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BRI'NSER Be WAGNER
ATTORNEYS.AI.LAW
22 NORTH RAILRO 0 STREET
p, O. BM23
PALMYRA. PENN: ' ANIA 17078
1717) 83 348
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PETITION Hm PHOBATE lInd f;HANT OF LE1TEHS
lis/a/,' of J'I!:J..J-L!'..c..L,-CJt,-,d.._...~ No. __~J-=5~_=-S_?~_
also kflOll'1I a,\ ...cL_,_ ____, , ...., _.., _,.. _ To:
I{eghler of Wills fOt Ihe
----:-~___,~-.-/J(~(:(~l\~;;I, C""lIly uf _-,UMIl_:-'JAN/J in Ihe
Soci,,1 S,'cl/ri/)' No. ..:(.:t.L _I{,_,.:i.CJj.~)" __ ,_ COllllllonweahh of Pennsylvania
The pClilio/l of Ihe undersigned respeClfully repre'enls Ih;ll:
Your pelilioner(s), Whll h/are IN years uf age III ulder an Ihe e"eeul......;',
in Ihe last will of Ihe ahuve dee,delll. d;lIed _._.5._"_.'2...~'1
and codicil!s) daled _______._.
nallled
,19_
hHllr rclC\'alll drcllnHlarh:C:\, c.". renunciation. dealh or ("('culm, eIC,)
Oecendenl was dOllliciled al death in _(~" 'J'), l.. ~ ~( , Counly. Pennsylvania, with
h t ~ I las, fam!ly,<)( principal .esidence at ) )l " " J.. J f.. U i (,: " 4'.,/ L
if. ( {~~0---.J.JL..:...LI~-LLL.t.J..q ,-'", 'I /1(, ~.. , i /1 t. t"_,L" "/I"
(Ihl \tr('('I, number and mundpalitYI I (I fI
De~e delll,lhcn . 3...!L years I' age. died Il u ,~.d~ / () ,19 '/ (.. ,
al Exeepl as I' 1I0w/1 e~edenl did not ;u:~r:(w~;{;~/~ivoreed a~d did nOI have a child born or adoPled
afler execution of Ihe will offered for probale; was notlhe victim of a killing and was never adjudicated
incompelelll: - )/1 <l _
, I
Oecendelll at dealh owned property wilh estimated values as follows:
(If domiciled in Pa.) All personal property S ,l"j <'tot' ,'('.
(If nOI domiciled in Pa.) Personal property in Pennsylvania S
(If not domiciled in Pa.) Personal property in Coullly S
Value of real estate in Pennsylvania S
situated as follows:
WHEREFORE. petilioner(s) respectfully requestl't the l1.robate of the lasl will and eodicil(s)
prr'ented herewith and the grant of lellers TES AMEN I ARY
Iheron.
(l1!\larnCnlary; adrnini\tr3lion -':.t.a.; adminimillion d.b.n.c.l.a.)
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OATH OF PEHSONAL ImPRESENT A TlVE
COMMONWEALTH OF I'ENNSYLVANIA t::;s
COUNTY OF CUMBERLAND J
The petitioner!s) above-named swea.!,) ur affirm(s) Ihat Ihe Slalements in the foregoing pelition arc
true and eorrcet 10 the best of the knowledge and bclicf of pelitioner!,) and Ihal as pcrsonal rcpresen-
talive!s) of the above decedent petitioner!s) will well and Iruly administer Ihe eslate according 10 law.
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Sworn 10 ~r af fjr~~~H and suhscri bed {
before me thIS _ day 01
~ ~tt. OC~O~_~ 96~
1/ } ,,,,I (. , (JI "t LO, . ~/ I;l ft~ <1
MM Y C. L EW I R,'gislkl I
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Thi, j, III (""if)' ,I\ill .hi, j, " 'nlO <Tll'l' "I rho l'f'('I,rrt.".j,;n,-j,-mri,'" ;" II" I~ I,,,.; 1",:,1., I~j.,;.l" I\PoVjl~r.11 in .ml1't'.n~
with ^l"1 ({I, 1'.1.. \HI. .lpl'ro\'l'\1 h)' II\(' (It'I1l'I.d ""l'Il1hl)'. .I111ll' .!l), I')~ \
WARNING: Ills 1II0golto dupllcato this copy by photostat or photograph.
Ft.c.' (or (hi, ll.rtiril.lft., $ \ 00
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(11.111('\ Il.ndt',u'r
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OCT 0 9 1996
No.
Il,II"
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COMMOtlWE"tlU OF pumSYlVAUlA. O[rAntMEUf OF flEAltlt . VitAL REcana!
CERTIFICATE OF DEATH
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., 220 - 16
Elizabeth
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..E. pennsboro Tw . ...
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ftculllborland
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II.Clorical/SoorolRry Illletall
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Salea
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, Sarah Harriet u 1
~,"'''lHOolOl)IIII:'$_ .....
..133B Bre.dt A.OOll
"laor 0i'Y0i'1OfI._..c-.c-J
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~arr8tt8'111e Cemetery ,~arret8Yl11e.
....YlAlClolDON...OI' KAJUookllD Funeral HOllO
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P,O, Box 20le
..Meohanlosburc. PA 17055
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b. 1'wollty- r I Vo (2~'\,) pel'Cr!1I1. lIlItll till!
Illlly nraham Evallgollot1c t\nllllclatlnll. 1.0 bc
UDed 00 it necn bent;
c. Twcnty-rivc (25'\,) percont unto
MeDDiah Village, 1.0 be uDed an il. DeeD best;
unto
beDt;
d. 'fwelve and
Project 1I0pe,
one-half (12K'\,) percent
to be uDed as it oeos
e. Twelve and one-half, (12K%) percent
unto C.A.R.E., 1.0 be used as it sees best;
IV. I appoint my oi.oter
Boggs and Doris Gardy HaineD aD
them as sole Executrix, of this
and her daughter, Beulah Fristoe
Executrices, or the Burvivor of
my Will.
V. I direct that no bond be required by my fiduciaries for
the faithful performance of thei.r dutieD in any jurisdiction.
IN IHTNESS WHEREOF, 1, ELIZABETH C. FRISTOE, herewi th set
hand to this my Last Will, typewritten on two (2) sheets
paper including the attestation clause and signatures
wi tnesses, this S' ~ day of VVI~ ' 1989.
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{y!:t4,L("; r/. ... Y.u.' tT-<'-
ELIZABETH C. FRISTOE
my
of
of
(SEAL)
Signed by ELIZABETH C. FRISTOE, by her declared to be her
Will in our presence, who have hereunto subscribed our names as
witnesses in her presence and at her request. this ~'~ day of
"", ' 1989.
, ):I~\,
,AuO-<:!--'l-- \.--'~<;':L_';"....,LI residing at ""'-'~'''--,-:-'''''''-1 (",4
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6~......~.......,.- -t-', 'JI.?_u~, 'Y~.., residing at .u,,,,'~~l--d nt'
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COM~10NWEALTII OF I'ENN:JYINANI,\
COUNTY OF CU~lBERI,AND
C J 0
I~E. ELIZI\BETIIC. F1nnTOE, S'",,1~ ,Ico"c', anI I,,~...J=
V,t1e..._.c.. , the teotiltrix and the witnennoo, renpectively,
whose names i11-e oigned to the dttached 01- [ol-egoing inntrument,
being firot duly oworn, do hereby declare to the undersigned
authority that the tentatrix nigned and executed the inntrument
as her Last Will and that she "igned willingly (or willingly
directed another to oign for herl, and that nhe executed it ao
her free and voluntary act for the purposes therein expressed,
and that each of the witnessen, in the preoence and hearing of
the testatrix, oigned the Will ao witnesoeo and that to the best
of our knowledge the tentatrix wao at that time eighteen yearn of
age or older, of nound mind and under no constraint or undue
in fl uence,
Pi, ;,'Lt-',r..., _/ ,7-l-'';/;: <<-
ELIZABETH C. FRISTOE
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~ch_ c(J- (c,\l - G 'l'-t ,j-" (I
IHTNESS I
(] Cl,c,,J! A':"" _ ~ ,,)J-<?--..<~.._< ~~~
WITNESS ~
Subscribed, sworn or affirmed and acknowledged before me by
ELIZABETH C. FRISTOE, the testatrix, 5'~.,.", i:. ,-f ,,'S I', and P".......,
v.lh-,.,,,,.c.. ,witneoses, this ~''''' day of yY\."'1 ,1989,
['(.0-/:.,-,/ ;t-> 1<--:+
,(SEAl,) NOTARY PUBLIC --\
NolarialSoal
Robort L, Fry. Notary Public
Upptr oIlIon Twp" Cumbcfland County
t.lyComm~I1Exrrilll\Au9, '~.1991
M.r:>llor, P..,n""''''~ I...oco""n el Nolan"
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21 - 96 - 876
RENUNCIATION
In Re Estate of
, , (,
C. LJ'i /.'tI,
/ I."t'~,(,
deceased.
To the Register of Wills of
(I" .. /,,_. (II ,'".
County, Pennsylvania.
The undersigned
/1., ,. (' d i, ! .1, ~ t'~I. ;.J..-..,q'Vj
~ Iv
of
the above decedent, hereby renounce(s) the right to adminisler the estate and respectfully ask(s) that Letters
J; .1 t A-/J}l ..' ...->t it~ t, , ~
If ,'/ I ' /
be Issued to ,( 1.1 oH (....v -1/ (L+ ,/ '/ :;. d.< '.. ",1 I
WITNESS
hand this / '" day of
~!J
,19 '1 to.
;:;,u(~:l:. F.:/'/.(. ;.- nO,..1
(Signalure) I!
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(Signature)
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(Signature)
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CER1'IF'lCATJOll OF ~~f)'/'l..C" lJ!!DEI.!._~HII-,I: .." (, ( a)
Name of Decedent: I, I..J ,I /" II
.
Date of Death: y, It '/I..
Will No. d'i I.. {, (, ,\ It.
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Ad I' ,7 ,.,} /
min. ,0. . L,
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To the RegisLer:
I certify that notice of beneficial interest required by
Rule 5.6(a) of the Orphans' Court Rules was served on or mailed to
the following beneficiaries of Lhe above-capLioned estate on
/.).3.<('/ :
Name
~,
~Jc,_<"L ( tl,
(/ '/ /;:
Notice has now been given to all persons entitled thereto under
Rule 5.6(a) except
Date: /. ,,/ B - 'I 7
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Signature '
Name n,. ,.' , c, (~, 1-1 (, I /,) (, .;
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Address ':.( .:.; I JJ'." ,d ( cu.'-(
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Capacity:
Personal Representative
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Counsel for personal
representative
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CER1' 11'1 CAT ION OF f1gTLCE U1JDI"5.-!l~'I,.I; 5. fi (a l.
of Decedent: .:; I /, ff I f / ../ ,
Name f ',) ,J , , .
, .
Date of Death: (' / LI '/L.
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Will No.
IfNI. ' t. t " /(.
(, .(~. l/
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/idmin. No.
To the RegisLer:
I certify that notice of beneficial interest required by
Rule 5.6(a) of the Orphans' Cou~t Rules was served on or mailed to
the following beneficiaries of the abov'1-CapLioned estate on
/ - J ,1 . (/7
,
Name
Addres!'
, II"
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:!JJ~-"".I)l<l.-. IO/H-to'l {II,; 1.(, ./<",~/(' Ji .j. <';r,-,,f;-,
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'{ j(J--')l_~x.JI {.. J)~__(({,"tl._ lll"_;'"";'J ,.'-1,(1' ).:.c (X ,';- .Jl~l."a I ),., ____2~ 1'7<:
I II I . I I
Notice has now been given to all persons entitled thereto under
Rule 5.6(a) except
Date:
;~/ It i
JCJ: ...L,
lB, '/"1
,I' ... ~ -~ ( .J,
Signature
Name I)" t", I '-,' (.- 1-( ,L I 1\ i "- '.
Address /.j:.,; /. },-/, If ,. d l (,'
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Telephone (~'/'l) '; ') <J, J '; - </.2
Capacity:
Personal Representative
Counsel for personal
t:epresentative
. .
CER'l' I FJCA'l'ION OF r.1_~)~fLCE_tJ1Ji)EJl_!UII.I~~liU_
Name of Decedent:
(~~ J / II . ("
I j , . I ,. ,
\ ,/ t., 'J !~
}idmin. ~~o . ^ r; i /' ,\ 1/
(' /' \ J! .
.
Date of Death:
Will No. It/'//.
To the Regisler:
I certify that notice of beneficial interest required by
Rule 5.6(a) of the Orphans' Court Rules was served on or mailed to
the following beneficiarios of the abov0-caplioned estate on
, '):..: t,'"1
,
Name
Address
;-
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entitled thereto under
Notice has now been given to all persons
Rule 5.6(a) except
Date:
/ - .;, B
1'7
,
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Signature
Name I , , (~ / /,'1 / f\. (, <;
Address , ,- h ,A, ,J I (1./..'
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Capacity:
Personal Representative
Counsel for personal
repr'?sentative
CERTIFICATION OF' NOTICE UNDEH IUlLE 5.6 ( a)
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Name of Decedent: y. I')
of Death: co. I
Date ,) " / () 'I t.
Will No. I ~I r ~ - Ot, S:' J(.
I..U, lIt'"
J
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Ad' N "0'
mJ..n. O.",(f:
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To the Register:
I certify that notice of beneficial interest required by
Rule 5.6(a) of the Orphans' Court Rules was served on or mailed to
the following beneficiaries of the above-captioned estate on
/,2;J,.d7
.
Name
fl. iL-/-- "L) )):. r L ~ to < I .~
.
Address
.;' fJ i-,
.
I .
Ii, \ d (.' .;(;t.,
,-
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f/p"". fL,~u.J' ,j(,,/ S,.l./)oAsr:/nt>-lrH:"JJ{.~"I',2, /"/lll.3
/C, I 11. t7 I f ;,y' fA I L'rl. ~ d". 3 I q i( 'lUX .. iff. l[ N, . .) (~ ( ~'/.l../. h' I" t.,._'/"kt(.
/1 oj ..:; 1(. (.. c,
.'? /L~-I-('C t -~'/'l-"'~ /\1. N ,; ,'J 1\ )'X u' ((I'",-{' d ii" . 'JY (.i/t. _ r' .J .~ (' "
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Notice has now been given to all persons entitled thereto under
Rule 5.6(a) except
Da te: /, ,J 3 - 'i ./
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Signature
Name
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Address /. i ~II. /)"'" .. d (, /i h~ ,
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Telephone (/17) ) 7 t/, .;1!; </,,2.
Capacity:
Personal Representative
Counsel for personal
representative
CERTIFICI\TION Of' flOnCE UlmEH__!.!.~II,f. 5.6(il)
Date of Death:
,:.fi"I.lt
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~,<' _ / f.l . r.J {.
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Name of Decedent:
Will No.
I if (I {, - (' i" ) )f,
. d' " " . (1 '
1'\ m~n. ~'4O. ,,/ I,.
/\ .~) J,I
To the RegisLer:
I certify that notice of beneficial interest required by
Rule 5.6(a) of the Orphans' Court Rules was served on or mailed to
the following beneficiaries of Lhe abov'?-capLioned estate on
i " ;I '.l ' '17
~
Addres!'
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) -:J ,J ,5 'J 'I ~'<', <, 7 7 7
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U;')d~ U.l ~ /.1, it t j... ~ "/'l/ /."; ,./ ,) 'Jj.;; -},',~ ,-' elC', /z. 7 tl
, t oJ /
'7/k " _.J..,'/ , ~ I I.' I '" <IJ' < Tk I ti {/.. ,- J ( <- ' '; ):..., " 'y , .A..,
Notice has now been given to all persons entitled thereto under
Rule 5.6(a) except
1<' It. 'I
c.' s' ,,:;;-/
Da te: / - ,J 8 - 'I '7
,
"
,.
/, t ", ~ .. "
Signature
:-,;. "tIEl, .u-f.,
Name
. >
/, " ! ':
r' j I
....- h tl 1/\ I (' C'
.-
Address':"':"', /,)'. ,{ 4 t( f Ii l~' ~
1. . i " }
/'. ,0 (, . - (I I . -y"" l,-f." l / ., of /i,' T a / / <1 /' t:f
Telephone (j"7l 77 L/ ";; ", 'I"~
Capacity:
Personal Representative
Counsel for personal
repr'?sentative
fOR DATlS Of DIATH AnlR 12/31191 CHICK HlRl
INHERITANCE TAX RETURN ~oy::~U~:;DIT 15 CLAtlollDJI
RESIDENT DECEDENT FILE NUMBIR '+-~---
COMMONW'AllH 01 ",,,,,...At,,. (TO BE FILED IN DUPLICATE,/ 0/,' (/7/
OfPAIUM(NIOf IIfVWU( l.M"':' I \t: ,) /"
Hm"fJ:~}~'I'J:"OOOI WITH REGISTER OF WILLS) COUNTY CODE YEAR
D(CIOtNI'~ NAMI IIAS1. fll!lT. Arm M.IUDII, ttlltlAl1 O((lOWl !l COM'I(I( ADOIl,!.!!. , ~ t
_~'0..04if-<____6..JLj 'C'oc'-!/"'~'---l c" ,__ : <"'t..J_J_LI"~Y' '-, l/i-~~l<::
!lOCIAI !l(CU'II' 14UMII_. " 0...,11 01 Ul...,ltl DAT( 0',111111 r,Y , C LLL-~, ~~ ~~
0, hI' I L3..C:..i. (1___,_ X~U'~{_ (, _ /L_1...:...'.~_L ~'9-,.-2IU "~'_L"',-~_<~ t. < l t..</ Vd._~
", .."w", '","""O"O;~;~':' ::"~"'~'~:""" ""':'~ _ _C",,_:~" '<UM=-__C::" RlCII~'O 1111 ,,""UCIoO"'1 t-
[l 1. Originol Relurn [.1 2, Supplemental Relurn 0 3. Remainder Return
(for dot" of death prior 10 12.13.821
o 4. limited Estate [] 40. future Interes' Compromise 0 5. Federal Estate Tax Return Required
(lor doles of death alter 12-12.921
g-i. Decedent Died Tellale [] 7. Decedent Maintained a living TrUll
(Anach copy 01 Will) (Allach copy of TrUll)
ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO.
R[V 1.\00 0.. (1 qAI
W
0-
",0<<",
u;:~
wQ.u
",00
u",-,
8:'"
0<<
, 0-
"'z
Ww
"'0
"'z
82
~
0-
15
III
...
w
o
NAM[
IEUPHONf NUMIU
z
o
;:
~
'"
l:
Q.
0<<
...
W
'"
I. Reol Eltote (Schodole Al
2, Slock. and Bond. (Schedule BI
3. Clolely Held Stack/Partnership Interelt (Schedule C)
.4. Martgag" and Natet Receivable (Schedule 01
5. Cath, Bank Depotilt & Mi"ellaneoul Personal Properly
(Schedole EI
6. Jointly Owned Properly (Schedule FI
7. Tronl'''' (Schedole GI(Schedule II
B. Tolal Gran Anets (tolollinet 1.7)
9. Funeral Expens.s, Administrative Cas", Mi"ellaneous
Expenses (Schedule H)
10. Debts, Mortgage Liabilities, Lient (Schedule II
II. Total Deduclions (Iotollines 9 & 10)
12,
13.
.. -. ." ... - ,
/6--/36, I)
G-
Net Value of Estate Iline 9 minus line 11)
Charilable and Governmental Bequests (Schedule JI
14,
15,
16,
17,
z
0
;:: 18,
..
0- 19,
'"
Q.
'"
0
...
>< 20,
..
>-
21.
Net Value Subject 10 TaxlLine 12 minut line 13)
Spousal Transfers (for dates of dealh afler 6-30.9.4)
See Instructions for Applicable Percentage on Reverse
Side. (Include values from Schedule K or Schedule M.)
Amount of line 14 tOll.oble at 6% role
(Include voluet from Schedule K or Schedule M.I
Amount of line 14 tOll.oble at 15% rate
(Includ. values from Schedule K or Schedule M.I
Principal loll. due (Add tax from linet 15, 16 and 17.)
Credits Spoutol Poverty Credit Prior Poyments
+--.-
NUMBER
_ 9. Tolal Number of Safe Deposit Boxet
COMPLftf MAlllNQ ADDRUS
(1) -~
(21 ~2f1...:L.J..1_
(31
(41
( 5 I ----'--J..Q,3~-::r. '7 ''--
(61
(7 )
(91_&.;3. c- ('
(81 .2l~+-
(101
(1I) -;r:;,':jt'-l'
(121..d_J...t'.L...fd
(13) _.5~I--2-.J_ C' I
(141 r5. 4- '7 ;; .n
(151---,
(161 _L:,'LiL8..c_8...J____x ,06 =_...-lItJ.K,...7...3____
x =
(171 _________, .....__ ___n ,..._____x ,15 =
(18)
jtYf.z3
..--1 _,_ _ __ __ _____,__
'8-:_____.. ______
DilCounl
Inlerett
+ -~------- -
(191
(201
If line 19 is greater than line 19, enter lhe diHerenc.e on line 20.
aD
Th;, ;. the OVERPAYMENT 0
Check hore if you ore requesting a refuJ1d of your overpayment.
(21)
121AI
(2181
_u.!L{t S' /3_
.,_, t,..l'.()
n UQ f'l3
If line 18 is greater Ihon tine 19, enter Ihe difference on line 21. this is tho TAX DUE.
A. Enter Ihe interett on the balonce due on line 21 A.
B. Enter the lotol of line 21 and 21 A on line 21 B. Thit it Ihe BALANCE DUE.
Malee Ch.clt Payabl. 10: R.gl,'.r of Will., Ag.nt
~ ~ BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND TO RECHECK MATH -<-<
~~der penaltiet of perjury, I declare thotl have examined thit return, induding oc.companying tthedulel and ,tlolemen". and to the be" of my ~nowll!dge and belief.
lIlt true, corree! and complele. I declare that all real etlole hOl been reported 01 'rue market value Declorohon of preporer olher Ihan the perlonol repreulntative is
bOled on all information of whic.h preparer has any knowledge.
~IGNAIURl 01 PERSON RE~PO~IIlI( 'OR ItLIN(, R(TURN . AOOIlm--- ----., -~- ------------~--,-,~----~--~-'----~--'--.---- ---- ol.'T---------..--u.--~---,.----.
,0 ~>I.J_.~'/..-/j!'~=I'--"c:.~-- J3_:31.: L) ..1(/_liU'-___Lt {-, )c....~<__.\\")L:,,." 'L_I:_.J.8 ({ 7.
!lIQNATUR[ Of PR(PAIlR 0 (I IIrAN RlPIUftHAfIV( AOOII(:'~ .l ( I? ~ ) l' OAT(
A. lal(able Bequosts:
, . . 1
C""-Il{~,,..~,..,, ~ 1,--(./1,11/'"
J .:JCI') (:'(t.il..,....,./( l'~L,
,11 ~, ~ ,,_ )(_ .:__ A J t.U_~ " t.. I /,.,.:...';
) ',., ,I J ,'~ .
I.J.:._tl'-l..J,t't.L.' ""'<'('/~---"./.."- ~(II..J t,1.,..J l:..// ;-:;t.-:~
I ~'"l,: (. ,f t if' ~) XI 0/./ ('~ /~ I
J _. I . Ii
,< A_ . .. ,.L."...... LL\L(tl_f.-.L - _ 1(( Ivcr(U"~'/.\. L
...... '1....17'-_. J -' '...
",~,.."",- /Ij' t1J t'J .4-l..". <_~
-f'1-.~J.,I ,/4_,t.lCL.L~'''L' ~'rt.., {lJIL'''J~ t'i ,...- U'oI" tf~,.... f( _e'
d_., /.,t,,>vLU ",',L)I/ <'I.., 1 JUt L,u'-
~d.-'1-~u./ f.rr-'-' ("!- 'I "-,!-5I /"I'I-"/..- .'./'.L_.,L
, '! ,'. _~l"" ('... ../"',. ^-'/ L, q,
ZQ-4..M..'l. f.(I'U(l.,/_ 7t:'.l,': U-/"-",, /:'"q f'.1.. ,.'j".L.,L
1:1_" Cl..' u )).rt_ ..) I~ I" /
7 -^'/'....',LL~
/__lr..../~ /3", "'-'-'L _ <!.1.. '/ (t, ".,., '- ^",L ,-I
,/ /'J i.~-~,.d.__
, . . ..t-" <,-," t..LL~l c/"" , 1,S'I
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t'l!rJ_,'ct+I--t,~ c; ," c. "'/",e',?)"'(o!",I_l.l_,.. 'f L
I ' / '" "-'1'-'
I'lL tl (J..l {i..,.\.. )~Ll... "l (t}." J~'l~/l.-"'L'" ~
... ~ L,J,,-...._cc-<.., - 7'/3 'I ti. Lt'-2{''',-'L,
J/ -"&1, v\.,..,,,L
-)tfl.--"Jt.//-u-. ~ I" <,. :'/:Jt -"I "7L.L.I_-!__'-
/!,... l......-.....' J1<<..,'" {L<.V-_ .;<. ".$ 11, "L...",_ '-/u. ,,_,- . {(L..._, , ,;L ..vi _" j~
-':/.I;;~".d...:5t. {<}t'L-nJ.~~<.<.t~LrJ.'<<.._~~"'---' U'.',
II I . -..tt C.t.._('_L
. .......-
".. '~'lll. (11'1
,
~~J~j.
lU......O'..'''Alltl 01 'ltl'jHI~At.IA
INHllltAHCI 'al .IIU'H
'''IDIN' DIUDIN1
SCHEDULE J
BENEFICIARIES
ESTATE OF
FILE NUMBER
ITEM
NUMBER
NAME AND ADDRESS OF BENEFICIARY
RELATIONSHIP
p, A "./-
/)( ~.. ~ -.. -,'
I
.:/, .. ""L.-
)c t..t <<: f_....
,ljt d ~ ,e
.... c ~f-Li'(~-.r-'
,J d_-)'-.L( '-tr-.'
ITEM
NUMBER
NAME AND ADDRESS OF BENEFICIARY
I
B. Charitable and Go...arnment.~~ Boque,'h: 1 .. __ II, ,. . )
't.-y)..Ct.L <'_d._,,-' f,'J, Ie c,-- ., _-",,_, ,t'/' 'fJ' J' ,e 1.'.: '1- t L..... ~, I
.. '1 )' t' J / I"".'
,dL....tl..',-... /.)-,!- .};;.1:J-.' ~l..l.l-"J"'/..: ) y . ,. 5':i'
/3,"-,C<-1 .,J/t... /.. #-,,.>L - 1:1 'J 7/ ,,") )(., >L /,-u'I,"-l"oL") 1(,
.5';'1'/,'" ,"77'(
-r'f..-J-01_oL<..c I...
L'11.L"-J"'-' ,- ,..L....'-L..,
.-)1'_..: ( ;.. d, ,_{.~ oJ t..<-.. ": ~ U ''-.-'
.
/J. 't.....:, j.~
ri-~-t-.._.. F' ,,} .J.;; C'
';-)./..( L('(, eel c','\,....J.:n 'n
('J.~ t
l~-\..c -
-( , I ~,t {(, t' :L "J _/.:,
J['j' 1"'57- t't',j~
(.f, t,
TOTAL CHARITABLE AND GOVERNMENTAL BEQUESTS IAI,o en'er on Hne 13. Recop;'ulot;on) S
III mar. space Is n..d.d, In.ert additlonalsheels of same sin}
,
.,1", i' (
AMOUNT OR
SHARE OF ESTATE
-,
. I,
f'l
(
1
! ' (I
I, '1
. 'I
'I
1'1'/
I Ii
J, 'I
I, (I
AMOUNT OR
SHARE OF ESTATE
{~ '//
,: 1/..;
.3!j{/
3 reV
3 ,/J/
C--~.. .:'!
'hUl"l. !J"I
,
~:J~'~(\
,...~Vu-;:
(OM"O~YwUi1H 01 'hm~lI~A'~IA
INNlIllaHCI t,U tl1UIH
'UIDIHIDIUDINI
SCHEDULE J
BENEFICIARIES
ESTATE OF
ITEM
NUMBER
NAME AND ADDRESS OF BENEFICIARY
I.
A. Taxable Bequelh: LL'I"'~~I/ I"--'t.-L~, L' II_i. .r_ t '11,,J!__
t.:iu.....L., /..-. tJ, 7 r-" 'I 'Ii:. l''''' '- ';J t ) J ~l"j.-.t:J' ..I
,t ~~ J . t- l... '5 I ( ,~", J-4-_~b. \..i ';'tl -2 {J,
,v;..~-~-~,;t:I....'f ".< '-01 ,1- -
/L...-'" ([.I.u, ;')u:L ,;.' I (.II 'f
'-,i"lL..U.'f /~U:_',L' t,,,,--, fer'!'-'- '- L,_,! - jc>~ ./,Iu-n."_ .'
IlLL_,*' /t~L
/3d (i_LL. ]JuC
.;;, 10'"
IdLttLf tlCLrt[A_J,,-,<-' - 'ft. '(;7 ;2'01__ He I:.. (I".
,j'i.,"-"'_Al.l.I.:.. ,c_' -)/ J
,. ~- ,,:J""7
~~, ll,u_r<--I-<... - 13:1' /i.,,_,,(t;lU...
~I.A_r- (',I.I'-IX /..-6.'." (J_"lL..tl {/II<.
, )c)c,
o '[' , .;: } /)
if (L "-<A_L,L.. "<l..LVtL't..'L.V' 5" ,. {'i ....' ""-Ll,
r\!.d. ..<2,/-'7<.luJJc':ruL .lIt. 3
,
'>r.-(J...I.1/I'J, 't./u ;:'-c-,tA,[o._-'LtL~
.5{ '))L <,--k.L<"':"'" T tt!..
,-.u..Lj~,LcX;L/,,-,-",-, )/}_
:C. -L (LL~ tJU'~L . : I . t; \'" 5 6
ITEM
NUMBER
NAME AND ADDRESS OF BENEFICIARY
B. Charitable and Governmental Bequeus:
I.
()"r-'-
FILE NUMBER
RELATIONSHIP AMOUNT OR
SHARE OF ESTATE
j_LoL:l~, L' /.,7.1...._..
,JL.:tL....' /..1_ '/.:L......
)..)<..) ./ :u..<...-
'7Lu_"<'~ G, 'l;
..}L<....L~ (. '1~-
/ I
7Lu_'-...C~ 1.... Ii-
) LU_<-Jl_ (.. '/'1
i/. ,,- ,,--<L /. q
J LL'-.-.C.L.t
/j'-<<-....tl- " 1
~'Jl..L
AMOUNT OR
SHARE OF ESTATE
TOTAL CHARITABLE AND GOVERNMENTAL BEQUESTS (AI.o enle, on Hne 13, Recopilulolion) S
(If more .pac. II n..d.d, In..rt addltlonalsh..h of lame ,11'1
lI'iltll tit I''')
.
ESTATE OF
"~ ~~dl\
.. 'l~,:"..
COMMONW(AlTH Of P(NNSYlVANIA
INH(RltANCE TAX R(1UIIN
IIEStOENT OfC[O[NI
SCHEDULE H
FUNERAL EXPENSES,
ADMINISTRATIVE COSTS AND
MISCELLANEOUS EXPENSES
i
I.. nH,_,P_I~as. p.lnl..or T~pe
I FILE NUMBER
ITEM
NUMBER
A. Fune.al Expenses:
B.
4.
C.
1.
2.
3.
4.
5.
6.
7.
8.
DESCRIPTION
AMOUNT
1.
ti LL.d:-;-L'
(J t J ,L-,..L ,",-- -t '
/J).(..u..:t0., <:"CL -tLf~-'t..-t{.~
'-- I I {"
!(.J.... tl..-t"- ..L &-'-"-'
/ <::) (J , t'-(I
35':-"(1
<], t'--b
.5 (I". ~()
Admlnist.alive Casts:
1.
Penonal Representative Comminions
Social Socu.ity Numbor a' Porsonol Repre.entative: .._
Year Cammissions paid
2. Allorney Fees
3.
Family Exomption
Claimant
Addre.. of Claimanl at decedent'. doath
Streot Addro..
Rolation.hip
City
Stalo
Zip Code
Probate Feos
Miscellaneous Expenses:
"'~L<t./.J
.J a...fL<1-
'''YIL..LA--oLC iL L'
~'l.(';;
'c""-<---c.\..r IL_<'-LL<L,--,
0'tL.1LttLL ~II-{A__"j ,I lli...Cc',Lcll..-('Lt'_
j-lfLJ.'....,e <LCoJ-,'
</-() 6 7. /..5
q ,~/{)
13~7.5{,
1to.l.,f
V.2 . {'>-t.'
to 6. l'-(,J
TOTAL (AI.o enter an Ii no 9. Recapitulation) S
(1/ mo.e space Is needed, Insert additional sheets a' same size.)
'(VUOII.t 11.111
J'J~'9l\
....~J....:
COMMONWfAlfH OF 'fNN~YlVANIA
INHIIITANCI TAX lnulN
IUIDINT DaCIDINT
SCHEDULE E
CASH, BANK DEPOSITS AND
MISCELLANEOUS
PERSONAL PROPERTY
I Ploa.e P.lnl a. Ty e
FILE NUMBER
ESTATE OF
(All p,op.rty lo'n"y.own.d with Ih. Right of Survlvor,hlp mUll b. dllClo..d on Sch.dul. f)
ITEM
NUMBER
DESCRIPTION
t I....c< ku_ 1
I '
/L~rV
, ;) ,
l/ d-k. '<.1. <:...' / .L.J-<-1i_(rL
, (j
, ,
/ ./ 'c "-"-. i.....~' ;b tl.A-L-~ j'<'-
VALUE AT
DATE OF DEATH
/ S (J t. / SI
I f, '17 Cj. S/1
s
(Attach addilional B~- )( II- Ih.." if mar. .pac. I. n..d.d.1
IIVI~I"IU1J
SCHEDULE E
CASH, BANK DEPOSITS AND
MISCELLANEOUS
PERSONAL PROPERTY
!Io~.. p.int or Type
FILE NUMBER
.
~J~'~..
_$flu;.
COMMONWUl1H OF PENNSYl......NIA
INHEIITANCE 'AX IITUIN
nS1DIN' DECEDINT
ESTATE OF
(All property lolnlly-owned with 'he Right of Survlvonhlp mu.t be dllClo.ed on Schedule F)
VALUE AT
DATE OF DEATH
ITEM
NUMBER
DESCRIPTION
, ~ /1 d
i _J 1., t-'.
. /. I
,',' _.c_t.. j(!.."A_ 1
I
/l..-'-.A-<..--..._ ')/~' -
(j
-( " d_.~.'t.l <~
,
/, .,\...'/"<_.,) L,
:/~/ (f.,~-t'~....1 1'L
J
If, ~'7 (j s/ 1
. ,
:' ' Lt.. c.:... ~_ L_'-
TOTAL (AI.a entor an line 5, Reca ilulalian) S
(Attach additional 8VJ" )( 11" .heeh if more 'pace b needed,)
.' 51
, "
.'
'.
I ~;-- / jo( //
BUREAU OF INDIVIDUAL TAMES
IHIlUlIlAHC[ 1A1l. D1VI'Io!OH
DlPI. 110601
tlAIIA1SlUNC. "& 11lll.0hOI
COMMONWEALTH DF PENNSYLVANIA
DEPARTMENT DF REVENUE
NOTICE OF INIIEHITANCE lAM
APPRAISENlNI. ALLOWANCE OR DISALLOWANCE
or DEDUCTIONS AND ASSlSSNlNT or lAM
DORIS G HAINES
1336 BRANOT AVE
NEW CUMBERLAND PA 17070
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
05-12-97
FRISTOE
06-10-96
21 96-0876
CUMBERLAND
101
,
l/
*
"'1'" III" III tll
H lZABETlt C
!~--~~-~~~D;-;I'J.!d--~=l
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
CUT ALONG THIS LINE .. RETAIN LOWER PDRTION FOR YOUR RECORDS ....
REV: is'4"i"EX- "AF P- - 10'3": 97Y- NOT i C E- -0"" "iNH Eii iT Ai.jc E " TAX" A"PPRA i SEioiENT -; -A Li:ciwAN"CE" iilim - n____"" -- - --
DISALLOWANCE OF DEDUCTIDNS AND ASSESSMENT DF TAX
ESTATE DF FRISTOE ELIZABETH C FILE NO. 21 96-0876 ACN 101 DATE 05-12-97
TAX RETURN WAS, I ) ACCEPTED AS FILED I XI CIIANGED SEE ATTACHED NOTICE
If an assessment was issued previously, lines 14, 15 and/or 1&, 17 and 18
reflect figures that include the total of ALL returns assessed to date.
ASSESSMENT OF TAX:
15. Anaunt af lIna 14 at Spousal
16. Anount of Lina 14 taxable at
17. Anount of lIna 14 taxable at
18. PrIncIpal Tax Due
TAX CREDITS:
PAYNENT
DATE
01-27-97
RESERVATIDN CDNCERNING FUTURE INTEREST " SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. R..I Elt.t. (Schedule AJ 11)
2. Stocks and Bands (Schedule 8) (2)
3. Clasaly Hald stock/Partnership Intera.t (Schedule C) (3)
4. Hartg.oas/Hota. Racaivable (Schedule OJ (4)
S. Cash/Sank Daposits/Hilc, Parsonal Property (Schedule E) C51
6. JointlY Owned Property (Schedule F) (6)
7, Transfe,.. (Schedule G) (7J
8, Total Assets
APPRDVED DEDUCTIONS AND EXEMPTIONS:
9. funeral Expense./Ada. Cost./Misc. Expense. (Schedule H) (9)
10. Debts/Modgege Liabili ties/Liens (Schedule I) (10)
11, Tatal Deductions
12. Net Velue of Tax Return
13. Chariteble/Governnental Beque.ts (Schedul. J)
14. Net Value of estate Subj.ct to Tax
NOTE:
rat.
Lin..I/Cless A ,..t.
Coll.te,.al/Class 8 ,.ate
US)
11&1
1171
RECEIPT
NUNBER
AA185121
DISCOUNT It I
INTEREST/PEN PAID 1-)
.00
.00
4.559.94
.00
.00
20,386.07
.00
.00
IBI
6,361. 29
.00
Ill)
U2)
U31
U41
.00 X .00=
13,940.04 X .06=
.00 X .15=
UBI
ANOUNT PAID
1,108.73
TDTAL TAX CREDIT
BALANCE DF TAX DUE
INTEREST AND PEN.
TDTAL DUE
NOTE: To insure prop.r
credit to your account,
sub.it the upper portion
of this for. with your
tax pey.ent.
24.948.01
6.361 ?Q
18.586.72
4.646.66
13,940.04
will
.00
836.40
.00
836.40
1,108.73
272.33CR
.00
272.33CR
. IF PAID AFTER DATE INDICATED. SEE REVERSE
FOR CALCULATION OF ADDITIDNAL INTEREST.
I IF TOTAL DUE IS LESS THAN $1. ND PAYNE NT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" ICR), YOU NAY BE DUE
A REFUND. SEE REVERSE SIDE DF THIS FORN FOR INSTRUCTIONS.)
-. ... ~.
~,:, ~..",\
ilvwolJ ''''I
"~,:&:~,,
... ~ttl',.
COMMONWEALTH Of PENNSYlVANIA
. DEPARIMENI Of REVENUE
,IUUAU 0' INDIVIDUAL TAXU
DEPT, 280601
HARRtSIURG, PA 17128,01>01
DECEDENT'S NAME
a I ZA 2: t.-r H .:.' ....'A./:: ;rr. [
INHERITANCE TAX
EXPLANATION
OF CHANGES
filE NUM8ER
A/'/v -&;,!.' 7"4-
AeN
.
/C'/
SCHEDULE
ITEM
NO.
EXPLANATION OF CHANGES
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TAX EXAMINER:_____~~~!{_"'" _,Nf..."':,:::n' ,,~!.~:"t_~
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PAVKENTI
Dllach Ihl
pr Inlld on
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lop porllon of Ihl. Nollcl and sublll wllh your paY.lnl .Rdl payabll to Ih. nft.1 and add'I"
Ihl rlVlr'l .Id..
If RESIDENT DECEDEHI .akl chid. or .only ordlr payabll 101 REGISTER OF WILLS, AGENT.
If NDN-RESIDENT DECEDeNT .ak. chick or .only ordlr pllyllbl. 10: COHHONWEALTH OF PENNSYLVANIA,
REFUND CCR)1 A rlfund of a ta. crldlt, which was not raquI.lld on Ihl Ta. Allu,n, ..y bl rlqulslld by co.pleting an
"Appllcallon for Rlfund of Plnnsylvanla Inhlrllanc. and E.tall Tft." (REY-1313J. Appllcallon. arl avallabla at
thl OfficI of thl Rlgl.tlr of Will.. any of tha Z3 Rlvlnu. DI.trlct OfficI' or fro. Ihl Dlparl'lnt'. Zit-hour
answlrlng ..rvlCI nueblr. for for.. ordlrlngl In Plnnsylvanla 1-800-36Z-Z050, oul.ldl Plnn.ylvanla
and wllhln local Harrl.burg area (111) 1.1-809~, fOO' (111J llZ-2Z52 (HI.rlng I.palred onlyl.
REPLV TDI
DUI.tlon. rlg.rdlng error. conlalnld on thl. nollce should bl addrl..ld tal PA Olpart.lnl o' RlVlnul1 Burlau
of Individual Ta.I', ATTH: Po.t AS.Is,llnl Rlvlew Unltl Cept. 280601. HarriSburg, PA 11128-0601. phone
Cl11) 181-6505.
DISCOUNT:
If any lax due Is paid within thrle (3) callndar lonlhs afllr the decedlnt's dlath, a 'Ive plrclnt (5X) dl.counl
of the tax paid I. allowld.
PENAL TV:
The IS~ la. alne.lv non-participation penalty Is co.putld on the tolal of the lax and Int.r..t a,sl.sld, and not
paid b.for. Januarv 18, 1996, the flr.1 day aft.r the end 01 the ta. aan..ty p.rlod.
IHTEREST:
Int.re.t I. chargld b.glnnlng with flr.1 day o. dlllnqulncy, or nln. (9) lonlh. and on. Cl) day fro. thl data 01
d.alh, to the dati 01 paY'lnt. T.... which b.ca.. dlllnqu.nt b.for. January I. 198Z b..r Int.r..t at Ih. rata of
.Ix (6X) plrcenl p.r annul calculat.d at . d.lly ral. of ,000164. All ta... which b.ca.. d.llnqulnt on and aftlr
Janu.ry 1, 1952 will b.ar Inllre.t at a rail which will vary Ira. c.llndar y.ar to c.llndar Ylar wllh that ratl
announcld by Ih. PA C.part..nt of Revlnul. Thl appllcabll Inllrl.1 r.I.. for 1982 Ihrough 1991 .rl:
V.ar Inlere.t Rat. O.lly Int.re.1 Faclor
Vear
Inllrllt Rolli.
Oallv Intlrl.t F.clor
1982 20:C .000548 1981 'X .000141
1983 16:< ,000438 19U-1991 11:C- ,000301
195ft U:C .000301 1991 'X .000141
1955 13:< .000356 1993-199ft IX .00019Z
1956 In ,000214 1995-1997 'X .000l47
ulntlrllt Is calculatld o. foUows:
INTEREST = BALANCE or TAX UNPAID X NUNBER or DAYS DELINQUENT X DAILY INTEREST FACTOR
.-Any HOlle. I,suld after Ih. lax blca..s dlllnquant will r,'l.ct an Inta,a'l calcul.tlon to flftlan CIS) day.
b.yond Iha dati 01 tha a"I...ent. If pay.ant I. ..da aftar the Intara.t coaputatlon dati shown on the
Notlcl. additional Intarlst .ult b. calculatld.
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Name of Decedent: , ') I I /
Date of Death: ) I t IL
will No. / '/ 'I/. I , It.
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Admin. No,
Pursuant to Rule 6.12 of the Supreme Court Orphans'
Court Rules, I report the following with respect to completion of
the administration of the a~ove-captioned estate:
1. State whether administration of the estate is complete:
Yes ,/ No
2. If the an!;wer is No, state when the personal
representative reasonably believes that the administration will be
complete:
). If the answer to No. 1 is Yes, state the following:
a. Did the personal representative file a final
account with the Court? Yes t~ No
b. The separate Ol'phans' (..\lrt No. (if any) for
the personal representative's account is: j /.?e.. {' _f7t,
c. Did the personal representative state an
account informally to the parties in interest? Yes L___- No
d. Copies of receipts, releases, joinders and
approvals of formal or informal accounts may be filed with the
Cerk of the Orphans' Court and may be attached to this report.
Date: ',,'l?! '1'1
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Signat.ure
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Name (Please type or print)
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Capacity:. Personal Representative
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