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PETITION HHt PIWUATE IInd (;HANT OF LETfEHS
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!;stat<. of j)~1LI_L_!!K(;:'Dlt.i __ No, __aL:-gl.r~g gD
also kllO,'n a-) lr rIZH'''f'' __ __..' .-' To:
() 'L9-_~Ll.j~Y--- .-.-- -- Ilr~hlrr of ~~il~fQr ltk 1\
_.___~_. ,p",'.all'd, County of (dJ. .'1-'1-1 .J.lL in the
Sodal Security No, _L/L::-31_-:!f-::.~l",-., Conllllllllwralth of !'rnusylvania
The pelition of the undrr,igned re,prclfully repre,rnt' that:
Your petitioner!,). who h/are IH year> of agr PS.'lldcr anthe r~ccutti1:'r:'/Li t{ J
inlhe la't will of the above dcccdelll. daled __LL/lIl('L---'.L
and codicil!,) dated
named
.19fL
(\131(' rdt'\anl circllIl1\l"IlCC", ('.~. renuncialion, death llf ('\('(.lIor, cle.)
Dccendent wa, domiciled at dea~h in C {{ I n()~/.' (1-4~ _Z.C~un,ty., Pennsylvania, with
II l' I .j",t family.or rindp:r\ [,e,idencqt ::' 'J fUlu.WJ. ')/ t '
II If! (['~ . t. !Ie) I 7~: '-;
(Ii\1 ~1r(,CI. numhc:r am1muncIPaly)')
Dece9pent 111~9 ?/, Yfqrs of ~e. dkd ,!\(([fJl If iL' ? () 19 fA ,
at t ') I l7t.Z1t-/ I. ,I "')1' r-r:::- ,(Y I ,i,.' r. . /"...,.c rot'
Except as follows, dcc dem did n6t marry. as not divorce and did nOI have a child born or adopted
after execution of the ",iI offered for probate; was notlhe victim of a killing and was never adjudicated
incompetent:
Decendcnt at death owned f.roperty with estimated values as follows:
(If domiciled in I'a,) All personal property
(tf not domiciled i:l Pa,j Personal property in Pennsylvania
(If not dornio:ilcd in I'a,) Personal property in County
Value of leal e,tate in Penns)'lvania
situated as follows:
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WHEREFORE, petitioner!s) respectfully
pr..ented herewith and Ihe gram of lellers
request(s) the probate of the last will and codicil(s)
n--,::-, r J1l\ , r N 11HZ \1
tte,lamtntar); arJrnlRlmalHln c.l.a.; adminisuauon d.b.n,c.t.il.)
theron, '
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OATH OF PERSONAL REPRESENTATIVE
COMMONWEALTH OF PENNSYLVANIA 1 "'
;.- ISIS
COUNTY OF CUNBERLAND J
The petitioner',; ah('~e-named swear!,) or affirm(s) that the 'tatemenls in Ihe foregoing pelition arc
true and coro',,'1 \U the k,t (lllhe knowledge and bdicf uf petitioner(s) and that as personal represen.
tative!s) of Ihe ab"ve deceder,! p.:titioner(s) will well and truly administer the estale according to law.
Sworn I" or affirmed ~ ,ubscribed
b~~.r~ -,-~----- day of
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2t-96-980
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WARNING: Ills IlIunnl to dupllcalu \hls copy by photostnt or photogrnph,
ht, "II till' It Ildl, .111, ~.Illif
3880432
No.
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N9" 2 3 1996
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COIIIIONWEALTN OF PENNSYLVAN'A' OEPARTIIENT OF HEALTH' VITAL RECORDS
CERTIFICATE OF DEAT!t
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r,AS'l' \I Ii ,I, I\NIJ '['J';;;'l'AJ:).:m 01' Bjo~r'l'Y J. Al1'rHONY
--.--.- ------- -
I, BE'rTY J. AII'J'IiOliY, 01' tho 'ro~rnohip of Eaot pennsboro,
County of CUlnborlllnd and stato of Ponnoylvania, boing of oound
and disposing mind, momory and ulldorotllndin~, do Inako, publish
and declllre this my Lllot Hill llnd Teotllulent, hereby revolting nnd
malting void any llnd all prior Hills by mo at any time herotofore
made.
1.
I direct the pll~nont of all my just debts llnd funeral
expenses as soon after my docease ao the oame can be conveniently
done.
2.
I r,ive, devise and bequeath all the rest, residue and
remaindor of my estate, real, peroonal and mixed, whatsoever
and wheresoever the same may bo oituate, to my two (2) daughters,
to ~rit, HAllCY L. lffiAliEn and AliJlA HARlE RYDESKY, share and share
alike, per stirpes.
LASTLY, I nonlinate, constitute and appoint my t,~o (2)
daur,hters, the aforementioned 11AIICY L. KRAHEn and ANNA ;,lAI1IE
RYDESKY, Co-Executriceo of this my Last Hill and Testament, and
direct that they be excused from postinG bond or othor security
for the faithful performance of their dutios.
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COMMONI.'EALTII OF I'E~~SYLVM;tA )
COUNTY OF (;U~lhr:kI.A~1J
SS.
I. ___I2,,';TTY J. ;\::'1',[01'11' , the testat rix
whose name Is H!~n.(! to ,_:,. ilt tached or f orcllO In~ Inst rument, hav Ing
been duly qUil'lfled ilccord[n~ L(, law, do hereby dcknowledlle tllllt I
siRlwd iIlHI ~XL:'~lit\..d tfw !n~t rumcnt lIH my Last t,'f 11 Hod Tl!Htillnl!l1t;
that I signed it '.'II l[n~Jv; iII,d thilt I sil\ned it ilS illY free dnd volun-
tary act and deed, for the pllrpoo~S thl!rl!ln cunLlll1l!<.I.
B);;TTY
day of
S','orn and ilfflrmed to and acknowledged
J. AIl'l'HONY , the testatrix
Octoper , A. D., 1993.
before mc by
t this !)-;.~;'-
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CO~~ONWEALTH OF PE~~SYLVA~IA
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- NOTARIAL sCt'L. \,
IAARILYN KAY EAKIN. jl"l"iY Pc"'.
B c. m~~rl t'l~ COll~t)
MechanicsburL ere. U ' G 199~
My Cemmloslen E,pires Nov. ,
COUNTY OF Lt!MIlERLAND
\"e, the undersl/lned, J. ROBERT STAUFFER
and JOHN 11.._ EAj(IH , the witnesses whose names are
signed to the ~ttached or foregoing Instrument, being duly qualified
according to law, depose ilnd say that we were present and saw the
testat rix BETTY J. AliTHONY , sign and eXe-
cute the instrument as ~her Last Will and Testament; that the
said testatrix BETTY J. AllTHONY , executed it as
btIl&(her freo';;;.;]voluntary act for'the purposes therein expressed;
that ~ild, ", us. In the h~arln!l and Hight uf the testatriX, signed
the Will a'i wHnesse~; and that to the b~st of our knowledgc, the
test at rix .'as, ilt the t lllle, eighteen (18) or more years of age,
of sou;;:;:nI"d, and under nu constraint, dures~ or undue influence.
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Sworn and ~::uscrlbed to b~fore,'
me this S'/'" da\' of
Octobe~-'- , '1993.
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.. NOTARIAL SEAL ~
MAR(L YN KAY EAKIN, N,ta,;' P,\I,:
~lechani"burt eo", Cumbcr'1OC C.unly
My C.mmieslen EJpi"s Nov, 6. 199~
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COMMONWEAUIt or PENNSYLVANIA
OEPAnTMEfH or f1EV[NUE
BUREAU OF INDIVIDUAL TAXES
OEPr 280601
ttAnRlSnuna. PA 17128.(}(j01
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NO. AA 269719 "[V-ll" Ek 111-"1
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
RECEIVED FReM:
I
ACN
ASSESSMENT
CONTROL
NUMeER
AMOUNT
ANNA MARtE RVDESKY
POBOX 357
259 ORE BANK ROAD
DtLLSBURG. PA 17019
101
4i1 I"~" on
FOlDHrH[
FOlD HERE
ESTATE INFORMATION:
FILE NUMBER
- 980
NAME OF DECEDENT ILAST)
SSN 171-30-7393
(FIRST)
IMII
DATE OF PAYMENT
2/03/199B
POSTMARK DATE
2/02/1998
COUNTY
CUMBERLAND
DATE OF DEATlt
TOTAL AMOUNT PAID
... 1 .726.00
RAC
RECEIVED BY ,. ,-' ,', '-', / " . '.. "..J "t,..
MARY C. LEWIS _/,;;",j,,' /~,..!_~
HEGISTER OF WILLS - .' tf-
REMARKSANNA M RVDESKV
SEA(;HECKII 23
Hr- f:! ','1: ,~ :.if" ~\'ILLS
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CERTIF!~:A'l'lON OF_NQTI.CJLtlNJ]EH l~l}LE ~j_~H~J
Name of Decedent: Ill" rr'f--1-1lk~H;(A-11
Date of Death: /I,JOI/ ,'J.cl rIll'll.' _______
Will No. /.?qlr,-~01g0 Admin, No,
To the Register:
I certify that notice o( benelicial interest required by
Rule 5.6(a) of the orphans' COU(t Rules was served on or mailed to
the following beneficiaries o( the above-captioned estate on
Address
236?) ~{i;;;p'.3fo{)XJ RcJ '/ /11 eeJf!Jrf ICfh (ft.
ll5g {)reJ;~/(r.."i. 10.110'1 Nf\
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Notice has now been
Rule 5.6(a) except
given to
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all persons entitled thereto under
Date:--2/1j !q7
Ail'IIIA I! /U /1-11--U..J
Signat e /
Name ~I L, 4 a1/1tL- J-rn-
Address_Z30:3 31umD~1Tl(}jfV /(CJ,
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TelePhonei71LIRQ ( - q~~1
Capacity: V Personal Representative
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fOR DA'IS Of DIA'H A"IR 12/31191 CHICK HIRI
If A SPOUSAL
POVIRTY CRlDI' IS CLAIMID 0
fill HUMIIR
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INHERITANCE TAX RETURN
RESIDENT DECEDENT
(TO BE FILED IN DUPLICATE
WITH REGISTER OF WILLS)
OIl
COUNIY COOI'_
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SOCIAl UCUllly 'tUMIU AMomtl UCIIVID ISH IN!l'.U(UQN!l1
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COMMONWfAltH Of P[NN!.YlVANIA.
OlPUIM(NI Of R(V(NUI
Ol" 210601
ttARRISlUIIO. P... 11121.0601
DICIOINI" HAMI II A". flUT. AND MIOOU INIII"'1
AlJ'ltlolJ 11 E711 j,
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SOCIAl UCUII:I , NUM.IU
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-
9b
YEAR
0'150
NUMBER
-
03.
05,
E..8_
o 2. Supplemental Relurn
Remainder R.lurn
Ifor dOl" of dealh prior 10 12.13.821
Federal Ellat. To. Return Required
{i(1. Original Relurn
o A, limiled Ellole 0 .to. Fulure Inler..t Compromise
(fo, do'e. 01 deo,h ohe, 12.12,821
o 6. Decedenl Died T..lale 0 7. Decedent Mainlained a living Trust
(Anoch copy 0' Will) (Anoch copy 0' ',u.'1
'A 'CORRESP,O DENCE.ANDCONFIDENJIAL'TAX~ NFO~ ION SHOULD BEDIRECTED,T.O..;!:. .',
NAME (OMPUl( MAiliNG ADDRUS!
AI/~A (rl. 'n'tJ'1 ,. O. 'B-1 1S'
""'HOH' NUM'" ~ S, 0... l3A'~ llAJ
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20. If line 191s grealer Ihon line 18, enler the difference on line 20. This Is the OVERPAYMENT.
aD
Check hero if you are requesting a refund 01 your overpayment.
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I. Reol E1'ole (Schedule AI
2. S'och and Bond. (Sch.dule 81
3. Closely Held Slack/Partnership Inleresl (Schedule q
.t. Mortgages and Not.. Receivable (Schedule 0)
5. Cosh, Bonk Deposits & Mhcelloneaus Personal Property
(Schedule E)
6. Jainlly Owned Property (Schedule f)
7, ',an.I... (Schedule G) (Schedule LI
8. TOlol Gran Auel. (10101 lines 1.7)
9. Funeral Expense., Adminillralive Casts, Miscellaneous
Expen.es (Schedule HI
10. Debts, Mortgage lIabililies, liens (Schedule I)
11. Total Deductions (10101 lines 9 & 10)
12. Net Volue of Eslale (line 8 minus line 11)
13. Charilable and Governmental Bequests (Schedule J)
U. Net Value Subject 10 Tax (line 12 minus line 13)
15. Spousal Tronsfen (for dotes of death aher 6.30.94)
See Instructions for Applicable Percentage an Reverse
Sid.. (Include values Iram Schedule K or Schedule M.)
16. Amount 01 line 1.t taxable at 6% rate
(Include values from Schedule K or Schedule M.)
17. Amount 0' line 1.t laxabl. 01 15% role
(Include volues from Schedule K or Schedule M.)
18. Principal tax due (Add tax 'rom lines 15, 16 and 17.)
19. Credits Spousal Poverty Credil Prior Payments
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(11
(2)
( 31
( 4)
(51
(9)
TOlol Number of Safe Deposit Boxes
II"
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.6-
1,0.0
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( 8)
3!,j3t#
(10)
(II) ","0'
(121 :17. $ JPJ
(13)
(141 ,;l 7. $J&
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X ,15 =
(18) IUl-
lnlerll'
(15)
(16)
(171
~7, S.-t&
Discounl
+
(191
(20)
21. If line 18 is greater than line 19, enler the diHerence on line 21. This is the TAX DUE.
A. Enler Ihelnlerest on the balance due on line 21A. (,,,~~, (3)~,.
8, En'er,he 10lala' line 21 ond 21A an line 218, Thi. i. the BALANCE DUE,
Mak. ChIck Payable to: Rlgllt.r of Will., Agent
(211
121AI
(218)
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SCHEDULE E
CASH, BANK DEPOSITS AND
MISCELLANEOUS
PERSONAL PROPERTY
Please Print or T e
filE NUMBER
;l1'lw-O'l~O
COMMONWEAlTH O' PENNSYLVANIA
INHIIIlANCI tAX InUIN
laSIDIN! DteIDIN!
ESTATE Of
Jim J. ,.,.'TJIeIl'f
(All property 10lnt1y..owned with the Right of Suntlvoflhlp mutt b. dhc1o.ed on Schedule FI
N~T~~ER DESCRIPTION
(. vMlM 'Pt,q~Q/I~ 'P~oMtT'l
VALUE AT
DATE OF DEATH
,00"
TOTAL Also enter on line 5, Reeo
S 1000
(Anoch additional BY.- )( 11- sheet. if mare space II n..ded,)
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COMMONWfAltH Of 'lNN!tYlYANIA
INHU"ANCf lAX .nUIN
..,~,_ ~I~!DIN' DlelOIMT
ESTATni"-----
SCHEDULE G
TRANSFERS
PLEASE PRINT OR TYPE
FILE NUMBER
~~~_o~8,,-_
THIS SCHEDULE MUST BE COMPLETED AND FILED IF THE ANSWER TO ANY OF THE QUESTIONS ON THE REVERSE SIDE OF THE COVER SHEET 15 YES,
~i'T1't
J. A.mbul
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ITEM DESCRIPTION OF PROPERTY T01At VAtUE DECO, DOLtAR VALUE
EXCtUSION 'llo OF DECEDENT'S
NUMBER 'It(Iud. nom. 0' 'h. ',onl"''', 'h.ir ,,'o!~~~!I!.~_ ~!~~....n!,--~~f. ~'~On1''', OF ASSET _--'tiT~ INTEREST
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TOTAL (Aha .nt.r on lin. 7~ Recopilulolionl S ~!..al31f
III mo... spo~ ;s nnd.d, ins,lf additional ,he.rs 0' sam. lilt.}
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PNC lC! AN 1Tl' I'Nt; n.nk. Noli.... ^"""I..I..
Jl]J JLl'"- C""I' HIli. II^ I1IMII
PNC lANK. NATlo AL ASSOCIATIUN 000040
IRA 5ERVIC~5 cr -rOLV-22-1) TEL. 888-PNC~IRAS
ONE OLIVER PLAZ BANK FIN 22-11~6~SO
PITTSBURGH. PA 15222-Z602
-
IlETTY ANTHONY
25 ANTItDHY DH
I1ARYSVILLt PA
STAHI1EHl PERIOD
ol-U1-'6 THHU 12-31-96
i705309619
I
VATE
01-15~U
PAGE
1
09-02-28
,
SOCIAL SECURITY I. 171-50-7395
RETIREMENT 10 I' 6001003767
I
PRINCIPAL BALAN E AS OF 01-01-96
CONTRIBUTIONS F R THIS STATEMENT
CURRENT Y AR
PRIOR YEA
ROLLOVER
INTEREST CREDIT D THIS STATEMENT
DISBURSEMENTS -
NORMAL
FED. WITH c)LDiNG
PRINCIPAL BALAN
INTEREST ACCRUE
FAIR I1ARKET VAL
DATE OF BIRTHI
PLAN TYPE' IRA
24,892.83
0.00
PERIOD
0.00
0.00
0.00
PERIOD
1,48~.14
'l.89Q,.:DO-,
1.701.00
189.00
~4,li86.97
947.37
25,434.34
OF 12-31-96
VET CREDITED
OF 12-31-96 (80X 41
SUMI1ARY OF INVESTI1ENTS
ACCOUNT RAT~ "ATURITY INTEREST CURRENT
NUI1IlER DATE CREDITED VALUE
6l>001U08007 6.oJO 05-09-97 1.484.14 "Z4,486.97
I ---------- ------------
SUI1111RY TOTALS 1,484.14 24.486.97
INTEREST
ACCRUED
TOTAL
VALUE
947~ ST-
25,414.'3~
---------- -------------
947.37 25,434.34
....".....
THE FAI I1ARKET VALUE (BOX 4) OF YOUR ACCOUNT AS SHOWN
AIlOVE WI L 8E REPORTED TO THE INTERNAL REVENUE SERVICE.
PLEASE C~NTACT US AT I-B88-PNC-IRAS (1-888-762-4727)
IF YOU H~VE ANY QUESTIONS REGARDING YOUR IRA ACCOUNT.
\
OWl w., ,......,,,
'''''''.....,.
IIVllll".I'.111
ITEM
NUMBER
A.
I,
"
3,
"
:'
,
,
" B.
I
, 1,
I
I
2,
3.
,I
II
I
I
Please Print or Type
MBER
:1lq .. Oq~O
~J~'il\
-!tifs;.!
COMMONWfAUH O. PfNNSYlVANIA
INHUltANCE TAll: nTUIH
IUIDINT DECIDENT
SCHEDULE H
FUNERAL EXPENSES,
ADMINISTRATIVE COSTS AND
MISCELLANEOUS EXPENSES
'BfT1'I J. A"""''f
DESCRIPTION
Funeral Expensesl
/lI'I'*S. H~~ ..u~~" ~lTj ,IJl."
I<CJSTf- (tlltoJ I~. - (l\l'1It,,,,,
lII"ll/,OMI~ rn fllllR~ IjMDtlUS _ of'ffo) thou t!
Administrative CoslI:
Personal Represenlative Commissions
Social Security Number 01 Personal Represenlative:
Vear Commissions paid
Attorney Fees
Family Exemption
Claimanl
Address 01 Claimanl at decedent's dealh
Slreel Address
Relationship
Stale Zip Code
Cily
I 4. Probale Fees
I
:1 C. Mlscellaneou. Expen.e..
II 1. ePl. rte
"
I
I 2,
3,
4,
5.
6,
7.
0,
TOTAL (Also enler on line 9, Recapitulation)
(If more .pace I. needed, In.ert addltlanal.heet. of .ame .Ize.)
AMOUNT
"'rsf.
rJ()
(n*
'77
'3,,0
s 80,/6
Myers-Harner Funeral Home, Inc.
1903 MARKET STREET . P,O, BOX 291
CAMP HILL, PENNSYLVANIA 17011
Robort H, Hornor, Suporvlsor Phono: (717)737.9961
STATEMENT OF FUNERAL GOODS AND SERVICES SHECTED
Chugts arc ani)' (or Ihmc Ilem, Ih~1 you ,c:Icclcd or thai art' f(qulled H We' ;Ul' required hl' law ur hy illcmclcry nr cremalory In Uit any lcemi. we will
upl.ln In ""lllnK belo.... ,
If you w:)(clc:d a funerallhat may require embalming, such U II funeul wllh \'icwinft. yuu ma)' hnt' In In)' fur I mhalminK. You do nol hnc: 10 pay (or embalmlnl
you did nol appruvc If Y Jclrel d arranRc cnu lue S II tlure, crenulinn lit Immrdlalc hurial. If We' clwKcd ror emhalmlng. 910'( v.' I '.pbln why btlllw.
For the Sm~~ 01 'I" Dale 01 DuW ,vOt/, MO /99~
Ch..gelo,~!&'d: /IJ. li'.'1mLi Y?O.'&;rJ'S7 V//Ak~c;., >'1;. I7dl'1
Name I Addles' Cil)' 7~ SUit
Olher dUlhlll);
A. CIIARGE fOR SERVICES SELECTED,
I. PROFESSIONAL SERVICES !Jf
Servleel 01 Funcul Dlr<CIorlSurr "" I
Emb.lmlng ......'.......... ..,I. _
01 I pl.p..1I n or bod
W
~
CrtnU,lilln urn . . . . .
(Dmllpllon)
I-
I-
.......1-
OTIII.K
......,............,.....,...., I
SUB.TOTAL OF PROPESSIONAL SERVICES" . . . .
2, FACILITIES AND SERVICES
UIC or Cacllilla .nd lervleel COI .f} .J
vl.wlng (VlslllllonlW.ke). . , . , . , , , I.EJJ...
U" 01 lacllill'l.nd ICIVIc.]"..... tilL. ,f} 1/
101 Cunml crrcmony "nuy(( .(f'f'"--1J:IL
U" 01 lacllilla :nd "IVleel 101
M.moll.IServlce """'.,..",.1_
Use or equipment and service!.
101 grawlde l'IVlce, . .. . . . ., . . ., 1':::::::-
Olher UI. 01 lacllill'l
..,AII_
I-
I-
1-
TOTAL MERCIJANDISE SELECTED",.""""""
C, SPECIAL CIJARGES,
Forwuding or remain!. 10
,BI~~
(Flllleralllome)
Reeeh'ing or rc mains (rom
1-
................,..,..,....,..1-
SUB.TOTAL OF FACILlTIESIEQUlPMI U , ., . , ,. . .
" AUTOMOTIVE EQUIPMENT
~:~ell~ ..~.',~~~.~ .',e~~I~ ,I~, F~~~'~I II~~
Hc.rsc (CukcI Coach)
Loc.I...........,..".."...,. .
Limousine
Loal..."........."........ .
F.mlly car ::..--
LocaL.......,................. 1_
Flower car or floral disposition
Local.......,.......,..,..... .
L..d car/clergy car
Lo..I.....,........,...".... .
Car COI p.llbcmll
Loc:al.......................... --
OUI 01 lo...n lransporllllon , , , , , , . . .
..A21_
(rllilrralllome)
Immcdiate DUII,II . . .. , .. . . . . ...... 1---':'
Dlreel Cremalmn. ... ... . . . ..... . . I_
I-
SUB,TOTAL OF SPECIAL CIJARGES .,..""..""" C 1_ _
D. CA~:~.~?,,~A~~vEcD, ~P.~~I_
CcmCIl'rY Equipment. ....... ...... '_
l.ul:anllOcclI....................._
~CWlpJpc:1 NOllm-Luc.1 ,'..",., 1_
~''''lp'pc:1 NOllm-Oul,ol.lo...n.". 1_
Tclcphun. II< Td.gram. "",."", 1_
~""'.""':J."y.'.'~~
~;~', ~rr'.':ng~-:::.,:::":~':~~
(.."rtlril I CopiclI of Ihr Oealh
(<"inw. ....... .I:r:.., .., ..,. I ..30
Puller F~915~/~"" r3~"""" l-=r
Illlwers Kro.(lq~.s...~~~":'SI~
\.Iull Selvle. CharR',."""""" 1_
:~
I-
I-
I-
. 1- 07sr;
SUD,roTAL OF ADVANCES........,.............. D 1_
1-
1M
I 'leI!
, ~I!
.fj;{
1/,4M &?EJ'SU
We ehar~c you rOI our leIVle.lln obl.lnlog:
(sprrlf)' ,asb ad,'anw Ibal art mar.td'up)
SUMMARY OF CIJARGES
A. I'rorcsslonal Services, Facilities and
Equipm.nl, and AUlomotlv. 0179 _
Equlpm.OI................,..... 15ffi
II, Mrrch.ndl!t..................,.. I~S-
CD' sCp'hel'AldchllRCl ..,.............., II O<Sv.
. u vanm..,......,........, - uS'!?, ~
TOTAL OF ALL SECTIONS. . , .. .... .. .... ...., , .., 1_ _ '
PAID AT TIME OF OR PRIOR TO
ARRANGEMENTS... ....,.......". ...."..,....,1__
BALANCE DUE.. , .. . . .. , . .. , .. , , .. .. .. , . .. , .. '.. 1_ _
N FO EMil LMING /, /.
~/ 't.fT#'P,f/L4PiJ..} /V/OJW9
, I _
Ir .ny I.w, 'mtl'.')'. or Cl.mlluly lequlremeoll have lequlred Ihc purch',e
ur ~nr oC Ih. II.m, 1I11.d .blll'c Ih. I.w 01 rrqulrrm.nlls rxplaln.d belo'.\',
aHf~T.t',.!y
/
I.glcclhlll b.vecxamlned Ihcll'lRlol goods .nd l<rl'leell<leeled .bul'e .nd Cound Ihem 10 bt eorreel.nd mOlding II> Ihe "ranRemenlll hsvr requ"I.d,12eknowir' it
rredpl 012 copy QI Ihls Slatemenl 01 Fun.ral Good, ,nd ScrvlCCl Srleeled. I rrprrl<nl hIli hll'C ,u!fi,,,nl lund, mil.bl. ror p.ymenl 01 Ih. ClJh prtec 101 lb. go <Is
:and Krvlcrs sclr:cttd. I also aRret 10 tny; payment 01 . wilhin 0 dl)\ laRree 10 be joint I)' and 5('\'cnlly Ibhlc wilh anyone ebe ,. 10
signs below. A blc charge or I L~ (lC'r month amounlinJt 10 I per )'('ar ""III hr arPlied 10 Ihe unpaid balance b(ginnlng Ii rs
(rom the chtc or Ihis :agreement. will also pal' 10 Ihr Funeral Dirrclnr all rCl~()n:ah1c (0\15 raid hy Ihe hlOcu ()jreclllr In collcCI arnounls I 0"'( under this :lgrttml II.
Those CDS may Include auom . rccs, roUr! com and olher com, Any addilional Knires or mcrch.1nlli~ ordered f1 cquestcd arter Ihe duc of Ihis :lgrrcmcnl1 111
be consl d ~art or :l c the r hereor will he rcncclcd on the final bill or mlrmrnl
(Se.I)
(Se.I)
"'''''"'I'''IW
COMMON'WIAUH 01 PlHN'"\lAN'A
INHUIIANe. 'A. _nul,..
l"IDIN'DIClOI"!
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES AND LIENS
PI.a.. Print or TVp.
FILE NUMBER
~J!lb .o1iO
ESTATE OF
ltT1'1 j , A/ol'J)\1Il1
ITEM DESCRIPTION AMOUNT
NUMBER
1, (l\06I(.C: /IoM~ Jro"I(. it f.u T '81-
tfIJ I.. /It.
J.
"at U.. TtWl/OUe '10
3. S
If, ~"Bu.tsooJ rt&.E ..?oo
!, IIoItlto,,~~I~ /lJ$uAAoJU: ~'I
~. 'PM'lItD'- /.l ,iNS - 110 A~ 'ftO"ILEfl.. 3~
"'1. >>a&'1 SPIII,I /!OS pfT1lL. '1$'1
e, (~~Dlr rM,f)S - 'eoSCoU'$ ,on,
- ~ ,.~ 8~
-~ll)tot-l
TOTAL IAlso ontor on lin. 10, Recopilulatian)
(If mo,.. space ;s nHded, ins.rt odditionol sh.ek or lam. size.)
$ 3358
M\I.tlIIP.t""I
ESTATE OF
NUMBER
I.
*'
SCHEDULE J
BENEFICIARIES
COIlM()IM{AllH Of Pt:NNSYL VM<IA
INHERllAHCE lAX RJ:1URH
,
FILE NUMBER
).,q" -0'190
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
Do Not Lilt Trultee(l) OF ESTATE
OA.(,/ln't 'II. ..f ..~4.1 H"I-c
8 un J , Ilomlo'l'f
1,
NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY
TAXABLE DISTRIBUTIONS (include oulrlghl spousal distributions)
RUIIA m. 7hl~l~
fl. O. 'i'l' '30
llo/lslu'l 'l"", ,.,11'1
~~'1 KP/tmr.p-
~ 3o~ '/."I',<<.u,J ~..i.
ll'ltc/...o.c~'" I~' ,,,,oS(
~,IIfl1l-
'/'l. "' ~,J..J ~
~.
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 17, AS APPROPRIATE, ON REV 1500 COVER SHEET
II. NON.TAXABLE DISTRIBUTIONS:
A, SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAXIS NOT BEING MAOE
1,
B, CHARITABLE AND GO'lERNMENT AL DISTRIBUTIONS
1,
TOTAL OF PART n. ENTER TOTAL NON.TAXABLE DISTRIBUTIONS ON LINE 13 OF REV 1500 COVER SHEET S'
(" mom space Is needed,lnsert addillonal sheetS of the same slze)
-2-
COHl'lONWEAL
OF PENNSYLVAlH^
)
COUNTY OF
betara m. b..l...
. chill r"".
55.
whoss nAtIlt:
been duly
siBntSd and
char, 1 s1.6
tar)' ace. a
DETTY J. All'l'HONY . th.. t..ot..t r1.x
II 8TRnl'~ to che. QccacluuJ ur foreH,oing lnatl"umanc. havll\&
aLlf18d nccocdinK Lv l~w. ~o hereby acknowlud~1:S Lilac I
x~.:tJtled the' In!4truma.nt. aN my Last Will and TUbLtim."C;
d ~c willingLy; nod chat T s1Rnud 1e ~b my freu and vulun-
dtS.d. fur tha put'po.as chllc.in c.untilined.
l'!1':TTY J
day of
."'orn and affirmed ~o and M..:know.Lcdged
All'l'HONY . the: eeatacr1.x
t l>C1r . ^. D., J.99).
"
/Y/r".. ~ l' Ilc.)
~-:
/ r. f.~.
.-'-
COMMONWEAL H U~ ~~NNSYLVANT^
)
)
._ NOTARIAL ~EAL _
MARILYN IIAY ","I<IN, ",\'" tubl;.
Mtchlft\oWtL B.r.. .Curnbtr',,": ,~";S
M~ C.rIl",'lllltn E,pln;~ th". .
55.
COUNTY OF CM~ekLAND
\/e:. the und...s1I\nad, J. ROBERT STAUFl"ER
and JO M..........EA1<TN . che w1LlltlGGQ. who.. nam.. ara
aisned co he ~tcached UI Cu~u8~ln8 inacrument. heing duly ~ug11fi.d
acc.urding n low. de pUBIS and. say thltl,; WII Wyre IJreaent and IU1\l the
t:.e"~ot r:1x I BETTY J. AllTHONY . :fign alld e.xe-
I;uc.e the 11 Atrumcnc. da K..Iil'Iher Laac. Will and Te.8tamenL i Llulc' the
said caata r1.:x BI'.:TTY J. All'l'MONY . e""c:ut..d it as
~hR:t' ('I' "Q-3iirvo)uncary IiCt for'the PUr-PUSM" therein eJCpreaaedi
thatl ~ach . r us. in lilt' hearing ,RInd tl1ght of che CYBtAtr1~, ~lKl1~.J
th~ Will R. ~itlaesses. cnd thML co rh.. beat of our knowll1~g", the
ccsc;atr1x was. at; ~e time, eighteen (l8) ur anura y~ar:s of BgC.
or :suun" ':Q nd, .nd ~1\dor no conllcrolnc, durcutl vI' "ndue inCluunce-
,
Sworn and
me thirs
OotobClr
~i~cribed tu bt! tara
- dft.Y of
J.993.
,-'
....//0.. .
\(! ?;'L.
(
"'. No'rARIAL SEAL
"'''AIL TN KAT ",""<IN, N"ArY Publl'
M'~.nlcsburL elrl. c.....rlan. C.wRt,
Ml C,nanliot'ln [.plr.. "'tv, S. 1993
'/
l ..,
'l'hi... " 10 (t Ilil) Ih.11 rlU' I lilt II 111_1111111 hl"lI t:'\t'll I. ~,,[ Illth I' 'I'll , 11'111' III "I 'l'll\.d I I II ilH .111 III ,k,lIh dill)" 1111'1\ \~ 1111 Ill'. .1'"
LlllolI Hq~I"III.1I Tin IIn~',lll..J 1I"Ildll.I'I' ',\Ill lIt, 1111\\ n'\l ,I 'll lid "',Ilt \ 1l.1! I\lllll'!" lllllll 1;'1 1'1 I Ill-lilt III Idlll~:
WARNING! Ills IlIegol to dupllcote Ihls copy by photostat or photogrnph,
hi' to., Ihl' U'lllhi.lIL ~.' PIl
i'~-""-
j,'(..\1!!OLP~
' '!if", .:f,r.',
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Of'o9j,jfi~Tu\"';'
---
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1.11I.1IItl'~I,,".1I (J
3880440
NO\' , ~ 19;ij
1>,11"
No.
I
COMMONWEALTN Of PENNSYLVANIA' DEPARTMENT Of HEALTH' YITAL RECORDS
CERTIFICATE OF DEAT!i .
'"
'.........UIIlI
DNI 01 0IRlt"""' ~-.
L Nov 20 1996
I,
7393
-
DAtI a' ..-rH
tloli7rl.o.,__,
1lfQ~~""
s...'G'9"ec....."
:="'0
68 ,~
PeMSOOro
"""""'.......
.....Il""-......
~.WUl........
---
--
Widowed Deceased
1,..tJ ......iIIeI*flI...... East FeMB 'IWP.
"1.'2
17053
tu;lDlIfT'
""""
.._"'"
-
--
,...
Pa.
11......
'"
-
....
Cl.Irberlan:l .......' tMD :;"~=cf
YO'hCIl" NAWI,... ~ ........1WfIIt
,
-.
_...
............0
"'-"CI ClIIPOIfT1Cltt..-...~c.-r
._-
Woodlawn MelTDrial Gardens
.wcNfOAODNIIOI MQUh'
Pa. 17109
UClH"'~
==:.. Pa. 17011
-.
......CASl IMIPrg..
...0
..I)[
-
'.-":=
I If"":'
!]..(J I.
,
,
,
,
f'lUI1l: cw.~____""".""",
...-..~....~_.....,""",,"I
P.M mlOl' 4tc:H1OJlHCI Of)
--........
-.... .-..
""""""""'.......
"'0IRM1
"""01' tlIRM
PoVIOJN.lURY
\~o.,.",-,
''''Cll'1UIJRt
MNIlf 111 'M)Ml
tlllClllC ~ I'UUft'l'CltQJIWO
if
o
o
o
o
o J'UC.lClNJVIIl',~"""',"""......--.1IIIle II,
......--
...
-
-
-
-
... 0 ..0
'-'-
c:....MfIGl........
01[;(
...0
..0
- -
CtIII'TWtMll>d.......
.CUlTW"QIIQ""IIC&IoIt~......_"~__.,."..~.....IlI~...,._~"_"Dl
..........,...............__......"'.......c......_.......... .......,...........................................
..
~'
'. ,INGC8lIIT1P't"INCf'tIT1IClM~tI:IlJI~.,..."~II~III'*""
..........................___......................................-.f"... _.. ................... ...... .......
.--
, :::,-:-.:::.~.~~~~..:.:..:~~.~:~~~~~~~..~~~:~.~:~.~~~~~.~
,. .
N ....
1Ol,t ~.1 r' I
/?"
...
6- / iN _ L/
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
~
c.....
BUREAU OF INDIVIDUAL TAXES
IHlllMltAHC[ lAJI DiViSION
DlP'. zaa.Ol
ItAAAISlUAG, Pi ltua-DbOl
NOTICE OF INHERITANCE TAX
APPRAISEMENT. ALLOWAHCE OR DISALLOWANCE
OF DEDUCTIONS AND ASSESSMENT or TAX
..'1""'11.....'"
ANNA M RVDDSBV
259 ORE BARK RD
PO BOX 357
DILLSBURG
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTV
ACN
05-04-98
ANHIONV
11-20-96
21 96-0980
CUMBERLAND
101
BE TTV
J
Anount Renitt.d
PA 17019
MAKE CHECK PAVABLE AND REMIT PAVMENT TOI
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE. PA 17013
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~
ifiv:i5"47"EX"AFP-nI9-:9rnioTicr-oF-YNHEifii'ANCE-TAX-WPRiiisEHENT";"AL.i.-owiiNCE-oli-----------------
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF ANTHONV BETTV J FILE NO. 21 96-0980 ACN 101 DATE 05-04-98
TAX RETURN WAS. I X 1 ACCEPTED AS FILED
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. R..I Est.t. (Schedule AJ
2. Stacks and Bonds (Schedule B)
3. Closely Hald stock/Partnership Int.ra.t (Schedule C)
4. Hortg.gas/Hot.. Racelvable (Schedule DJ
5. Cash/Sank Deposits/Hise. Parlonal Property (Schedule El
6. Jointly Owned Property (Schedule fJ
7. Transfers (Schedule G)
8. Total Assat.
) CHANGED
NOTE: To insure proper
credit to your account,
submit the upper portion
of this forn with your
tax pay..ant.
12,500,00
.00
,00
,00
1,000,00
,00
25.434,00
18)
11)
12)
(31
t41
151
1&1
171
38.934,00
191
1101
8.048.00
3.358,00
Ill)
112)
1131
1141
11 .4n6 nn
27.528.00
,00
27.528,00
APPROVED DEDUCTIONS AND EXEMPTIONS:
. 9. funaral Expansas/Ad... Costs/Hisc. Expanses ISchedula HI
10, Dobts/Mortgogo Llobllltlos/Llons ISohodulo II
11. Total Daductions
12. Hat Valua of Tax Raturn
13. Charitabla/Govarn..antal aaquasts; Non-elactad 9113 Trusts (Schadula J)
14. Nat Valua of Estata Subjact to rax
If an assessment was issued previously, lines 14. 15 and/or 16, 17 and 18 will
reflect figures that include the total of ALL returns assessed to date.
ASSESSMENT OF TAX:
15. A.ount of Lina 14 at Spousal rata (15)
16. A.ount of Lina 14 taxabla at Lin.al/Class A rata (16)
17. A..ount of Lina 14 taxabla at Col1ataral/Class 8 rata (17)
18. Principal Tax Dua
NOTE:
,OOX,OO:
27.528,00 X, 06:
,00 X ,15:
1181
,00
1,652,00
,00
1,652,00
TAX CREDITS:
PAYMENT
DATE
02-02-98
DISCOUNT (t1
INTEREST/PEN PAID I-I
'67,74-
AHOUNT PAID
1,726,00
RECEIPT
NUHBER
AA269719
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST AND PEN.
TOTAL DUE
1.658,26
6,26CR
.00
6.26CR
. IF PAID AFTER DATE INDICATED. SEE REVERSE
FDR CALCULATION OF ADDITIONAL INTEREST.
I IF TDTAL DUE IS LESS THAN Sl. ND PAYMENT IS REQUIRED.
IF TDTAL DUE IS REFLECTED AS A "CREDn" ICRI. YOU HAY BE DUE
A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS.)
t'~ -d ::0::0
:1 OJ ~l ~
" , "
$:
-<
I
U1
~ ~..:~ (
'. N Vio
~~ .:;, -
-..J
RESER.A'IOH' E.I.I.. 01 d.c.d.nl. dyln. on or b.lor. O.c..b.r 12, 1.82 -' II ony lulur. In..r..' In ,h. ....1. I. Ir.n.,.rr.d
In po.....lon or .njoy..nt to Cia.. a (collatar.l) b.n.flclarl.. of the dec.d.nt aft.r the ..plratlon of any ..tat. for
Ilf. or for y.ar., the Co..onM.alth h.r.by ..pr...ly r...rva. the right to appr.I.. .nd .....~ tr.n.f.r Inherlt.nc. T....
.t tha lawful Cia.' 8 (collat.r.l) rata on any such future Intara.t.
PURPOSE Of
NOIICE:
To fulfill the r.qulr..ant. of Sactlon 2140 of tha Inharltanca .nd E.t.ta T.. Act, Act 21 of 199~. (72 P.S.
S.ctlon 914D).
PAYH[NT I
a.t.ch the top portion of thl. Notlca and .ub.lt with your paya.nt to the Regl.t.r of Will. printed on the r.v.r.a .Id..
uH.k. chack or aonay ord.r payabla tal REGISTER OF MILLS, AGENT
REFUND (CR)I
A r.fund of at.. cr.dlt, which wa. not r.qu..t.d on the T.. R.turn, .ay ba requested by coapl.tlng an "Application
for R.fund of Pann.ylvanla Inh.rltanca and Estata Ta." CREV-15151. Application. .r. .vall.bl. .t the Offlc.
of tha R.gl.tar of will., any of the 25 R.vanu. DI.trlct Dfflc.., or by calling the .p.cl.l 24-hour
an.warlng ..rvlc. nuab.r. for for.. ordering: In p.nn,Ylvanla 1-800-362-20S0, out. Ida P.nn.ylvanla and
within 10c.1 Harrisburg ar.a (717) 187-8094, TOOl Cl17) 772-22S2 Weedng lapalrad OnlY).
OBJECtiONS I
Any party In Intar..t not .atl.flad with the .ppr.I....nt, allowenca or dl..llowanca of d.ductlon., or a......ant
of ta. Clncludlng dl.count or int.ra.t) a. .hown on thl. Notlca au.t objact within .I.ty (60) dey. of racalpt of
this Notlc. bYI
--wrlttan prote.t to tha PA n.pert..nt of R.venua, Board of Appaal., n.pt. 281021, Harrl.burg, PA 17128-1021, OR
--alectlon to have the .att.r dataraln.d .t .udlt of the account of tha p.r.onal rapre..ntatlv., OR
--app.al to t~. ~rph.n.. Court.
AnHIN
ISTRAtlVE
CORRECtiONS I
factual arrors dl.cov.r.d on thl. .....,".nt .hould be .ddr....d In writing tal Pi Dapart.ant of Ravanu.,
!ur.au of Indlvldu.l T...., ATTNI po.t ~\......nt R.vl.w Unit, D.pt. 280601, H.rrl.burg, PA 17128-0601
Phona (711) 781-6S05. Sa. pag. 5 of the booklat "In.tructlon. for Inh.rltanc. T.. Raturn for a Ra.ldant
O.cadant" (REV-lS0l) for an ..pl.n.tlon of ad.lnl.tr.tlvalY corractabl. arror..
OISCOUHh
If anY t.. dua I. paid within thr.a (51 cal.nder aonth' aft.r tha dlcadant'. d.ath, a flv. parc.nt (SZ) dl.count of
tha ta. paid I. .llowad.
PENalTY:
Tha ISZ ta. ..na.ty non-p.rtlclpatlon pan.lty I. co.put.d on tha total of the ta. .nd Int.r..t .......d, .nd not
paid b.for. Janu.ry 18, 1996, the flr.t d.y .ft.r the .nd of the t.. aana.ty p.rlod. This non-partlclp.tlon
p.nalty I. app..l.bl. In tha .e.. .enn.r end In tha the .... tl.. p.rlod a. you would epp.el the te. .nd Int.r..t
that ha. b..n .......d .. Indlcat.d on thl. notlc..
INTEREST I
Intlr..t Is charg.d b.glnnlng with flr.t day of d.llnqu.ncy, or nine (9) .onth. and on. (I) day froa the data of
daath, to the data of pay.ent. ,.... which b.ca.. dellnqu.nt b.for. January 1, 1982 be.~ lnter..t .t tha rata of
six (6Z) p.rc.nt p.r annua c.lculat.d at a dally rat. of .000164. All ta... which b.c... dallnquent on and aft.r
Janu.ry 1, 1982 will b.ar Intare.t at a r.te which will very fro. cal.ndar yaar to cal.ndar y.ar with that rat.
.nnouncad by the PA n.parta.nt of Rav.nu.. Th. .ppllcabla Intar..t rat.. for 1982 through 1998 are;
'!!!! tntara.t Rate Dally 1nt.rut fector !!!! tnt.n.t Rata OftllY tnterut Factor
1982 20X .00OS411 1987 .~ .000247
19U 16Z .0004!8 1988-19ql llZ .00OSOI
1984 11X .000301 1992 .~ .0DDZ47
1985 UX .00OSS6 1993-1994 7~ .000192
1986 lDZ .OOD214 199~-1998 .~ .000247
--Int.n.t Is calculated .. folloWIl
INTEREST = BALANCE OF TAX UNPAID X NUnBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR
.-Any Hotlc. I..u.d aft.r tha ta. bacoaa. delinquent will refl.ct .n Inter..t calculation to flft.an (15) day.
b.yond tha d.t. of the a.......nt. If p.y.ant I. .ade .ft.r the Inter..t co.putatlon date .hown on tha
Notlc.. .ddltlonal Int.re.t au.t be calculat.d.
~
(y
"
STATUS REPORT UNDER RULE 6.12
Name of Decedent: _Re -\- "1 j f1,.v -\- h 0 ..., 'I
I
Date of Death: II \;c ~lo
I
Will No. )..\- l\1.-c1S>O Admin, No.
Pursuant to Rule 6.12 of the Supreme Court Orphans'
Court Rules, I report the following with respect to completion of
the administration of the above-captioned estate:
1.
State ~ether administration of the estate is complete:
Yes V No
2. If the answer is No, state when the personal
representative reasonably believes that the administration will be
complete:
3. If the answer to No. 1 is Yes, state the following:
a. Did the personal representative file a final
account with the Court? Yes No ./' .
b. The separate Orphans' Court No. (if any) for
the personal representative's account is:
c. Did the personal representative stat~ an
account informally to the parties in interest? Yes ~ 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: 10\13\9'1
,
AJa 1~ 'i VA 11 /}1~
signatureu- 0.<
;U fJ A1 ('j J... K,.( .4111 E t?
Name (Please type or print)
023113 ~fUr"(JIfr..Il',,) ~f) lYJedl/lJ 170\-j-
Address' ,
(17) b 9/- 7(., 41
Te 1, No.
Capacity:
~Personal Representative
(HAH: rmf/ AM3)
Counsel for personal
representative
.". ... "
I
I
I
I
STATUS REPORT UNDER RULE 6.12
Name of Decedent:_p)~ '\\-'\
Date of Death: I \ \ ;10 \ ") (/1
Will No. ,) \ - ", (" '1)'{)
-1 {.\ ,\.1.\(: {' i' '\
Admin. No.
Pursuant to Rule 6.12 of the Supreme Court Orphans'
Court Rules, I report the following with respect to completion of
the administration of the above-captioned estate:
1. State whether administration of the estate is complete:
Yes \,./ No
2. If the answer is No, state when the personal
representative reasonably believes that the administration will be
complete:
3. If the answer to No.1 is Yes, state the followingl
a. Did the personal representative file a final
account with the Court? Yes No ~
b. The separate Orphans' Court No. (if any) for
the personal representative's account is:
c. Did the personal representative state an
account informally to the parties in interest? Yes ~ 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: 101, ?11'i
Signat.ure
(HAH: rmf/ AM3)
Name (Please type or print)
P n p, ry' :3 5 " .J )'-) tJ,C,' ,),1,) J:: R.o
Addres sO, 1:-1-0; Bll ^ 6-, (:I rf '7 O. ')
("717) Jli:l. .'1373
Tel. No.
Capacity: ~personal Representative
Counsel for personal
representative
\
.'