI Clf..MCUTY usselman l'uneral UClNK HUUK" arrlsburg, Dauphin Co. Pa lIo.e lac. )24 lIummel Ave. ~moYle "'" ..... ~er,-I ,... "" CAll N'lNWO lO t.a0lCAA. ...0 oM "'... .., Uwld."'_1a*n I~_ 1=-= """ ~ QINf........ ---........... .... lQ,....,....ft_~_....ft"""'l ".N.lnt <<-_-..........-.....-....0....... 011 loIl...,__........ I: Dl.M1DICJlASAl;.CH$IC)JtHCta) ...,. AU'lOrI'l' ,--.os """"""OIOUIH --.I""""'" 0/ COW\nION 01 CAUII -. 0 "'....... - ...~ - 0 '......"""'~ 0 ...0 - 0 c:..w....""IlM--' 0 o.uIOl~Y ,"""''''0..,-1 flUlO#KNfI'Y "",,"YRWOM'I OlKAlMlCJWtfIlAIIrfocc;uANO '11M 0 ..0 - .... cun....lCNttI...., ..... .ClInntllCl""IlQIJIIIIf"I'--~C&MddMll'l"""''''''''''''~_NI..~""",.."Ol(~_l.1l "-....................._.............-~II...._..""". ......... .........., ,.... ...... ........... ... .. ~ W, "lAC' OIIN.AJflY.... '-'f '-.........,..-. ~-~I ... -, o 1 ~ MA/ol( .v.oADQNUOII'tAIOHWHOCOtWUTIOCNJ5IOICltAfH t'f [lltrtllll'''''.'''''' /I'tJJ"~. _ ~< V {\ O ' ,..,rr-;t;t.., It ~,'1"'.;~ ONUI.IDl_ 0.,_. 'HK r; --c-AHO""T'"..a'"'M:lAM."..,.........Il'~..........d.~IlIUoMd-. .......... """'MMti. ....._-.... .........., ................. .....'-...,1'....- ........ W,pI,//1 __ ~. -.-.;--..---...A. _ _ -,-- ..;LI -/qqw,' u'75 C'lC'l \ri :JJ C7'" :n~1 ::;. (11 j"1 .-::" 0-. c::l N C/'I ;..~ \l') c ~: ;.::, :l. - lAST WIU ANlJ THS1:-UIHNT OF J'ICTORl,j M. /J/A 1'1' I, Victoria M, llIall, of Ncw Cumberland, Pennsylvania, revoke my limner Wills and Codicils and declare this to be my La~t Will and Testament. ARTICLE I PA Yl\U:NT OF m:BTS AND ~:XP~:NS~:S I dircct that my just debts, funeral expenses, and expenses of la~t illness be paid as provided under the Victoria M, Blall Living TJ1lSt. ARTICU: II DISPOSITION OF PROPI<:RTY All of the property that I own at my death, or which shall become payable to my estate or my personal representatives, and any property that I have the power to dispose of under my Will shall be distributed to the Trustee of the Victoria M. matt Living Trust to be administered and distributed as provided under that Trust. ARTICLE III NOMINA nON OF EXECUTOR I nominate Virginia M. Deasey, of Lakcland, Florida, and Charles M. Blall Jr, of Manhattan, Kansas, as Co-Executors, without bond or security. If one (or both) of the above nominees does not seNe for any rea~on, I nominate Ralph Deasey, of Lakcland, Florida, as replacement (or sole) Co-Executor, \vithout bond or security. ARTICLE IV EXEClJroR POWERS My Executor, in addition to other powers and authority granted by law or necessary or appropriate for proper administration, shall have the right and power to lea~e, sell, mortgage, or othetwise encumber any real or personal property that may be included in my estate, without order of court and \vithout notice to anyone. " IN WITNESS WI IERF.OF. I haw subscrihcd my namc bcluw, Ihis~?~ day uf _0dy---. 19.!t". ~~ nz"n~~--.- Victoria M. B1atl We, the undersigned, hereby certify that the above instrument, which consists of et'.H (~) pages, including the page(s) which contain the witnes.~ signatures, was sigltcd in our sight and presence by Victoria M, Blatl (the "Testator"), who declared this instnlmentto be hislher Last Will and Testament and we, at the Testator's request and in the Testator's sight and presence. and in the sight and presence of each other, do hcreby subscribe our namcs and addresses as witnes.~es on the date shown above. Witness Signature: ~y ao..\A ~ ~/(;17 nAr7...J Witness Name: ;4-t.-1..-4.",/::;, i11' .E;:'().,vvJ Witness Address: )-?~)"Z. ~)~~l~~ ffi.l-'/ ~""" ' .) .~ (?.4_ I..,~~...,J " Witness Name: J:., /., X~i L) "LJ-'< '- U~j. 1/ /- /J U 1c.1(," W Witness Signature: I ! Witness Address: -1_"5/?-- /1" nk /.. /J- ~tJ.-(!;U)J1J~~-/?LJ- / 7 ~ "7 ;. ,. 2 T<' \\'ilncss Sign;i1nrc: 4) It!'/ ;J/ --) /. \\'ilncss Nmnc: III tll' It 1 ~' . ,!./,ii:./tc. t r' I .,). C.~I'C i" Witncss Addrcss: 1:)J~('af'{ ).QU-c". N($~V~llf) I ).led trncl /"f!III)o., /'1'1"7'-' .. l'cIIIISII\;lIlia ScIl.I'IIII;IIt' ('Ialhc ('OIlIlIlIlIl\\Callh 01 l'cllnslll'allia C'"I1lIY 01 f'......, Jt'~~,v<1 I. \'il:lllti;, ~1. Illall. Icslalllr \\hll"-' lIalllC is si~lIc" IlIlhc allacllc" or IflIC~lIill~ illslnllllclIl. halillg hcclI "nly lIualilic" ;Iccohling 101;11\. "0 hClch~ acI-lIo\\k"gc Ih;,11 sigllc" ;11I" ewclllc" IIIl' illslrlllllclIl as lilY I asl "'ill: Ihal I signc" il \\ iIIillgly ami as lilY hw ;111" \'Olulllary acl lill' Ihc plll]lllSCS Ihcleill elplc",", SlIom or allil111c" 10 ;lI1d acl-no\\lcdgcd helill'c II1C hy Yiclolia ~1. 11Iall, Ihc IcsWlor. Ihis ot.'l ,I;IY 01 J/,J. I;' . Il}?t ' (SEAL) t~/P.u.--7JJ1 /J ,e.~ \'idOlia ~1. 1lI;11l (Tcslalor) /J/' /' ~'J~' ./ tllid(/vl!f.'PP;'llq/i t,' " (Sign:rlurc 01 nll)ccn ,/ 'LJ irt~y /:.lL U~ t (I lllici:,( cap:'yflY prollicer) 1I0TARlALSEAL WNCHE MacF.GONGlEWSl<l, Nolaly Public ~ Twp. CUITIleI1J1d COunty My COIMI11s1onElqllm1.pl\l 5, 1997 .\Ili".l\il COmlllolll\cal~ll.r l)cn?~~~)'anj;~7 f" COllntynl, C..?,t{~I./}I/'.{',~/I/( c.I:' .'1 :\,1 ,L,. < Wc. ,~Uh",,=,.~/)f.t.'i,:U.'U . .~'::o r~ . and . .Ir.... ,:I/tA) ;,;!:". ....J~-h.,-y'.....),I.hc \\ Ilnesscs \\ hose nalllcs MC slgnc" lolhc :l1l:lchcd or lilrcgoing ill~ill11lcnl. heing duly lIu:llilicd :lccording 101:111. do dcposc ;nul s:lY Ih:ll wc wcrc present ami ""I Icslalor sign :lnd clcculc Ihis will :IS his hcl' 1.:lsl \rill: Ihallhc lestalor si~ncd willingly :llld clcculed il :IS his hcr Irec :lnd \'olunl:lry :ld IiiI' Ihc pUl]lOSCS thcrein cxprcsscd: 111:11 cach or us in Ihc he:ltin~ :lnd sighl or Ihc Icsl:llol' sign cd Ihc \\ ill as :1 wilncss: alllllhallo thc hcst or our I-no\\lcdgc thc Icst;ltOI' W;IS :lllh:ltliIllC III or 1II0l'C YC:lrs or agc. or sonnd lIIind al1llnllllcr 110 constrainl or 11ndnc inl1ncncc, . .. " , ;.'~,: :". ',' 'I i ,J' 't ~'" ;- , ., ;J;SII-: \'.' I . ,.j,. ;r;' l~.';' ,~",;'" ,.,:) , .i:~..1.'1 P II .., .';ll 1 1... ~ , ~ i , ~ ~:' ~J~ (t. '0 N .::> ~ 'oJ Ie :JC": ,.:;\ .oJ ::> 0: OU - . . . . " J../- Jf)9& - &, '7 'j Register of Wills of Cumberland County, Pennsylvania RENUNCIATION Estate of Victoria M. 81all No. Deceased The undersigned, VIRGINIA M. DEASEY, daughter the above Decedent, hereby renounces her right to administer the estate. Witness his hand this ~ day of AUl!ust. 1996. ,...~ .. _~___ __ . ".A _ V GINIA M. ASEY ~ 2631 French Avenue. Lakeland. FL 33801 (Address) Sworn to or affirmed and subscribed ) before me this cY G, day of August, 1996 'V- -- Ii.- """""^,,,...,... nn '0 ~ {F' (h " :~ El N 0-. \4,.-; -j;' C :0 ;Om " I: . '.i l.'.' c; NrifARIAL SEAL Maronc;!.' , I,~illcr, Nolary Public Harri5btl . c' ,\ Dauphin County My Comm"'''-'" :.<oirc5Jan, 10,2000 ~.."..~.......-,......... . - ~ ._--- -.,.,.-. .-.... ... OW' .. ... {5'~~ d)- q(P-O(; lS ESTATE SETILEMENT AGREEMENT This Agreement made this .J:S. day 0(;; Lt. N\ 0 , 1997. by and among Charles M. Blatt. Jr.. Executor of the Estate of Victoria M. Blatt. Jr. and Virginia M. Deasey. sole heirs of the Estate of Victoria M. Blatt. In accordance with the desire that the settlement and distribution of the Estate of Victoria M. Blatt be resolved as expeditiously as possible and without the delay of a formal Court accounting. the undersigned. in consideration of the mutual covenants herein expressed. and of the sums received. and intending to be legally bound hereby, agree that: 1. The said Victoria M. Blatt died August 17, 1996. testate. 2. The undersigned hereby agree that the entire estate be distributed as set forth in the Schedule of Distribution attached as Exhibit "A" and hereof made a part. Without intending to limit the rights of remedies of the personal representative. the undersigned further agree to indemnify the personal representative and save him harmless against all liability, loss and expense (including, but not limited to. costs and counsel fee) which the personal representative may incur. whether due to the personal representative's negligence or otherwise. as a result of making the above distributions without formal court audit or other formal estate administration. 1 .. .. 3. The undersigned hereby forever fu\ly release, compromise, settle and discharge any and a\l claims. demands, actions or causes of action, legal or equitable, absolute or contingent. vested or hereafter to accrue, which they may have against any other party hereto or against the Estate of Victoria M. Blatt. deceased or the personal representative thereof, by reason of any matter, cause or thing growing out of or relating to any property or assets of the said Estate of Victoria M. Blatt, or growing out of or relating to any act of the personal representative in their individual handling of said Estate, even if attributable to negligence. and agree that any period for the limitation of actions for the co\lection or any erroneous distribution or distributions sha\l commence only at such time as the personal representative sha\l have obtained actual knowledge of such erroneous distribution and that in no event sha\l the period of co\lection of any erroneous distribution be less than two years after the actual discovery thereof by the personal representative. 4. The undersigned agree to execute such additional releases as the personal representative may submit to them in order to confirm his discharge from any further liability to the parties in connection with said Estate. 5. This Agreement, sha\l be binding upon the undersigned, their heirs, next of kin, personal representative and assigns. 2 ~ \ <..... . " . .... Virginia M. Deasev; Florida Real Estate 5,000.00 33,500.00 10.585.8.6. Cash Cash 49.085.86. 98.171,71 ProDosed distribution of cash totallinl! $4.146.91 be aODroved as follows: Charles M. Blatt. Jr, Cash 2,073.46 Virginia M. Deasev Cash 2.073.45 TOTAL $102,318.62 . III"; ~ 4, COURT OF COMMON PLEAS OF CUMBERLAND ORPHANS' COURT DIVISION COMMONWEALTH OF PENNSYLVANIA ESTATE OF VICTORIA M. BLATT LATE OF BOROUGH OF NEW CUMBERLAND CUMBERLAND COUNTY. PENNSYLV ANI A FIRST AND FINAL ACCOUNT OF CHARLES M. BLATT, JR. EXECUTOR SUMMARY AND INDEX PRINCIPAL Balance Before Distribution Distribution to Beneficiaries $159,500.18 (2.723.161 $156,777.02 $55.154.85 $101,622.17 $98.171.71 Receipts Net Gain on Conversions Adjusted Balance Less Disbursements TOTAL PRINCIPAL BALANCE REMAINING $3,450.46 INCOME Receipts Disbursements $696.45 0.00 TOTAL INCOME BALANCE REMAINING $696.45 COMBINED BALANCE REMAINING FOR DISTRIBUTION $4,146.91 2 '. -. PRINCIPAL RECEIPTS Plus Florida Property 122,653.62 19,538.00 Inventory Filed To which is added: Reimbursements . Defined Asset Fund . Pro Ration of Real Estate Taxes . 1996 Tax Refund . Funds Transferred Prior to Death to Pay Expenses . Funds deposited by heirs 8.66 803.86 529.00 5,000.00 10.967.04 TOTAL PRINCIPAL RECEIPTS $159,500.18 4 COMMONWEALTH OF PENNSYLVANIA DEPAR~MENT OF REVENUE r~~~~ ~l~ BUREAU OF INDIVIDUAL TAXES INI1UUUNC[ fAIl DIVlstOIot DlPT. :8ObOI HARAISIlURC. Pi 11I:8-01IQI NOTICE OF INIIERITANCE TAX APPRAISEMENI, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX 1I1.~'" II Irt III.HI DONN L SNYDER ESe BOSWELL ETAL 315 N FRONT ST HBG PA 17108 DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 06-16-97 BLATT 08-17-96 21 96-0675 CUMBERLAND 101 VICTORIA M Anount Remit hd - I I MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HDUSE CARLISLE, PA 17013 CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ iiiv:i54"'i" EiCAFP-C o:i:9rnioTicE--OF-YN'HEiiiTANCn'-"X-APPRA iSEHENT-,--Ai.rOWANCE-1:ili - - -.. '-' u - ---- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF BLATT VICTORIA M FILE NO. 21 96-0675 ACN 101 DATE 06-16-97 TAX RETURN WAS: I X I ACCEPTED AS FILED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGltlAL RETURN 1. R..I Estat. (Schedule A) ell 2. stocks and Bonds (Schedule OJ (2) 3. Closely Held stock/Partnership Interest (Schedule C) (3) 4. Hortg.gas/Hotas Racelvable (Schedule DJ (4) S. Cash/Sank Deposits/Hise. Personal Property (Schedule E) (5) 6. JointlY Owned Property (Schedule fJ (6) 7. Transfers (Schedula G) (7) a. Total Assets CHANGED NOTE: To 1nsure prope,. credit to your account, subnit the upper portion of this for~ with your tax paYllent. 111 ,000,00 544,25 ,00 ,00 11.109,37 .00 ,00 181 122,653,62 39,152,03 11.057,23 UlI (2) (3) (4) APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) (9) 10. Ddbts/Mortgage Liabilities/Liens ISchedule I) (10) 11. Total Deductions 12. Net Value of Tax Return 13. Charit.ble/Covern~ental aequests (Schedule J) 14. Net Value of Estate SUbject to Tax Gn.,nq ,F. ]2,444.36 .00 ]2,444.36 If an assessment was issued previously, lines 14, 15 and/or 1&, 17 and 18 will reflect figures that include the total of abh returns assessed to date. ASSESSMENT OF TAX: 15. A~ount of Line 14 lb. A~ount of Line 14 17. A~ount of Line 14 18. Principal Tax Due TAX CREDITS: PAYMENT DATE 11-04-96 03-07-97 NOTE: .00 4,346,66 ,00 4,346,66 at Spousal rah taxable at Lineal/Class A rate taxable at Collateral/Class a rate US) 1101 (7) ,00 ]2,444,36 ,00 x,OO= X ,06= X .15= UBI RECEIPT NUMBER AA146903 M185248 DISCOUNT I') INTEREST/PEN PAID Co) 157,89 ,00 AMOUNT PAID 3,000,00 1,188.77 , TOTAL TAX CREDIT BALANCE OF TAX DUEl INTEREST AND PEN. I TOTAL DUE 4.346.66 ,00 .00 .00 . IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. IF TOTAL DUE IS LESS THAN 11. NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" ICRI, YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF TNIS FORM FOR INSTRUCTIONS. I rRlNCIPAL CONVERSIONS INTO CASH GAIN LOSS Real Estate: Inventoried: 111.000.00 Redeemed: 111.000.00 Personal Estate: Smith Barney Inventoried: 1)714.93 Redeemed: 1.714.93 Dauphin Deposit Bank and Trust Inventoried: 1 !}92.79 Redeemed: 1992J9 Dauphin Deposit Bank and Trust Inventoried: Redeemed: 2,877.71 .QQ. [b877 ,71) GNMA Fund Inventoried: Redeemed: 544.25 ~8.80 15455 2,723.16 NET LOSS 5 . . PRINCIPAL DISBURSEMENTS Schedule H (see attachment) 39,152.03 11 ,057.23 4,188.77 40.00 65.58 631.74 Schedule I (see attachment) Inheritance Tax Boswell, Snyder, Tintner & Piccola (costs advanced) Virginia M. Deasey (costs advanced) !2.S.Q 55,154.85 Charles M. Blatt, Jr. (costs advanced) 6 SCHEDULE H FUNERAL exF-ENSES, ADMINISTRATIVE COSTS AND MISCELLANEOUS EXPENSES co......ON,wM:ll" O. .~~~~.h'i.N.. IN"'\~Ic'h'iVtc!'.o'loW'" ,r/lT1! OF Plealle Prlnt or · FlU! NUMDER 21.96-0675 SS~ 209-12-6770 08 17 1996 /ICTORIA M. BLATT lifM IUMDER OESCRIPTlON 1 2 Funoral EJpon_: BRACHENDORF M~~ORIALS HARKER HARRISBURC EAST CEMETAR"i - GRAVE OPENING 3 4 MUSSEl.'WlS FUNERAL HOME - FUNERAL EXPENSE REV. HOFFMAN' HONORARIUM 1. Toeal of Coneinuaeion Schedule(s) /ldmlnl.traUvo Coals: Personal Represent.lIve Convr/soJon. Social Secur1ly Number 01 Personal Represenlatlve: Vear Cormisslons paid 2. Attorney Fees BOS~ELL sNYDER TINTNER & PICCOLA 3. Family e.emptlon Claimant Address 01 Claimant at decadenr. death Slroot Address City - Relallonshlp Zlp Code 51ate 4. Pro bale Fees Regiseer of Wills Mlscallaneou. e.pen_: 1 BELL ATLANTIC PHONE BILL 2 BELL ATLANTIC - PHONE BILL 3 BOSWELL, SNYDRER. TINTNER & PICCOLA - DISBURS~~ENTS 4 BOSWELL SNYDER TINTNER & PICCOLA. FILING FEES, COPIES, PHONE, FAX. ETC. 5 cHARLES M. BLATT _ REIMBu1lES~~ENT OF COSTS ADVA-~CED 6 CUMBERLAND COUNTY LAW JOURNAL - LEGAL ADVERTIS~~ENT 7 DAUPHIN DEPOSIT B~~ & TRUST - CHECK CHARGE 8 HECHINGER'S - RENOVATION SUPPLIES FOR HOUSE Toeal of Coneinuaeion Schedule(s) TOTAL (AlSO enler on line 9, RecOlllllJlallon , (II mar. apacela noedo<l. tnsort aeldlUonal.heels 01 sam. alz..) I :oPy"Ql'lt(c) tn. form ,ort...'. only CP5YI'lml,lnc. /lMOUKT 1,21,7.00 ' 625.00 - 5,290.00 50,00' 185.50 ' 7,000.00 : 243,68 67.34 113.87 208.31 150.00 5,645.12 60.00 17.24 14.56 18,234.41 $ 39,152.03 For'" 1500 SCtl.du1a HeRt....f.") ,. of: VICTORIA K. BLATT ~ See #: 209-12-6770 ,ce of Death: 08/17/1996 Continuation of Schedule "-B2 (Attorney Fees) Amount Description 1 BOSIlEIJ. SNYDER TINTNER Eo PICCOLA - ATTORNEY'S FEE I 7,000.00 .........-.... 7,000.00 " , ! VICTORIA M.' BLATT G Sec~: 209.12.6770 ~te of Death: 08/17/1996 Continuation of Schedule H-C (Miscellaneous Expenses) Amount Description 9 HECHINGER'S. RENOVATION SUPPLIES FOR HOUSE 99.49 10 HECNINGER'S. RENOVATION SUPPLIES FOR HOUSE 78.44 11 HOME DEPOT . RENOVATION SUPPLIES FOR HOUSE 12 LOWES. RENOVATION SUPPLIES FOR HOUSE 33.43 78.99 13 LOWES. RENOVATION SUPPLIES FOR HOUSE 45.82 14 LOWE'S. RENOVATION SUPPLIES FOR HOUSE 606.27 92.13 48.92 13.83 63.20 15 LOWE'S, R~~OVATION SUPPLIES FOR HOUSE 16 LOWE'S, RENOVATION SUPPLIES FOR HOUSE 17 LOWE'S - RENOVATION SUPPLIES FOR HOUSE 18 LOWE'S. RENOVATION SUPPLIES FOR HOUSE 19 M & Z CARPET - MAINTEN^,~CE OF RESIDENCE FOR SALE 857.81 M & Z CARPET - DEPOSIT FOR RENOVATION FOR HOUSE 450.00 21 NET EXPENSES FROM SALE OF p~~SYLV^,~IA REAL ESTATE . ~~PENSES 10,850.99 22 NICK WOOD - REAL ESTATE APPRAISAL 250.00 23 ORENDORF GROUND MAINTENANCE . YARD WORK AT RESIDENCE 206.80 24 PA A.~ERICAN WATER COMPANY . WATER BILL 22.91 18.58 5.98 25 PA.AMERIC^,~ WATER COMPANY . WATER BILL 26 PA-AMERICAN WATER COMPANY . WATER BILL 27 PA.AMERIC^,~ WATER COMPANY . WATER BILL 5.98 5.98 28 PA-AMERICAN WATER COMPA.~{ . FINAL STATEMENT 10.00 29 PATRIOT NEWS - ADVERTIS~~ENT FOR YARD SALE 103.00 30 PP&L. ELECTRIC BILL r1.W~~'H Of '~NNSYLV"NI" , "~t:Ilt.N't'otc"IDWr"" SCHEDULE I DEBTS OF DECEDENT, MORTGAGE UABILITIES AND LIENS Pi.... Print 01 T FlU! NUMBER 2196.0675 BLATT SS# 209.12.6770 08/17/1996 m;:M NUMBER 1 AARP INSURANCE DESCRIPTION AUTO WITHDRAWAL FROM CHECKING ACCOUNT 2 AMOCO - CREDIT CARD BILL 3 ~~OCO. CREDIT CARD 4 BANK DEBIT FOR UNSIGNED SAVINGS BOND 5 BELL ATLANTIC - PHONE BILL 6 CAPITAL ONE VISA - CREDIT CARD 7 CHOICE - VISA - CREDIT CARD 8 Clro LIFE INSURANCE - AUTO WITHDRAWAL FROM CHECKING ACCOUNT 9 DADE COUNTY TAX COLLECTOR - REAL ESTATE PROPERTY TAXES 10 DAUPHIN DEPOSIT BA.~ ~~D TRUST CO. - INSTALL~ENT LO~~ NO. 60421558001 11 DAUPHIN DEPOSIT BA.~ & TRUST CO. - SATISFACTION FEE FOR LOA.~ 12 DENNIS HOLLINGSWORTH, TA.~ COLLECTOR - R~~L ESTATE PROPERTY TA.~ 13 ~~~ON - HASTER CARD PA~ENT 14 LEONA B. BECHTELHEIMER, TA.~ COLLECTOR - REAL ESTATE PROPERY TA.~ES 15 LOWE'S - RENOVATION SUPPLIES FOR HOUSE 16 MURRAY A. BRONSON - OSCEOLA COUNTY PROPERTY TA.~ 17 PA-AMERICAN WATER COMPA.'IY - WATER BILL 18 PA. GASTRONTEROLOGY CONSULTA.~TS - MEDICAL BILL 19 PP&L - ELECTRIC BILL FOR PROPERTY 20 PUTNAM COUNTY TAX COLLECTOR - REAL ESTATE PROPERTY TAXES 21 SUBURBAN CABLE - CABLE BILL 22 SUBURBA.~ CABLE - CABLE BILL Total of Continuation Schedule(s) TOTAL (Also enler Dn nn. 10, RecapillJl.tion) (II mora spac. 13 nooded, Insert .ddltlonoJ shoots 01 soma size,) ~opyrtoht (et In. fo'", .oU......... only CPSystlm., '"Co AMOUNT 28.00 10.90 46.60 121.94 115.73 1,057.78 650.00 .... 15.75 6.34 1,261.15 30.00 17.15 19.83 168.04 2,590.76 24.75 31. 54 41.11 103.00 29.14 19.55 19.55 4,648.62 s 11,057.23 Fo,," 1SOOSch'd\lI,I(A,...,I..'3) . '. . . .. , I VICTORIA H. BLATT l Sec~: 209-12.6770 :e of Death: 08/17/1996 Continuation of Schedule I (Debts of Decedent, Mortgage Liabilities and Liens) Description Amount .3 SUE CARTER. TAX COLLECTOR WALTO~ COUNTY. REAL ESTATE PROPERTY TAXES 32.33 4 VERMONT HEIGHTS. ACCOUNT ~O. VH 33326 . Lot 20 St. John's County 4,616.29 -.....-....... 4,648.62 . ., , . " , , .' . DISTRIBUTION TO BENEFICIARIES Charles M. Blatt. Jr.: Florida Property 9,921.71 Cash 33,500.00 Cash 5.664.14 49,085.85 Virl!inia M. Deasev: Florida Property 5,000.00 Cash 33,500.00 Cash 10.585.86 49,085.86 TOTAL DISTRIBUTION TO BENEFICIARIES $98,17L71 7 I .. . , . . I'" . PROPOSED SCHEDULE OF DISTRIBUTION TO m~Nl~[l(JA8lli1i It is recommended that the pre-<listrlbutloll 10111111118 $9H,111.11 he lIpproved: Charles M. Blatt. Jr.: Florida Real Estate 9,921.11 Cash :n.~IK).OO Cash 5.664,14 $49,085.85 Virginia M. Deasev: Florida Real Estate 5,000 ,00 Cash 33,511O.00 Cash IOj85.86 ~9 .085 ,86. 98,111.11 Prooosed distribution of cash totallinl! $4.146.91 be lIoproved 115 follows: Charles M. Blatt. Jr. Cash 2,013.46 Vlrl!lnia M. Deasev Cash TOTAl. 2.013.45 $102,318.62 10 I ..' . ~~";;',,,;:...... I'" . t .. . STATE OF PENNSYLVANIA SS: COUNTY OF DAUPHIN Charles M. Blatt, Jr., Executor of the Estate of Victoria M. Blatt deceased, being duly sworn according to law, deposes and says that the foregoing account is true and correct to the best of his knowledge, information and belief, and that no persons claiming to be interested in said Estate as creditors,legatee, next of kin or otherwise, have given notice of their claim to the deponent, in writing or to Boswell, Snyder, Tintner & piccola, their attorney, in writing. c(i;:f..:!~ Sworn to and subscribed before this,.J <, day ,1997 L ,'~:"" .".,,~' 0.... ....' ,..'.,r.'.) l~ NOTARIAL SEf,L ; MaronoUa F. IAiller, Notary f-I)r'i: l HArrlsburo, PA OJuphHl C'",nr\' 1 My C:~I~~"r, F.mow, '/;'''. 1 a, ~:,i:O ; 11 , la I . ," I I ,... I I IN RE: THE ESTATE OF : IN TilE cOUln 011 COMMON !'I.I!AS DECEASED . . : CUMlIl!ltLANI> COUNTY, !'I!NNSYLVANIA : OR!'IIANS' couln IJ\VISION VICTORIA M. BLATT, : PILI! NO. 21.%()(,7~ SATISJo'ACTION ANI) AWARI) The undersigned, hereby acknowledge thut Churles M. BlUII, Executor of the Estate of Victoria M. Blatt, deceased, has distributed III the undersigned the following: Cash 9,921.71 33.~OO,OO 5,664.14 Florida Real Estate Cash Cash ~.073.46 $51,159.31 as full payment of all sums due pursuant to the Lust WlII and Teslament of Victoria M. Blatt, directs and authorizes the Clerk of the Orphan's Court Division to mark satisfied of record the award which may be made In his individual favor. IN WITNES~.wH ER EOI' ,the undersigned has caused these presents to be executed this ~~ day of. J",)Lf ,1997, I - Lv\.. ("iA-/~ ~~a CHARLES M. BLATT,JR. Soc. Sec. No. 194-44-8238 ~ ; , ~ I. ,.... , , ..... , VICTORIA M. BLATT. DECEASED : IN THE COURT OF COMMON PLEAS : CUMBERLAND COUNTY, PENNSYLVANIA : ORPHANS' COURT DIVISION : FILE NO. 21-96'{)675 IN RE: THE ESTATE OF SATISFACUON AND AWARD The undersigned, hereby acknowledge that Charles M. Blatt, Jr., Executor of the Estate of Victoria M. Blatt, deceased, has distributed to the undersigned the following: Cash 5,000.00 33,500.00 10,585.86 2.073.45 $51,159.31 Florida Real Estate Cash Cash as full payment of all sums due pursuant to the Last Will and Testament of Victoria M. Blatt directs and authorizes the Clerk of the Orphan's Court Division to mark satisfied of record the award which may be made in his individual favor. IN WITNESS WH EREOF, the undersigned has caused these presents to be executed thiso::'5" dayof.:JU II r; , 1997. Witness: ~;l~ ~kclJ~r .'~t>..J"'u. ~ . ::1'/' ./..~CL.J-'-"" VIRGINIA M. DEASEY ',J"l Soc. Sec. No. 195-38-9469 _.-'~'-''';._''-''' .... ro' It: '')1 JlJil 30 i' \ ::8 Ci Gl .(.. . I ~. . .... . co"~mYM.lt"~Oo'F~fI\,Wbr'N" HAR ru5R6~b,"~'~ \ JI~OllO I I r-_ I " }.. I, !) _\ '~.I" .. INHERITANCE TAX RETURN RESIDENT DECEDENT (TO BE FilED IN DUPLICATE WITH REGISTER OF WillS (", RCVat5\lOU.(7-14) ron OATnor D(ATtt AFTER ,,/:)Hil CtlECIOtERE IF A 5'>QU5AL , n FILE NUMBER CAB H P L E PO C R C KOK P S o E C E o E N T OECCDINT'S NA,.,.[tlA~T, 'lAST, AND MIOOU INITIAL) IIUTT VICTORIA M, COUNTY coor OrC[UENrS COMPLETE ADonC:l5 1312 OAK UNE NEW CUMBERUND, PA AI 2196.0675 VEAR 17070 (8) (II) (12) (13) 14 . (16) 72,444.36 X ,06' NUMBER DAtE OF DrAlIl OB/17/1996 CUMBERUND AMOUNT REcnVEDIS[E INSTRUCTIONS) 0.00 T A X C o M P U T A T I o N (17) 0.00X,15' (18) (19) (20) (21) (21A) (21B) S1QNATlJREOF PERSON RESPONSIBLE FOR FILING RElURN CHARLES H. BLATT, JR. 3221 HIGHLAND CIR. ~Hj\:riAN~"Ks"'665'03"""""""""""""" BOSWELL SNYDER TINTNER & PICCOLA POST OFFICE BOX 741 HAiiRis'BURG'" pi\'" iYi6il.:074"i....... ..... ........ OAT[ OF OHntl ",OCIAl arCUfHfYNUMOCR 209.12.6770 07/31/1925 Coun1y (IF APPlICADLEI5URVlVINQ 5POU5['!] NAME IlA5T,FIRSt AND MIDDLE INITIAll SOCIAL seCURITY NUMoeR X 1. O.lglnel Rolurn 4, UrrOIod Es1alo 05, la, Romaindol' RolUrn (10' dsl.. 01 doalh prior 10 12-13'82) Fodorel E.IsIO Tax RoMn Roqul.od Tolal Numbo< 01 Salo Doposll Be... 122,653.62 50,209,26 72,444.36 72 ,444. 36 0.00 4,346.66 0.00 4,346.66 3,157.89 0.00 1.188.77 0.00 1.188.77 Und.r p.nAltI'. 01 perJury, I dlcllr. that I hi"" ,qmlntd 1nll r,lurn,lIlclUdlnll Iccompl.nYl"lIlcnllSul.. .nd aut.m.ntl, and to thl bl.l of my Il,no....'.dg.'nd t1.~.f.ltl.lru., correct and compl.tl.1 dlclar. tha' III ,ult.utl has b..n "pallid altrul matht valul. DeclAration of pupa'" other than th, plftonalnp,...ntllivll. bAud on aUlnlormation 0' whlth pr.p.r" has any knowlldgl. R E C A P I T U L A T I o N (9) 39.152.03 2. supplomonlal Aolurn 4a. FUlur.lnlolO.1 CoIT1'.otrlso (10' dal.. 01 doalh allor 12'12.82) []] a, DocOdont DIod Toslalo []] 7. Docodonl Malnlalnod a Uvlng T.u.1 AIIOCh co 01 Will Allach a co 01 Tru.1 C P ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTeD TO: R ~ NAME COMPI.ETE MAILING ADDRESS R 0 DONN L. SNYDER ES UIRE BOSWELL SNYDER TlNTNER & PICCOU ~ ~ TELEPHONE NU"BER 315 N. FRONT STREET _ T 717 236.9377 HARRISBURG PA 17108.0741 1. Roel E.lalo (Sehedulo A) (1) 111,000,00 2. Slock. and Bends (Sehedulo B) (2) 544.25 3. Closoly Hold SlockJPartno",hlp Inlorosl (Sehodulo C) (3) None 4. Mortgagos ond NolOS Rocolvablo (Sehodulo D) (4) None 5. Cosh, Bank Doposlts & MIscotlanoou. Po.senal P.oporty (Seh, E) (5) 11,109.37 a. Jointly ownod PropOf1y (Schodulo F) (6) None 7. Tran.'.", (Schedulo G) (Schodulo L) (7) None 8, Tolel G.oss Assots (Iolal Unos 1-7) 8. Funorel E>cponS09, Adtrlnl.traUvo Co.ts, Mlscotlanoou. E>cponsos (Sehedulo H) 10. Dobts, Mortgago UablllUos, Uon. (Schodulo I) 11. TOlal Doduclion. (Iolal Unos 9 & 10) 12. Nol Valuo of E.talo (Uno 9 trlnu. Uno 11) 13. Charflablo and Govornmonlel Bequosts (Schodulo J) 14. Not Valuo Sub oct 10 Tax (Uno 12 trlnu. Uno 13 15, Spou.a1 TranslOf' (10' dal.. of doalh allot 8.30-94) SOO In.truclion. lor Applicablo Porconlage on page 2. (Includo valuos horn Schodulo K 0' Schodulo M,) 18, Amount 01 Uno 14 laxablo a16% 'alo (Includo veluos horn Schodulo K 0' Schodulo M,) 17. Amount or Uno 14 taxabk1 8115% rato (Include valuos horn Schodulo K or Schodulo M.) 18. Princlpel lax duo (Add tax '.om Uno 15, 16 and 17,) 19, C.odlts/Sp PovOlly prior paymonts Dlscounl + 3.000.00 + 157,89 20, II Uno 181. groalor Ihan Uno 10, onlor Iho dilloronce on Uno 20, Thl. Is lho OVERPAYMENT. ~ 0 Check here If you are re uesUn a refund of our oye a enL 21. II Uno 101. g.oalo, Ihan Uno 19, onlo' Iho dillOfOnce on Uno 21. Thl. I. lho TAX DUE. A. Enlo' Iho Inlorosl on Iho balanco duo on Uno 21A, B, EnlOf lho 10lel of Uno 21 and 21A on Uno 21B, Thl. Is tho BALANCE DUE. Make Check pa able 10: R I.te, 01 Willa, A nt ~ ~ BE SURE TO ANSWER ALL QUESTIONS ON PAGE 2 AND TO RECHECK MATH .. .. (10) 11,057,23 (15) 0.00 X lntorost OAT[ 03-03.97 DATE 03.03.97 Form 1500 (R..... '-1<1) Act 1148 01 1994 provldel lor the reducllon 01 the tax rotel Impoled on the net velue 01 trenllerl to or lor the ule 01 thl lpoule. The ratel al prelcrlbed by thl llatute will be: 83% (.03) will be applicable lor &llatel 01 decedentl dying on or alter 7/1/94 and belore 1/1/96 82% (.02) will be applicable lor estotel 01 decedentl dyIng on or alter 1/1/96 and belore 1/1/97 81% (.01) will be applicable lor Islatel 01 decedents dying on or alter 1/1/97 and belore 1/1/98 8Spousal tranalers occurrIng on or alter 1/1/98 will be exempt from Inherllance tax. PLEASE ANSWER THE FOllOWING QUESTIONS BY PLACING A MARK (Xl IN THE APPROPRIATE BLOCKS. YES NO 1. Old deCedent moI<e atronefer end: L ,etolnthe U18 or Income of the propertytronsflllled.. . . . . . . . . , . . . . , . . . . , . . . . . , . . . . . . . . . . X b. retain the righl to designate who shaD uselhe property transferred or Its Income. . . . . . . . . , , . . , , , . . . . ,. X c.retoInareveralonarylnterest;or..............,............,................,. X II. recelve the pronise for me of eltherpoymenta. benefits or CIlO? ,.......,..,................. X 2. If deolh occurred on or beforo [)ecornbor 12, 1982, did deCedent within two yellS procodlng dealh tronefer property wt1/lOUI rocolvlng adequate consldorallon? If death occurred oner Docombor 12, 19l12, did deCedenltronefer property within one yoar of death wt1/lOut rocolvlng adequato consldorallon? . . . . . , , . . . . , , . . . . . . . . , . , . , . , , . . . . . . , , . . . . , . . . . . . . . . . . , . , X 3. Old deCedent own en'n truslfo~ bank lCCOunllt 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. Fafm 1500 (RI". ,....... Copyrlght(C) 1114 form 10Uwatl only cPsy.l.m.1Inc. "IV - 1101 EX . 112..111 COM~\l\l~~_~jbY.N'" SCHEDULE A REAL ESTATE ElITATI! OF FlU! NUMBER VICTORIA K. BLATT SS~ 209.12.6770 08/17/1996 2196.0675 (Properly JolnUV'owned wl1I1 RighI of SUrvlvonhlp mUll be clacloMd on Schedule F) All r..1 ..tale ohould be reported Illolr rnorllll vol... which II dIIIned II lIMo prIoIll which prcperty _ukl be ..c:hInged be_ I wtlllng buylr Ind I wtlllng liller, nllthlt being compIIled to b or 11I1 bolll hevl ruoonobl. knowl of lIMo rel.vlnl IIc\1. ITEM NUMBER 1 DESCRIPTION VALUE AT DATE OF DEATH 111,000.00 REAL ESTATE. 1312 OAK LANE, NEW CUKBERLAND. PENNSYLVANIA TOTAL Also entor on One 1, Roc It\Jlallon (II more apoco Is nooded, Insert IddlUonol aheels 0' same size,) Coprrtoht(cl tl'" fo,m .oltwat. onlyCPSy.t.m.,lnc. S 111 000.00 Form 1500 Sch.dul. A CAIV. t2-1I) AIV.1I0IlX' 1....1 COIA\I.\l\lhm4\,W~AN'A ESTATE OF SCHEDULE B STOCKS AND BONDS FILE NUMBER 2196.0675 VICTORIA H. BLATT ss~ 209.12.6770 08/17/1996 All ITEM NUMBER 1 In .owned wtth RI hI 01 Survlvorah mUll be dIlCloMd on Schedule F, VALUE AT DATE OF DEATH 544.25 DESCRIPTION GNHA FUND lAP . ACCOUNT NO. 988 70085327 TOTAL Aloe ent... on Rne 2, Rec Itulallon (11 more apace Is needed, Insert addl1lonal sheets 01 same alze,) Copyrlght(c) 1114 form .oflwuI ani)' CPSYS'lm..lnCo S 544.25 Form 1500 Sch,dtolt. 8 (R.y.....e) " '. ftEY- tlIOU. II-Ir, COMr..m~{\W~/hY'HI' ESTATE 01' SCHEDULE G TRANSFERS PIo.... Pltnl or FILE NUMBElI 2196-0675 VICTORIA H. BLATT ss~ 209.12-6770 08/17/1996 nns SCHEDULE MUST BE COMPLETED AND FILED IF THE ANSWER TO ANY OF THE QUESTIONS ON PAGE 2 IS YES. ITEM DESCRIPTION OF PROPERlY EXCLUSION TOTAL VALUE DECD'S DOLlAR VALUE OF NUMBER ,.~~e'-id~l~::~~' !~: tlan.",,,, 'h...~t. OF ASSET "'INT. DECEDENT INTEREST t1ondI11i-.1 I" d.t.o't"",, , , ! TOTAL (AJoa enter on fine 7, RllCIDltulatlon) 0.00 (If more spece Is needed, Insert addltlonalaheelS 01 same alze,) Cop)'rlllhlfeJ 1.14 10'''' .ollwul onIyCPSytt.m.,lnc, Fo,m 1500 Sch.dule Q (R.v. 2.17) 'UV-lIt1 IX' ('..Ill ESTATE OF B. c. CO~::'~.l\grti'l~.y~~f1l"NIA SCHEDULE H FUNERAL EXPENSES, ADMINISTRATIVE COSTS AND MISCELLANEOUS EXPENSES PI I". Pr1nt or . FIll! NUMDER 2196-0675 BLATT SS#- 209-12-6770 08 17 1996 VICTORIA M. ITEM NUMDER A. DESCRIPTION 1 Funeral Expen...: BRACHENDORF MEMORIALS HARKER 2 3 4 HARRISBURG EAST CEMETARY - GRAVE OPENING HUSSEUlANS FUNERAL HOME - FUNERAL EXPENSE REV. HOFFMAN - HONORARIUM 1. Total of Continuation Schedule(s) Admlnl.traUvo Co.ta: PlllllOnal Roprasentallve Conmlsslons SocIal SecIlr11y Numbel 01 Pornonal Rep,esontallvo: Yoar Conmlsslons pald 2. Anarnay Foes BOSWELL SNYDER TINTNER & PICCOLA 3. Farrily Examptlon Clalmant Address of Clalmanl at docedonfs daath Stroot Address City 51010 Zip Coda RoIatlonshlp 4. Probate Foes Register of Wills 1 Mlacellaneou. Expen...: BELL ATLANTIC - PHONE BILL 2 BELL ATLANTIC - PHONE BILL 3 BOSWELL, SNYDRER, TINTNER & PICCOLA - DISBURSEMENTS 4 BOSWELL SNYDER TINTNER & PICCOLA - FILING FEES, COPIES, PHONE, FAX, ETC, 5 CHARLES M. BLATT - REIHBURESEMENT OF COSTS ADVANCED 6 CUMBERLAND COUNTY UW JOURNAL - LEGAL ADVERTISEMENT 7 DAUPHIN DEPOSIT BANK & TRUST - CHECK CHARGE 8 HECHINGER'S - RENOVATION SUPPLIES FOR HOUSE Total of Continuation Schedule s TOTAL Also ontor on "00 9, R IlUlatlon (II marl 1IpllC41 II needed, Inllrt .ddlUonal Iheeta 01 samo slzo,) CoPyrilll'\t(C) 11M form lollwl" only CPsy.tlml,lnc. AMOUKT 1,247.00 625.00 5,290.00 50.00 185.50 7,000.00 243.68 67.34 113.87 208.31 150.00 5,645.12 60.00 17.24 14.56 18 234.41 s 39 152.03 Fo,'" 1500 Schldull HeRIV..,..II) CQMMO~WrOL T~ 0' PINHSY\.VANIA IN" "\ AN (TAX "nunN A II IN OIClOINt SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES AND LIENS Pl.... Prlnl of FILE HUMBER 2196-0675 ITEM HUMBER 1 2 3 4 5 6 7 10 11 REV-unO. (,-It) EST" TI! OF VICTORIA M. BLATT SS# 209-12-6770 08/17/1996 DESCRIFTIOH AARP INSURANCE _ AUTO WITHDRAWAL FROM CHECKING ACCOUNT AMOCO - CREDIT cARD BILL AMOCO - CREDIT CARD BANK DEBIT FOR UNSIGNED SAVINGS BOND BELL ATLANTIC - PHONE BILL CAPITAL ONE VISA - CREDIT CARD CHOICE - VISA . CREDIT CARD 8 cNU LIFE INSURANCE _ AUTO WITHDRAWAL FROM CHECKING ACCOUNT DADE COUNTY TAX COLLECTOR - REAL ESTATE PROPERTY TAXES 9 DAUPHIN DEPOSIT BANK AND TRUST CO. - INSTALLMENT LOAN NO. 60421558001 DAUPHIN DEPOSIT BANK & TRUST CO. - SATISFACTION FEE FOR LOAN 12 13 DENNIS HOLLINGSWORTH, TAX COLLECTOR . REAL ESTATE PROPERTY TAX EXXON - MASTER CARD PAYMENT 14 LEONA B. BECHTELMEIMER, TAX COLLECTOR - REAL ESTATE PROPERY TAXES 15 16 17 18 LOWE'S _ RENOVATION SUPPLIES FOR HOUSE HURRAy A. BRONSON - OSCEOLA COUNTY PROPERTY TAX PA_AMERICAN WATER COMPANY - WATER BILL PA. GASTRONTEROLOGY CONSULTANTS - MEDICAL BILL 19 20 PP&L _ ELECTRIC BILL FOR PROPERTY PUTNAM COUNTY TAX COLLECTOR - REAL ESTATE PROPERTY TAXES 21 SUBURBAN CABLE - CABLE BILL 22 SUBURBAN CABLE - CABLE BILL Total of Continuation Schedule s TOT"L AI"" on'or on Uno 10, R 1tu'.lIon (II moro space Is noodOd,lnsor1addi1lonalahOOlS of .orro slzo,) Cap)'rl;hl(t) 1114 tOf", ,oftwar. anly CPSYlt,m"lnc. AMOUNT 28.00 10.90 46.60 121. 94 115.73 1,057.78 650.00 15.75 6.34 1 , 261.15 30.00 17.15 19.83 168.04 2,590.76 24.75 31.54 41.11 103.00 29.14 19.55 19.55 4 648.62 s 11 057.23 Fa,m 1500 Schedull I tRn', ,,,"I REV - un EX . (1-") cO":I.'<<\l~4\'lfa~'NIA E8TATI! Of SCHEDULE J BENEFICIARIES VICTORIA H. BLATT ITEM NUMBER SS~ 209-12.6770 08 17 1996 NAME AND ADDRESS OF BENEFICIARY RELATIONSUIP 1 A. Tlxable Bequlll1l: Charles H. Blatt 3221 Highland Circle Hanhattan, KS 66503 Son 2 Virginia H. Deasey 2631 French Avenue Lake land , FL 33801 Daughter ITEM NUMBER NAME AND ADDRESS OF BENEFICIARY B, Ch.u1tlble Ind Govommonlll Bequlll1l: FILE NUMBER 2196-0675 AMOUNT OR SHARE OF ESTATE Ono-half of residue One-half of residue AMOUNT OR SHARE OF ESTATE $ 0.00 TOTAL CHARITABLE AND GOVERNMENTAL BEQUESTS Also enlor on Rno 13. Roc 1I\III1Ion (II more spllC8ls noodod, Insert Iddillonsl sl1ool3 of same slze,) Copyright (el ,"". fOfm loltwat. only CPSytt.ml.lnCo Fo,m 1500 Seh.dlll. J (R'v, 2-17) iOLIDATED UNIT INVESTMENT TRUST ACCUMULATION PROGRAM STATEMENT ~Z!;l I I I I I filE Ullt1A FUIID IAI' I I I I I I 9UU IOIl1l!.3H I I I I I I I I I I :P~E"5C CHt:~K Aco"tSS AS'HOWfl AoO\l1 ,I" HICOqRCCT, ,t..E.A'lC NOTE: AUV CH,H.GES Otf Rt'JER3E 510E 1__________________________________ THIS STATEMENT REFLECTS THE FOLLOWING "'". " " , "'.. ,"'It .ccou'" .."...... "0" "."...NC. 'i ~:~~~':.~~ ~~:':;: ~'.:;;., o. "'.. .,.... ",ceo""" .........,." ..,..I.,. ......CN '.0""'. AceDU"' ,,,.. "........c. ,...'''I''IC..'IO'' "0. H".....- co., '""...... ...c."n. 2119'IZ-6770 7008~321 ;!1l9-12'b7'/1I .UOH VICtORIA H BLATl D I ~ I1AK U\llt hFw r.\It,tlll,~1 Mill PII 170'/0-13\(: VlcrURIA M "LilT' I .'.l.! lll\!( t ^'~;: t:tU L~::-~II[IH^~1IJ I'll !}1110-1?3(, .. il\":UlMIES .\~o C:::~~E:i~C~j5 TO THE BANK OF NEW YC;lr(. ,.\O:;NT '7', WAll STREET STATION, NEW YORK, N,Y, I026S.o9H 'Oll FREE '.BOO.22,.ml TION INFORMATION FOR THE GtlHA FUIID lAP t. OIITMI.UTIOH ,...OM C....ITAl.fO" INCOMe. a. M&INYCITMCNT 0" ...CCUMUL...TION ,...OO.....M DIVIDCND/C...,.ITAL O...INS, )ATE FOR ACCUMULATION PROGRAM 07/\7196 QISTRIBUTION OF CAP IT ALJINCOME 'S TO UNITHOlOERS OF RECORO 07/22/96 PAYABLE 07/23/96 REINVESTMENT DETAtL $2.95 SHARES 25.663 \ ,146 1.\61 I \ \ 26.~70 DOLLARS OFEt\lIIG DALAIICI':: OIVIOftlD PAID AT I 511Af:ES FIJ111'\I"'~ED fRON \)ll!ll.EtlO RElNVESTNttlT AT $20. \a PER SIIARj I\lS'fRIMUllll11 FRIlM nOllll FUIII) U~lli 1l0LDrtl135 (Si:E DETAIL bELOlo/1 SI"\I~l::; l'IJII';\Ii.~f.D ri:lIl-1 IlIlrW fUIIIl U 1 S n\ IIUI WII II r $..11.18 FI:~ SIlAR TRANSACTION OESCRIPTION "16 "16 I);' ~h 'In $.\15113 PER SHARE $~3.tll ~. (,1.0511I0 BAI.AIICb I1AII!{['f VALU" $2" ,Ill pER SIJAKE $54(,.25 TRUSTEE DtSTRIB~E>E-'F-A TEREST AND PRINCIPAL NITS UNIT HELD TRANSACTION DEseRt ON PAYOUT d:..U: fli~~':.o:.. :.t:'ne:. !I' 05[': O'I~:A ~"'IlES 11' J,u, UI.I':'~ $n,nn~JZ TOTAL $7,Uu $lb .r.? UNIT HOLDINGS: 'in t.:ii'1'.i':. "h\!II'A! I'A~' \H~t 1;:.~1 ( 40 CIII\SI; l>!M~rll\ 1 r r.~ I'~ J '10.. [P^l \ , I \ \ I ,NT. yEAR TOTAL. T'" .....'""IILD O.Ylo.ND INCO.... .... ...,_.. ...... au...."."N" DIVID.ND INCO.... NO"....U........I"" ....011' ,..... c.."..... ..." ..0"6 .,..... C..IT..... .....N .." ".,....", " ,...,.:0 ",,,, ",TO" '"' "" ,.',,'",'. ..,." ~,,~ Dt ".,0 '"". ,.. ""..'... ,.v,"u. ...."" .",.u'" '0 0%..... .. ".. u,:O ", ...""", TO'H 1'.:0'... '" .%'0'" ...H'" ,." ,_".",%'OT" ".,.to",,,,,, ","0" 'H' ",,,,,,,"0' ......."-' . ,. ,., .",...,...'" ...: "..U .c' ,.. n...."'".: ".., '0'" ."" ,:"eJ ...' ,.."" "'V,,,,,,,, O' .".',.."0" ,..",,<"0" ..~~ IlFU 1996 U6.67 A. SE':'T:,:':~:::;~I~ S:'A':'=::-!E~!':' ':.'" =':::",....~:._'":::: or :::':~:::c e:'..J :10. 2 !:1..:;r, ~ \:':' 'J:":"\:":" :O:;:',-::,o;JI.!::: ..------..------ I , :::::-,)!~ ' . 3. ':~i'!: or :..:~~ 'I. :-.<;F.:C:"::! :::S C:'S! I:' ,., PC: r:"..\ : 1 \'" 1:-::"\ c.::-..... ]. t : c::-w. '::-.~.. ~. ::-." ..... -...... ::':~~r::, .. !. \:.\.'1.r::' (,21-:;')1: H:'..!:2~1l.. Ie. ::0':1'1::-:':" !Q.,. l' !',:,:~:'I~.d -=." q:.'/" 'Ic'':' .t S-;'.\-;'It-..:-,~ ':~ .':':.a:' ...~'::."~,1:-.': e:S':J. .\.-O:'J:-.':.J ;:.1':':' -=.: .t.~,:, ':y '::-.. '.':'::''f~'::': .1.,':1.': A:e ....C.oI:'.. :':.'~I :-:I.:<.=. ':1<:C;. ....lfr. ;:.l.:.'i O'.:.':I':':!.' '::',,, c:':'':'~.<J: ':!-.II!: "':'f ':',:'/:\ l',o:, !O:' :..:-.!'Q::,"..\'::"::::-:I.:' ;:..::;:,:sn .1.:'1-:': I:. :':Q':. :':-'::::"':':!.':!. :':-. ,::-..0;.:':.1.:'.. .... :~..i~ !~i'~;...:).r::'1 .~. ::o\:-'.!: :U::I ;.:::u~s cr 'O:1-'.C;.:~ It. :I~:': ~:~ '-=:!~:;~ C7 ,::.:.::~ ::;..;...! ;,:,;u::::o or :.::::~:\ :t33:!: ;. ~:-:.\':s:.::: !,:.\:! er '1:,::":;t.:,;" !!:":.:-: 5;' ::-.1.::''11 :'. ! :',1':':, ..':. as !~ft:'';'-;':: :::::'r: .Y;~?:C"Ci: C~?_"?7..\::C:-: Cit:...\. :I. ll,\.:u'!:' ie. ~itO?!:~::'! :..:C,\::O:I :'1:': O:Jo: :..\.:i! ::!~I C-.::-'.!!?..:..\:O. ~,\ :.~e~: .:~. :;::.__z::::::'; .;..::::: ., ~t._:.!:.;.!:;: ;:.;..:: 1':~::"': AJ:;':;.;~: C::'j;":':'f :2 ~, ~H~ :tCVt=';:~: C-':~:.3~?.:..\:::' C;,'':~'':j', ~,\ ,':';<: I '~r S::':"'-Z::.:::::: :1:' ~~:~e~ ~~:e~~ CL:? ~:.::.~'\ 4 .." ... s'.::-,~:;,;t.,! cr !O:L'.~;:Z"'~ :~\::S;.C::::: r.. S',:~:,:'),,"I.': :r SZ:":"!7:. ~ ::u.::S;'C::?:: ....... I:::: '=~"5S ",~~"~I': .....:'r" TD....... JO'':.~'''''Z:'. ~_.._....__ ~.'~: ;-'e~ ;.."..: ,~,_...," !.~~'__~A" ~'L--.' -~ ~o-_...u." ..... ~':--:":~ :..:..,.:~.: ,.:! ~,., .. <:~:.- "I.'.:' r l'.. ,,-. ..... ~..~=~!:. ?~~~~~~~ '::'. ......"e.'e ~--~:.. ... ...... ,,~. ~ . .,: . ;''''. I '::. '. ... .:..,. - .....t ..... . :.... ,.... I ..' ,\~....:,':.~,,~~s !::- ~~,,-, ~_,~:! :',0 S~:.:..,:' ':': ,~...t.".~'~ .:.~.':r~~....,~, oI-=::, ',:--r ~,,~. ~.:: 5"....- :.-: \-:::"'~~":':' .:.....o::.:-.:.:..:.....&::~, ..' .~ 't.,. ';" , :;'" :m~ I:.::. ,.. ....,.._y- ",..-, ,.-......./ ..,..~, ....,.. .. ~"4"~' "I'': 4~ ':"". 0;:.....-... I.:.:'. "_" ..'1 ... .~ -..-....,- .. r: :'';~,~'/ '.1'~'!" .. :..: :.. ~! ': ~ .:..:....,.. : :-: :-:~ .. :" -::-'" . '_4'.." ,...._;...-;.. '; ~ ~ : ~ ~:: . ~ :.: ':. ~~':SS ~:':'':::': :::! i?CX !C?_".C"'''!7:. :':'1.!::.:: ...... ':::.';'S: :":::'':::: :I::: :, S::':'::? :.:.:.,9:%.H , ):~':. ~,",:"'.-::-:::> ,,:\:: 3':' ~", ::: !!~r ~r ;-~'. ~.-~,.- ..- -,--.," ---.~ ::", ,,;~_;;,: ".~,,", ,J ".', "".'" '::"", ~...,_._:, '_,_,., -'I.'." 0;:..-.....- ...... I.... ..,.... ':;., ~::., ':!"a ;... . :~1 , :-:":'.':''':'7.7. ... , ' .. ' .,.:7'~-:":':':~.! :~: ;':'':'::': ,.:, 7~ ~. .-- .,..~-.." ....-~'1... .:-.. '..,..i'....L::.;.:....' 'i~':~:~~~...-: -::~!='':'-! ':':' ".::,,:,:, "-.'!' .... !:"".!..._':'......,-'t...-..:~.. :-~..'..,!,! .. !:':1': -..:-~:.'t~., :.,~-: .,~~_.I! ..I '1",:_..01 ---"-1.~. . ..,' ,!.::':.f': I .. ,........ "'.W.' .... .t.... . ,......, ! ~: . ,., ... ~: : . . & ~ .!:~ . ... ,:.~_"... oI.,....,.~ ,. -.-........ "! :1. :,'::1....,.., 't ,..-... , .. ....,. -::,:,._., .._,-: ~. .V ,.. "-::....:1~-9~":.J !,:: :.':,~., ':"':.1:'~ ';./ S..:".:- .... _..,'''''~.- "":.'1 ..... ~1'''': __._ ~.. '00., ,....- :.-=.I'.:s~~...~s !'::' ~~9~t .:=-:':,,:.~ ,:.,0 <:;,,::O!- '... .. "'.' c.,.:~-:..' ..t~9'1 ~. -... --'':- ~ ,~.. . .. <:::'':~,~',o ~.1.:('t. t.., t:......... ,:!:.,. ';e"c'" L ,~ .!~.:.'::-:."":,..-:.,:'1"!'.'.,.. ~ . .: . .. -' .. ._.._1', -:: ':_::..'f :.; l. :::.:. ,... ,::;: .... . "'. '.', 1":'- ~ :2 40 . . .:~:':. .....:."""':'!'- s"....,- ::_':'_'" ':~ ::-1:..''; .., .~ .t.,: ... ~ .... ." . .. !:". ::'I,:"L:: !::. ~:r::":' il'.!:.::::::: .-..::-:.:::: :'.-: S::':"Z? :':.1~:.n :':':.\.:. ,:..::- 3':!i'J?' .!'J?..':'.':~,'!?. .~::. .::..:;:; A-: ~:-:.._::.!::-: :-:'7:i.-:;: !:!:..:.::'. :.:.:..!:J.U '1-::. C.\S! ;.: $Z:::'!:J~:~= :?C~/:' :!':?_').';':;Z::. I :':.:o.~ :::, :.:~,1::.:~ .~~:.. ~:':u ;..~:.:~.~ :'':'1 ~: :;,,:.:~: :.: .!!:l.U I ~ :]:]:.. C::u A::~ :'.a !:':~ 3c:::11I: ~3::. :'8.1 ~~~ ~2~:!. ~11!~: !~:::~.: (::'~5 :.::\, 1:':':0." ,::, ,( ~:'i.:':'L:!' I::. :,us ?,.':.'::~:.:~.. :0.:. 5.:.:..: !:.:.:o._ u.. :.::,H:.I~ ! 13:1. C.\J~ :):: n.::i : ';, ~:?..'.':".;.:\ ;;..:..?:. l~::' C,\5:! :;~: :, ~ : P.:;~ ~::':'Z? ::0... '':::'='_:':'7:'.ti:' :-..:t::" a: ~:'.'::'o/..:'i. :e:5:"?~ :: .s :.:::~~:..':..:. '::;:;.' :! :;:&,tJ :,: :~ ~.~:.s S~ol.~e::ti~.': ::. 3=-:'/ L~":.J.,:::o,:,.:'.':1 :!~.::'1'i :: l':.e:":'~' '0""'0'..,,,. N, \ \:. ':::)"\<,\C(;..,, .,.. 1..:..... ,~~:.:,:. "'O'Y::!.-;-r.. \1~ClI ~_' Q !!Oit..'\C'.(!?....:....J....1 ~ - .~-- ~------::;;: c:~,.~ I' U ,:~'-'?, Ck~ ~'" //7 4e:.qJ.. -..-.-.. ...... ........... ,. ... .-.. :.......... .: ........-..... .... --"-.. . $::::':':? ~~:..: \1..1': ~~;,\,!3 :3':3.: ~ 1r 'l.l! ..-.... $:." ".=:::.::-: C:".\:,J:::J !::'::""-Z....!::7 ,:\:-'::0;::': '.\~! : .'..:. !">~~ . ~. ... ~..t-",.'J." t.:":':~':-~: _:-- L-'_ t:_:.:,"-:-_ )'l_~.':'.-:." ~ !"".':;:5 ;..-: .'- ..... ,.' ::.~ 1t~4t''':,:,'':'1 :~-..:..u..;:.;:J :'.'.'~~~- :'.~.:. ......:t;...... "I' r"....-...~.... " ... -... tl~~.;!. '!,.:!:.:: ":~ -:.:~/':..,~:..,:-~~..:.~. -" ... ....... .' ~.._....t,..:.._,..... ,. j..";...-....,"; ..... h:".';.:. Ton ':.: r..,,:,:::,:~~:.:.;~___ ,.. ,. ..... . .. ::.=..:..L.1...4.u.:.:....;.: "'':....~. .t.-.. ...\" ::\-. -:..:.':':..1.:..... .,.... .... '!:.~:.z.;I'r..:-:::..:.-..:..~\,;.,... 'I.~" .-, T;.' ":": .I.!:.:.=~.:ll..~.:..:. .~::;~~ V,:,:,,;-::~;: .;':'~:"-::X::::. ..~:~.- ..(':'--::1";.:....:.:.';.l.-.:.'.:::~.," .. 5:~':;:' ',on7r;:,:;-: e:1;~1.~~:: <;..,~....,.... "':'\.::I~-;'- ,''':0'':'': "'_.:'" "::1 ';':::'l!'': ",,:,:"'C;';~ ,;-:;_"l~1;"::~':' ":,,, '1... . .t.. ,. t(".....-. ':'" """": -.. -"';. ,.....~. ~ ,,;.....- . !:&. .,..-,..., .,,:.~~_..:,~~ ,.~ ''''. ..-.....-..... '."'" .... .,.... ?:". -,~-:; r.... ,...~. "'..__..._....... T~~ . .. ~.. .. . .~:.'. r':"'~ ~~... r... 1 ~;..~,;.H ~........-...... .,,..t: .V ."'........ 'I::, J::. I" ;:;: ,., , :" ." .. I':!. :=::'.:: :U:':::.!: 3': :.!~::!,. ':, 5: '.\:: ::. ;.:....:.;:C: .. ,,:a'" ".1 f"" ~..... I,... . . ....... .. :":.....~~"; !_~_ ':..:'_'~ ~: :2..~:"'~ ,~ ~...._..~,~. .......,..... ,...._...~ I.... ... :":3--: ....t.:..1.~:" ,..,,~:~", !:'l" "":'. ~ 'J ~"= ........., ....J.! . -=~":. ,:.!!:r.~..."'!S ,~"-:1:-:''l':) ~,:-:: ':.~:~!'... , , -.. , -. -- . .. ~.,. 1 : : : -':':"."';...' .. .: -.' . . . . . ........ . ... -::.";".! , \ "1 -:..:- ~ . .. . - . ., ., ,. ...,.. . . .' -.; .... " ....... . , ~.; .."..,_,.1 .......-1....... : :-:::. y::-::,,~.. ':":5..:..l\~e!' .;...~. ~.....-...~. -,~~. ; ';:" <";"':' "". . ;:. o:........~ : ,,<: ~.. . :.::!. ,\C:;;:.zC;".... .:.::.;::-::..z::-: :::~. ,::~'! ~~~~C::: , . ~."-'."f"- .... .....J...~ ~.~ .... .~.--...-..... -.... ~.,....~ ....' - . .. .. :..;. " .... ~~., _...... 'l"'.-:-.'::'::- :;;:,: ~;,:. ;~."~.~.. !;~:.. .: ~ '.. ~":""_.._ ?~.-'-11";:-"" . ~.III: '1_'" t-" 'l'.._, :~:~: ~~~_:~..~:~ ...., , :.~"::.~-:,,' ,.:=:.... .-.- :~ .. ~J!... ...It -..... ""'11""'''-'' ':;~"':";:" ...'... :".- .e--.~" ~-~."':'. -:...",:",:,., '::...":',':',, ... ,...._,..._ T._ -:"1.' ':' .\. ~. .... "':.~..~..':'1' :~:::~:~_~!~~~::~~.:.~::~~':'.. .''::-'::'':'" ,!:-.::=~..~!'._";' :::. ::: (, 't.: ... t..... .... ,., :::....... ....., :;: ,: :';', ",; .... ~.._. ... . ~,"::''!..- "'._~t.... ...- ~. ..c....':'-.. ...,~ ': ~-':: .~!:-...t~.. ! !'.!' .~..' "!.1.' ::,~::~:~: ; ..,." ~....-:'!....~._ .,'I"-.."l....,,~ ~... .. I" ...... 11 ,:E~' "..~.:,.. '.." ,-.. ; ;::,: I:::!. I I' .... .u._......,_ .......- "... . ~:::: :;-.:......::' "- _. __ OJ"'_"~~ i >: :~;~"~~~:::'~:";...,,-:..: I ..... -:. :.~,=...,,- S"';"- \ ".0 S":.:'~:':.':=l:' ':~:"':.;'!;':':I.,,;;.::-. I ......... ........ :t::=:'::--::::::: C:~",\.'\'4::; (:!::,;':.,: I i , I J .~. "'.' ,. ......... -1(...10;"1.--" ,;". ~,"'-~-~" ......-: c ;.." ;: ;;:':: ... ... :; :::~~;=::~:::: ;::::~;: 3~.:~:.: , :~::.,~, " ~~ ~:.~~t ~~1, ~~:':.~:~ : s:';~ !:=. s.:,,;~~~ ~l ,;,.::~.H .. ::;;';.~I- . . ~.. . ,. ,~.: ":(':.:.... , ~ . .... "II, ..a ..... .a ... ... i: . ~ ; " ""II, ..... ...... ~ ..:' , . ... a'" .... .. . H.!':' H'. '~ ...;....~. _!':'':'.H .... ~.. - ." ... .... . ... .... .. .... " !:! t ~i:'.~:'; ,'i' ~ e! ':.~:.s .':.~':..~.~.':.. -- -:':.' S:'i:,.:!..~~:~H :.:...:'.:.....1':.i'1 :,':,;.,':. :~ a ;:~,a~":.~~ c:::;:~. :~ ;:'71 :. c! ':.:,;:.1 (~ I.t:....,~!:.. C.:-:':'::~.~ -:.~ ~~ a. -:':-':1 :::::-0 '1:.:' r'-<J:t s::..:.t:\'!f :'::1::1:> ,,= "!=":'fr'~ ~.~ ~,~~, 0:1" . ,..~. .,= 0.:: L:~ ... .... ..... ,. . ~., . ........ .. ..... ~!. .,. :~ .11 i5 .:: e.::""';' ,:1i" ,-:.:.':.1:-:-.0:. ,~~JYJ~ ~,,-:,";:'~~I:'.-:. ;":;1:'.':. D Dauphin Deposit Bank and Trust Company ~U-' .'~,,' " , ",,,, ',..4 , < . MAItI OFFICE: 213 MARKET STReET, "ARRISDURG, PENNSYLVAtHA 17101 n ~.J.i::~.:.Lf.0:_!~J ~ 711255-2121 U: i !~~ SEP 1 6 1996 ~' dl.k5G15rrCrC:.l~. Decedent Confirmation ----..-.. ..--------......-- Name: Victoria M. Blatt Social Security No.: 209-12-6770 Date of Death (000): 08/17/96 Account No. 0015941531 0094251169 60421558001 ------------------------ ------------------------ ------------------------ Type Checking Checking Installment Loan ------------------------ ------------------------ ------------------------ Date Opened or Issued 02/04/69 01/10/83 11/06/92 ------------------------ ------------------------ ------------------------ Date Closed or Matured ------------------------ ------------------------ ------------------------ Date of Death Balance $1,992.79 $2,877.71 $1,261.15 ------------------------ ------------------------ ------------------------ PLUS Date of Death Accrued Int. $1.70 $1.10 $.82 ------------------------ ------------------------ ------------------------ Joint OHners (if any) None None None ------------------------ ------------------------ ------------------------ Date of Joint OHnership ------------------------ ------------------------ ------------------------ ------------- ------------- ------------------------ ------------------------ ------------------------ Special Comments: N/A Addttional information available at 520.00 per hour. On8 hour minimum. Date Prepared: September 9, 1996 Prepared by: Carolyn A. Berkebile Customer Management Informaticn Dept. (eMI) Page 1 of 2 Telephone No. (717) 255-2054 M 00-020-216 (REV 7/931 D-\UI't-tlN DU'O'ioI' D.,~", ",...,0 TRU~T COMI'AN". H.'R~I"lIUKG. Pl~"'S'rl\'AM' 1'''.1 1'"" No 2 of 2 To Boswell I Snyder, Tintner & Piccola Name: Victoria M. Blatt SSN: 209-12-6770 000: 08/17/96 No. 01301462 ------------------------ ------------------------ ------------------------ Safe Deposit Box ------------------------ ------------------------ ------------------------ 09/11/79 ------------------------ ------------------------ ------------------------ ------------------------ ------------------------ ------------------------ Not Applicable ------------------------ ------------------------ ------------------------ PLUS Location: late of Death Accrued Int. West Shore Plaza Office ------------------------ ------------------------ ------------------------ oint OM1ers (if any) None ------------------------ ------------------------ ------------------------ ------------------------ ------------------------ ------------------------ ------------ ------------------------ ------------------------ ------------------------ pecial Comments: N/A Additional information available at 520.00 per hour. One hour minimum. Date Prepared: September 9, 1996 Prepared by: Carolyn A. Berkebile Customer Management Information Dept. (CMI) Telephone No. (717) 255-2054 LAST WILL Al'W TESl>1MENT OF VICTORL4 M BL4TT 1, Victoria M. Blatt, of New Cumberla.nd, Pcnnsylvania, revoke my fomler 'Vilis and Codicils an~ dcclare this to be my Last Will and Tesl.'lrnent. ARTICLE I PAYMENT OF DEBTS M'D EXPENSES I direct that my just debts, funeral expenses, and expenses oflast illness be paid as provided under the Victoria M Blatt Living Trost. ARTICLE II DISPOSITION OF PROPERTY All of the property that I OMl at my death, or which sluill become payable to my estate or my personal representatives, and any property that I hoIve the power to dispose of under my Will sluill be distributed to the Trostee of the Victoria rvL Blat! Living Trost to be administered and distributed as provided under that Trost. ARTICLE III NOi\fLN'ATlON OF EXECUTOR I nominate Virginia M Deasey, of Lake land, Florida, and ChoIrlcs rvl Blatt Jr, oflvfunhattan, Kansas, as Co-Executors, without bond or security. If one (or both) of the above nominees does not serve for any reason, I nominatc Ralph Deasey, of Lakeland, Florida, as replacemcnt (or solc) Co-Exccutor, \'.Iithout bond or sccurity. ARTICLE IV EXECl'TOR POWERS My Exccutor, in addition to other powers and authority granted by law or necessar)' or appropriate for proper administration, shall have the right and powcr to lease, scll, mortgage, or othernisc encumbcr any real or pcrsonal propCl1y that may bc included in my estate, \\ithoUI ordcr of court and \\ithout noticc to anyonc. Witncss N~mc: 41~, 1J~ _~l;l:.~n ~A /' 11111'" { hi. ~ +r. Vl ~-}" Witncss Sign~turc: Witness Addrcss: ~tr~~~~~I~~A I ~" 7'" '. ~ . , I i I , , L '010 HIli , \ \ I , i \ I I \ , oJ,'; .,) I" I RECEIVED BY,' ..:I I~ f l. './ /I, ' '"J ,.I'-!- ... ,GNATJli) - I ./" '., I, MI\RV C . LEWIS .'. ,,/,\) /'/ ,{ REGISTER OF WILLS " DNo.AA 146903 COMMONWEALTH OF PENNSYLVANIA DEPARTMINT O' REVENUE OFFICIAL RECEIPT. PENNSYLVANIA INHERITANCE AND ESTATE TAX . .1\10\\6211'....' ACN ASSESSMENT 'l' CONTROL ~ NUMBER AMOUNT D RECEIVED fROM: 1'01 ..~.O()o.oo CHARLES M BLATT JR 1312 OAK LANE NEW CUMBERLAND, PA \7070 ESTATE INFORMATION: ~ FILE NUMBER U 21-\996-0675 ~ NAME OF DECEDENT (lAST) ~ BLATT VIc'rORIA M II DATE OF PAYMENT B POSTMARK DATE COUNTY SSN 209-12-6770 (fiRST) (MI) , . CUMBERLAND DATE OF DEATH 08/17/96 REMARKS CHARLES BLATT fa TOTAL AMOUNT PAID '3,000.00 SK SEAL CHECK II 097 REGISTER OF WI LLS , .. ,.- ,~_._. --- --- .-'- -- .~.-. .-- ._-.'- - .--.." ,.... u__-- ... ..~-~~. _ J'-r ...:. (j I ~ ,~ BUREAU OF INOIVIDUAL IHII[RIIANCE lAll DIVISION D[Pl. lBDbDI IIARRI5BUAG, flA I1HS-ObOI , .) TAXES COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF INItERITANCE TAX APPRAISEltENT. ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSltENT OF TAX DONN L SNVDER ESQ BOSWELL ETAL 315 N FRONT ST HBG PA 17100 DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN (/ 06-16-97 BLATT 00-17-96 21 96-0675 CUMBERLAND 101 Anount Re"itt.d 1* Ill. a., II'" 111.'" VICTORIA M l MAKE CHECK 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 ~ riEV:is4"j"E)("Aj:P-ioP~7Y-NO"ficE--ciFufNHEifi;:iiiicE-TAX-A-PPRA'isEifENi'-;-AL.i.-ciwiiiicE-eiliumm-m----- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF BLATT VICTORIA M FILE NO. 21 96-0675 ACN 101 DATE 06-16-97 If an assessment was issued previously, lines 14, 15 and/or 16, 17 and 18 will reflect figures that include the total of ahh returns assessed to date. ASSESSHENT OF TAX: 15. Anount of Line 14 .t Spousal 16. Anoun! of Line 14 taxable at 17. Anount of Line 14 taxabl. at 18. Principal rax Due TAX CREDITS: PAYltEHT DATE 11-04-96 03-07-97 TAX RETURN WAS: I X I ACCEPTED AS FILED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1, Ro.l Elt.t. IS.hodul. Al III 2. Stocks and Bonds (Schedul. 8) (2) 3. Closely Hald stock/Partnership Intera.t (Schedule CJ (3) 4. Hortg.gas/Not.. Raceivable (Schedule OJ C4J 5. Cash/aank Deposits/Hlsc. Parsonal Property (Schedule EJ (5) 6. Jointly Owned Property CSchedule f) (6) 7. Transfers (Schedule G) (7) 8. Tot.l Assets APPROVED DEDUCTIONS AND EXEMPTIONS: 9. funer.l Expenses/Ada. Costs/Hisc. Expense. (Sch.dule HI (9) 10. D.bts/Hortg.ge Li.bilities/Liens ISchedule I) 1101 11. Tot.l Deductions 12. Net V.lue of T.x Return 13. Ch.rit.ble/Governaent.l aequests (Schedule J) 14. Net V.lue of Est.t. Subject to T.x NOTE: r.t. Lineel/Cle.s A ~.t. Collete~el/Class 8 ~.t. 1151 llb) 1171 RECEIPT NUltBER AA146903 AAIB5240 DISCOUNT 1+1 INTEREST/PEN PAID C-I 157,89 ,00 CHANGED 111.000.00 544,25 ,00 .00 11.109,37 ,00 ,00 IBI 39,152,03 11 ,057 ,23 1111 1121 USI U41 ,00 72.444.36 .00 X ,00= X ,06= X .15= UBI AltOUNT PAID 3,000.00 1,180,77 TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE NOTE: To insu~e proper c~edit to your account, subnit the upp.r portion of this fo~n with your t.x p.ynent. 122.653.62 ~n,70q 76 72,444.36 ,00 72.444,36 ,00 4.346.66 .00 4.346.66 4,346.66 .00 ,00 .00 . IF PAID AFTER DATE INDICATED, SEE REVERSE FDR CALCULATIDN DF ADDITIONAL INTEREST. IF TDTAL DUE IS LESS THAN fl, ND PAYltENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" fCRI, YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORIt FOR INSTRUCTIDNS,) ~., (-, ~'\ ~ ., , .. ,~. u..: 1-:1 (.... ,~- ~~ ,-' RESERVATION I E,t.t.. of dlCldlnts dying on or bafor. Olc..bat 12, 1'82 .- l' any future Int.r..t In thl I.\at. II tran'farrad In po.....lon or .nJoy..nt to Cll.1 B (co1latara1J blnetlcl,r... of thl dlcldant aft.r thl Ixplratlon of any ..tat. for 11" or 'or ya.r., thl Co..onw..lth har,by ..pr..,lv r...rv.. thl right to appral.. and .1.'" tranl'.r Inherltancl tax.. at thl lawful C1... . (co11atar.1) rata on any such future Int.r..t. PURPOSE OF HOTlCEI To fulfill thl requlr...nt. of Section 2140 of thl Inheritance and EI'at. Ta. Act, Act 21 of 1995. elZ P.S. SacUon ",.0). PAY"ENT I Detlch thl top portion of thh Notice and sub.it with your ply..nt to thl RIghtu of will. prlntad on thl r.v.r.. side. .-Maka ch.ck or lon.y ord.r payable tal REGISTER OF MILLS, AGENT REFUND (CR)I A r.fund of a ta. ctadlt, which w.. not r.qu..t.d on the Ta. A.turn, .ay ba r.qua.t.d by cOlplatlng .n "Application 'or Rlfund 0' Pann.ylvltnla Inh.rltance and Est.ta Tax" (AEV.ln:U. Application. ara avallabl. at tha Office of the R.glstar of Will., any 0' tha 21 Alvanua District Office., or by celllng tha .p.el.l 21t-hour an.w.rlng .arvlca nueb.r. 'or fota. ordarlngl In Pann.ylvanla 1-8DO.162-2050, out.lda P.nn.ylvanla .nd within local Hatrl.burg ara. (7171 787.80'4, fDD' (717) 772-2252 (H.arlng I.palrad Onlyl. OIJECTIOH$1 Any party In Intara.t not .atlsfl.d with tha .ppral....nt, allowanc. or dl.allowanc. 0' d.ductlon., or .......ent 0' ta. (InclUding dl.count or Inter..tl .. .hown on thl. Hotlc. au.t obJ.ct within .I.ty (601 d.y. of r.calpt 0' this Hotlce bYI "written protllt to th. PA D.part..nt 0' R.v,nu., Board of App..l., Dapt. 281021, "arrhburg, PA 17128.1021, OR ..al.ctlon to have tha ..tt.r d.ter.ln.d .t audit 0' the .ccount of the p.r.onel tlpr...nt.tlv., OR ".pp..l to the Orphan.' Court. AD"IN ISTRATIVE CORRECTIONS I Factual .rror. dl.cov.r.d on thl. ........nt .hould b. addr....d In writing tOI PA D.part..nt of R.v.nu., Bur.au 0' Individual Ta..., ATTNI po.t A,,"....nt R.vl... unit, aept. 280601, Harrl.burg, PA 17121-0601 Phone (717) 787-6505. Sa. page 5 of the bookI.t "In.tructlon. for Inh.rlt.nc. Ta. A.turn for. R..ld.nt alcadlnt" (REY-I50I) for an IMP1.natlon of _d.lnl.tratlv.Iy corrlctabI. .rror.. DlSCOUHTI If any tu due 11 paid within thr.. CS) cal.ndar aontn. aft.r thl d.cedant'. d.ath, a flv. p.rcent (51) discount 0' the t.. paid I. allow.d. PENAL TV I Thl 151 t.. aana.ty non.partlclp.tlon p.n.lty I. cOlPUt.d on tha total of the t.. and Intara.t .......d, and not p.ld bafor. January 18, 1996, tha flr.t day aft.r the .nd of the t.. aan..ty parlod. Thl. non.p.rtlclpatlon pan.lty I. appaalabIe In thl .... lannar and In tha tha ...a tl.. p.rlod a. you would .ppaal tha taM and Intar..t that ha. b..n .......d .. Indlc.t.d on thl. notlc.. INTEREST I Int.ra.t Is charg.d blglnnlna with flr.t day of d.llnqu.ncy, or nln. (9) Bonth. .nd on. 11) day 'ro. tha d.ta of d.ath, to th. data 0' p.y.ent. taMil which b.c." d.llnqu.nt b.fora J.nuary 1, 1982 bl.r Intara.t .t the rat. 0' .1. (61) p.rc.nt p.r annua calculat.d .t _ dally rat. of .000164. All ta... which b.c.,. d.llnqu.nt on and aft.r Janu.ry I, 1982 ..Ill b.ar Int.r..t at . rat. ..hlch will vary fro. c.llnd.r y.ar to cal.ndar y..r with that rat. .nnounc.d by the PA D.part.ant 0' R.v.nu.. 'h. ftPpllcabl. Int.r..t rat.. for 1982 through 1997 ar'l '!!!!; Inhr..t R.t. O.lIy Intarnt Fector !!!! Intara.t Aat. Deily Intarnt Fector 1912 201 .000548 1987 'X .0002'" 19U 16:< .000418 1988-1'9'91 11:< .00nGl l'98. 11:< .000301 19'92 'X .0002'" 1985 13:< .000356 19'91-19'94 ]X .000192 1986 10:< .000271, 19'95"1'997 'X .0002'" .-Int.rllt Is celcu1ehd .. tallow. I INTEREST = BALANCE OF TAX UNPAID X NUNBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR .-Any Hotlc. I..ued after the taM b.co... d.llnqulnt wlll r.fl.ct .n Intar..t c.lculatlon to ,Itta.n CIS) day. b.yond tha d.te of the .......ant. If pay..nt I. .ad. aft.r tha Intar.st co.putatlon data .hown on thl Hotlca, additional Int.r..t .u.t ba calcul.tad. , Register of Wills of CUMBERLAND County, Pennsylvania INVENTORY Eala1801 VICTORIA M. BLATT No, 2196-0675 also known IS OaloolQoalh 08/17/1996 ,lloc8asod SocIal Security No, 209.12 - 6 770 CHARLES M. BLATT , JR. , PtlnIClnal Ropr_ntallve(a) 01 the .bovo Ealato, docoasod, II9fffy thai tho homs appearing In the lollowlng Invenlory Include 011 01 the peraonal _Ia __ oItuato and 011 01 the roal88la\o In the Commonwealth 01 Pennaytvanla 01 oaId Oocedon~ th.t the valuation placed oppool1o each hem of aald Invenlory repr_nla IIa fa/( value IS 01 tho dale of tho Oocedonra dealh, .nd thai Oocedont owned no real .....18 outslde 01 the Col1'lllOnwealth of Pennaytvanl. except thai which appoll1lln . memorandum et tho end of thIa Invenlory, I rwoll9fffy thot the otalomenla made In this Invontory are true .nd corroct. Irwe undorotond th.1 faloe otaloments hore/n are made SUbJect 10 tho penallles 01 lB PL C,S, SectIon 4904 re/oUng to unsworn IalslIIc.tion to sulhorlllos, Name 01 Attorney: DONN L. SNYDER , ESQUIRE to, No,: 06858 Per80nal Repreaenl.Uve ~no~Jle: C~/!~ CHARLES M. BLATT, JR. ~n.lure: Adw~: 315 N. FRONT STREET Address: 3221 HIGHLAND CIR. HARRISBURG, PA 17108-0741 Telephone: 717 /2 3 6 . 9377 MANHATTAN, KS 66503 O.Ied: to' '1Ft7 . . Oeocrtption Value (See continuation page(s) attached) (Anach .ddlllonal ehoela h neoos,,,,,y) Tolal: 122,653.62 NOTE: The Memorandum 01 rOIl est.le outslde tho Col1'lllOnwealth 01 pennaytv.nl. may, .t lho _n ollho peraonal ropr.....nl.llve, Include lho value 01 each hem, bulsuch figures should not be extondod Inlo tho Iotal of tho Inventory, Pr.par.d by Ihl Ptinn.ytvanl. ea, A..od.tlon Copyrlghl(t) 1Dte form ,oll.at. only CPS)'It.ml,lnc. Form .RW-7c.ml - - ~ _...,. ___... __-0 , INVENTORY Estate of: Date of Death: County: VICTORIA M. BLATT 08/17/1996 CUMBERLAND CASH: ARRP HEALTH INSURANCE TRUST - REFUND OF UNUSED PREMIUM 2.66 28.00 AMOCO - REFUND 10.00 BELL ATLANTIC . REFUND 14.47 CAPITAL ONE - REFUND OF CREDIT CARD BALANCE 1,029.13 CASH FROM SALE OF BOOKS - TO VIRGINIA DEASEY 150.00 COMBINED INSURANCE COMPANY OF AMERICA - REFUND OF UNUSED PREMIUM 1.45 DAUPHIN DEPOSIT BANK AND TRUST CO. - CHECKING ACCOUNT NO. 0015941531 1,992.79 DAUPHIN DEPOSIT BANK AND TRUST CO. - CHECKING ACCOUNT NO. 0094251169 2,871.71 HOUSEHOLD GOODS - SOLD AT YARD SALE 3,198.00 NUVEEN - DIVIDEND 79.00 READERS DIGEST - REFUND 11.23 SMITH BARNEY . ACCOUNT NO. 724-22020-13-410 1,714.93 ..---..--------- 11,109.37 -1-