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LAST WILL AND TESTAMENT
OF
BRIAN KELLY ROBERTSON
I, BRIAN KELLY ROBERTSON, Social Security Number 183-50-6099, of
the State of pennsylvania, declare that this is my LAST WILL AND
TESTAMENT and I revoke all other wills and codicils previously made by
me.
FIRST: I appoint my Mother, J. THERESA EDMONDSON as my Personal
Representative concerning this Will.
a. I request that my Personal Representative be permitted to
serve without bond or surety thereon and without the intervention of
any court, except as required by law. I direct that my Personal
Representative act in unsupervised administration so as to administer
my estate with a minimum of court supervision. If it becomes necessary
to have ancillary administration of my estate in any jurisdiction where
my Personal Representative is unable or does not desire to qualify as
ancillary legal representative, I appoint as such ancillary legal
representative such individual or corporation as my Personal
Representative shall designate, in writing.
b. I direct my Personal Representative to pay the expenses
of my last illness, the expenses of a funeral appropriate to my station
in life and custom of living (including a suitable monument or marker
for my grave), and written charitable pledges which I have made. I
grant my Personal Representative the power to extend or renew any debt
for such time as my Personal Representative shall deem appropriate.
c. All estate, inheritance, succession and other death taxes
with respect to all property passing under this my Will shall be paid
from and borne by the principal of my residuary estate, without regard
to reimbursement, as if such taxes were administration expenses. My
Personal Representative may pay such taxes at any time deemed
advisable, whether or not then due and payable.
d. My Personal Representative is requested to settle my
estate as soon after my death as may be practicable, and to payor
deliver every legacy or bequest to my beneficiaries without waiting any
time that may be believed to be customary in probate matters.
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PAGE 1
OF 3 PAGES
e. I have served in the Armed Forces of the United States.
Therefore, I direct my Personal Representative to consult with a Legal
Assistance Attorney at the nearest military installation and with the
Department of Veterans Affairs and the Social Security Administration
to ascertain if there are any benefits to which my family members are
entitled by virtue of my military service.
f. I may leave a letter of intent with the executed copy of
this Will for the purpose of giving guidance to my Personal
Representative concerning the distribution or sale of certain items of
my property. I request, but do not require, that my Personal
Representative honor my wishes therein expressed.
SECOND: To my Brother, PATRICK MICHAEL ROBERTSON, I give my house
(including all furniture) and land, located at 20 East Columbia Road,
Enola, Pennsylvania.
THIRD: I give, devise and bequeath, absolutely and forever, all
of the rest, residue and remainder of my estate and property of which I
may be seized or possessed, or to which I may be entitled, at the time
of my death, wherever situated or of whatever nature, be it real,
personal, or mixed, to my Mother, J. THERESA EDMONDSON as her sole and
absolute property if she shall survive me.
FOURTH: Except as otherwise provided in this Will, I have
intentionally failed to provide for any other relatives or other
persons, whether claiming to be an heir of mine or not. Insofar as I
have failed to provide in this will for any of my issue now living or
later born or adopted, such failure is intentional and not occasioned
by accident or mistake.
FIFTH: Any beneficiary who fails to survive until one hundred
twenty (120) hours after my death shall be deemed to have predeceased
me, and the gift to that beneficiary shall be disposed of accordingly.
SIXTH: The term "Personal Representative" as used in this Will
means Executor, Executrix, Independent Executor, or any other title of
like import which is used to describe such a fiduciary.
SEVENTH: In addition to any powers granted by the laws of the
state in which this will is probated, I hereby authorize and empower
the fiduciaries named in this Will, to the extent of the discretion
herein granted, to sell, exchange, convey, transfer, assign, mortgage,
pledge, lease or rent the whole or any part of my real or personal
estate, to invest, reinvest, or retain investments of my estate, to
perform all acts and to execute all documents which my fiduciaries may
deem necessary or proper in regard to my property. If any of my
fiduciaries elect to receive compensation for services, such
compensation will be that allowed by law.
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3 PAGES
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EIGIITII: If any part of this will shall be invalid, illegal, or
inoperative for any reason, it is my intention that the remaining
parts, so far as possible and reasonable, shall be effective and fully
operative. My Personal Representative may seek and obtain court
instructions for the purpose of carrying out as nearly as may be
possible the intention of this Will as shown by the terms hereof,
including any terms held invalid, illegal, or inoperative.
IN WITNESS WHEREOF, I have at Carlisle Barracks, Pennsylvania,
/h I~I( c..), "
:.) day of (-(I_I, <..,1,\.1 ,1996, set my hand and seal to
my LAST WILL AND TESTAMENT, consisting of 3 typewritten pages,
page bearing my handwritten signature.
this
this
each
This document was prepared under the authority of 10 U.S.C,
section 1044, and implementing military regulations and instructions,
by Robert P. Formichelli, who is licensed to practice law in the State
of New York.
/3V~~ Xf2Q
BRIAN KELLY ROBERTS N
EALI
The foregoing instrument was, at Carlisle Barracks, Pennsylvania,
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this :.) - day of tCdl,," :,\:, , 1996, signed, sealed, published and
declared by BRIAN KELLY ROBERTS N, the testator, to be his LAST WILL
AND TESTAMENT in the presence of all of us at one time, and at the same
time we, at his request and in his presence and in the presence of each
other, have hereunto subscribed our names as attesting witnesses, and
we do so verily believe that the said testator is of sound and
disposing mind and memory at the date hereof.
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3 PAGES
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COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
ACKNOWLEDGMENT
I, BRIAN KELLY ROBERTSON, testator, whose name is signed to the
attached or foregoing instrument, having been duly qualified according
to law, do hereby acknowledge that I signed and executed the instrument
as my Last Willl that I signed it willinglYl and that I signed it as my
free and voluntary act for the purposes therein expressed.
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'BRIAN KELLY ROB~SO
AFFIDAVIT
We, ~~ /! &,,~ ;..,1.-//. , Iic.S/"l A' J-;..doJ','r ?, and
r;stC;:' ~CUI<: 6,.- , the witnesses, sign our names to this
instrument, being duly qualified according to law, do depose and say
that we were present and saw the testator sign and execute the
instrument as his Last Willl that the testator signed willingly and
executed it as his free and voluntary act for the purposes therein
expressed; that each subscribing witness in the hearing and sight of
the testator signed the will as a witnessl and that to the best of our
knowledge the testator was at that time 18 or more years of age, of
sound mind and under no constraint or undue influence.
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Witness -=-;;7 WItness U ~Witness v
Subscribed, sworn to and acknowledged before me by BRIAN KELLY
ROBERTSON, the testator,
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me by
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and subscribed and sworn to before
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fit))';! 1'/ /Cedr It/' ,I r.?: , and
'-_ 'II,
, the witnesses, this I!,:; - day of
( u.- . ,-" " i
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I
, 1996. /' _
\..,,*(/ C_'. )fr.,i ,-
NOTARY PUBLIC My Commission
.
Evr',.....an.
NOUlrlal Sell
KIm C, Guyer. NolaIY Public
Carlisle BolO. Cumberllind CountY i
My Commlsslon Expire. Nov. 10. 1997
, l;.oniler.
r
CERTIFICATION OF NOTICE UNDER RULE 5.6(0)
Name of Decedent:
Brinn Kelly Robertson
Date of Death:
December I 11)96
Will No.:
11)96-01013
Admin. No.
I'A No 2196-1013
To the Register:
1 certify that notice ofbenelicial interest required by Rule 5.6(a) of the Orphan's Court
Rules was served on or mailed to the following beneliciaries of the above-captioned estate on
December 13 11)96
NIlm.c
Address
J Theresa Edmondson
5100 Inverness Drive
Mechanicsburll I' A 17055
738 Boserville Rond
Newville P A 17241
Patrick Michael Robertson
Notice has now been given to all persons entitled thereto under Rule 5.6(a) except None
Date: December 13, 1996
~('~
Signature
Name: Linus E Fenicle
Address: 2331 Market Street
Camp Hill I'A 17011
Telephone: (717) 763-1383
Capacity:
Personal Representative
x
Counsel @~ersonal
representi!tlge ~
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WELTMAN, WEINBERG & REIS
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IirTOKNms AT l.AW
175 Snulh Thlnl Slfl.t'!. Suill' IJUU
Culumhu\ Ohl<l .aJ215.5D'1
(1)14) 22K.7272
CI.IlVliI.AND' COl.UMIIUS' CINCINNATI .I'ITTSIIUIIGII
March 17, 1997
CUMBERLAND COUNTY REGISTER OF WILLS
CUMBERLAND COUNTY COURT HOUSE
CARLISLE PA 17013
Re: Estate of BRIAN ROBERTSON
Claim of NOVUS Services, Inc., fka Discover Card Services, Inc.
Our File No. 01136547
Dear CLERK:
Please find enclosed a claim to be filed in the Probate Court. Please forward back to
this office a time-stamped copy of the claim.
Attached for your convenience is a self-addressed. stamped envelope.
Very truly yours,
Probate Department
:tms
enclosure
cc: Attorney Linus Fenicle
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Invonlory of Iho roal and porsonal oslalo 01
Ill'lnn KellY_Jl_~he_,:.!!!,)~_ docoasod
. _._..___._._ ~______.__. _.0
__~ ___________.________._ d_ _~..._~_..__
Household Furnishings
57,900 00
425 93
1,049 81
3,000 00
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I 500 00
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House and lot located at 20 Columhln Rond, I\nolll, Ph 17025
Members First Federal CredIt Union
Savings hccount 35486-00
Checking hccount 35486-11
1984 Oldsmobile Cutlnss Sierra
TOThL ESThTE
62,875 74
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COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUM.ERLAND
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lillm(lIl(I.~(ln
___ according 10 low. dopolol ond 'OY' Iholsho Is the Executrix ._._
Brinn Kelly Robertson
r::--.------ -.--- -.-- 01 Iho Ellolo 01
EnolO
1010 01 _..._ ...._ . , Cumborlond Counly, Po., docoe,od ond that the
within Is on Invonlory modo by _J.._JJlIlrRIHLlill..m9JlIlson ._ __ __._, Iho sold Executrix
01 Iho ontiro 011010 01 laid docodonl. conli,tlng 01 oil Iho porsonal pro".rly ond roel 011010, oxcopt roel oslala ouhldo
tho Commonwoallh 01 Ponn'ylvonla, and Ihal Iho fl9urOl opposllo oach Itom 01 Iho Invonlory roprOlont II', lair voluo
a' 01 Iho dolo 01 docodonl', doalh.
._.___._....J.L 'l1wresll
bolng duly sworn
and ,ub,cribod boloro mo,
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Nolanal Seal
Jcnn!lor S. Kuhn". Notary Public
Camp 1'1.'1 8010. Cumberland coun~
My COlnn",:.'on Ey'p,rcs Sop\. 11.20 0
MCI1lU~:.I'\jl"'Tj')'ht;'.Uia ~~~Qci3tion 01 Notaries
Add"..
Dato of Doalh
DIY
Mo"th
Vea,
INSTRUCTIONS
I. An Invontory must bo flied within throe monlh, after appoinlment of personal ropro.onlatl...
2. A .upplomont Invontory must be flied within thlrly day. of di.co..ry of additional a"oh.
3. Additional ,heoh may be aHached .. to porsonally or really
4. See Article IV, Fiduciaries Acl of 1949.
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INHERITANCE TAX RETURN
RESIDENT DECEDENT
(O..ONWfAIlt'OI''''''\'''''''. i (TO BE FILED IN DUPLICATE 21
""^'b~~~W~~',""UI WITH REGISTER OF WILLS)
U"IlIlI~~U5lG. "... 1/118 (11.01 _ ~ I ~ ___~ n~_~ __ _ _ __ _ _ t;.OU!'l~Y coor_
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ffi W(ii:I~lC\J'll"'u;.;iiI----- iO...lt 01 OU.I" '10"'11 lJl fll~1t1 Enoln. PA 17025
~ 183-50-6099 J_1~.LlL2~ _._ _.o__ ____ ~"~'l Cumberland .
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~ (for dOll" 01 deoth prior 10 17.13.871
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X,co 1101 do't" of deoth olter 12.12.82)
u~U; 06. Drcedent Dird Tr\'ole 0 7. Dect.dent Maintoined a living Trust
4. (Alloch copy 01 Will) (Altoch copy of Trust)
ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO,
N"""l - (OM'~lll "".,l.lllt~C. ...tlORf~~
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'I. lOR DAllS or DIATH AnlR 12/31/91 CHICK IURI
I' A SPOUSAL
PPVIRTY C.!l.~DJ!-'.s_Cl~'!>I.ID 0
ilL! NUMBER
96
1013
NU_~~!R
Y_r~_R_
_ 8. Total Number of Safe Depo,it BOlu
Linus E. Fenicle
'111'H~TIg---
Reager & Adler, P.C.
..--- 2331 Narket Strc~('"J
___c::..~p H i1~ P.\ 17Tl1'
(11_~7 .900.00
(2)
13)
14)
(5) _~..ill. 74
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1. Real EI'o'e lSchedule A)
2. Stach ond Sendl (Schedu!e B)
3. Closely Held Stoc\..lPorlnenh;p In'erel' (Schedule C)
4. Morlgogu and NOll" Recelvoble (Schedule D)
5. Cen,"" BO/'k Depo,i'l & MilCelloneoL'1 Pt'rlenel Properly
Is,~.d,l. El
6. Join11y O....ned Properly ISd'.edu1e F)
7. Trons'er, (Schedule 0) (Schedule tl
8. Tolal Gran Anell (talalli"e, 1.7)
9. Funeral E,penlel. Administra1iwe COlli, Milcellaneoul
e.pen", (Schedule H)
\0. Debll. Mortgoge liobilitiel, lien, (Schedule I)
11. TOlol Deductionl (Iolallinel 9 & 10)
12. Net Value 01 elta'e (line 8 m;nuI line 11)
13.
1111 78,742.74
(12) ~67.00)
(131
(14) JI5,fl67.OO)
(b I
(7)
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62,875.74
(8)
I 9 I --9-,.IS.6.. 71
(10) 68,996.03
14.
15.
lb.
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Charitable and Gowernmen'o\ Beql.lCl'1 ISchedule J)
Nel Value Subjecl10 To. (line 12 minuI line 13)
Spoulal Tro".le" (lor dOlt" of death oher 6.30.94)
Sea In\lrUClion\ lor Ar.rlieohlct PC"rcronloge on RevellO PSI
Side. Ilnclude wUlul:I lum Schedule K or Sdwdulo M)
Amounl of line 14 1011 able 01 bOlo role (16)
(Include value, hom Schedule K or Schedule M.)
Amount of line 14 laxable 01 15~4.t rale P 7)
IInclude ",oluel from Scht'dule K or Schedule M.)
PrincipolloJ( due (Add tal from lir\c' 15, 16 and 17.1
(, "dill Spav,ol Poverty (n.di' Prior roymf'nl\
,.
__________ x. .____=
x .Db =
o
x .15 =
o
(18)
Oi\Counl InlNc,'
(19)
(20)
.
o
II line 19 il greeter than line IB, enter 11l(~ dilference on linu 20. This il lhe OVERPAYMENT.
a c .-I:m'l,I.H _.I&'J,"..I/ WI H.I'I-. 111i1~ ...iltTr.r.w:1.'J.!I'..l'l 1I~'111l-1I1.
If line 18 il greater than line 19. cn'er Ihe difference on lint' 21. Thil i, the TAX DUE.
A. En'er the intere,t on Ihe balance due on lint' 21A.
B. EnlN t"t' lolal 01 line 21 (lnd '11A on line 21B. Th;I il Ihe BALANCE DUe.
Mo"!,_~_hu(k P~y_~.b_l.o.!.~:_~_u_gi~'.!..o.r_o_~~~I~. .^.9o"I________ +,_... .____ _.__
121)
(21A)
(2\8)
n
>- >- BE SUR6o'ANSWERALL oj.iesTioNsoN-REVER'sEsioE AND TO RECHECK MATH-- .:.(-~
Under penalties 01 perjury. I declare thai I "ove eJomined thil feturn. including ouompanying \Chedulel and I'otemen". and to the bt'I' of my ~no.....ledge and belief,
it i, true, correct and complele. I declore that 011 reol eltole hOI been rrpor1erf at true morkt'1 walut'. Declaration 01 prepare' olher than the pellonol reprelentoti't'e il
bOled on all infofmotion 01 .....hich preparer ho, any I..no.....ledge.
5' lUlf RSONRlS'ON~'~flllt~GIl(tURU AODMfSS ,. 1 " .) OAn , /
X'-- _ !? -d!!''I'!~j~ ~,,2-/(.lY:!I<-U.!l:!.l!'-'::'d'... ;7(;d.:<d.(;;A.~'.!?o <<LB">' -'//.,/9/';,,/
\ ". 0'" "'0""" ~"""..' ""..'" ~" a / ~ tfi~'. ~/)7$ '/b D'" ,:I...,,,,,~ .
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COMMONYo'IAll'H Of PINN$VlW.HIA
INHUItANCr tAX JIltullN
IUIOINt DltlOINt
SCHEDULE E
CASH, BANK DEPOSITS AND
MISCELLANEOUS
PERSONAL PROPERTY
Plec.. Prinl or T .
ESTATE OF
ROBERTSON, BRIAN K.
.
fILE NUMBER
21-96-1013
(All properly joinlly.own,d wi'" ,h. Righ' 01 5,,',,1, o.,h:p 1'!'I",t be d;uloltd en 5th,d"l. ')
ITEM DESCRIPTION VALUE AT
DATE OF DEATH
NUMBER
1. Members First Federal Credit Union 425.93
Savings Account No. 35486-00
2. Members First Federal Credit Union 1,049.81
Checking Account No. 35486-11
3. Household furnishings 500.00
4. 1984 Oldsmobile Cutlass Sierra 3,000.00
IAlloth additional 8YJ. )( ".. ,hull iF I'!'IO" .pan il "ud.d.)
IIYUIlI..I'-'"
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(OMMONW["'\'~ 0' '[NH~'l't'...t~IA
INH[.11...t~C[ 'All( 'URN
RUlDIH' DlCf,?-fHI
1 SCHEDULE H
FUNERAL EXPENSES,
ADMINISTRATIVE COSTS AND
MISCELLANEOUS EXPENSES
- ~ -.
-
ESTATE OF
ITEM
NUMBER
A.
1.
B.
,.
Plea,e Prln' or T'(1'.
FILE NUMBER
21-96-1013
ROBERTSON, BRIAN K.
DESCRIPTION
Funeral bpens",:
Neill Funeral Home
3401 Market Street
Camp Hill, PA 17011
Admini,tratlvo Co,'"
Penonal Representalive Commissions
Social Securily Number 01 Perlonol Repre.enlolive:
Year Commissions paid
2. AlIorney Fees
Reager & Adler, P.C.
Family exemplion
3.
A.
C.
1.
2.
3.
A.
5.
6.
7.
8.
Relalionship
Claimant
Address 01 Claimant 01 decedent's deolh
Slreet Address
City
Stoto
Zip Code
Probate Fees
Cumberland County Register of Wills
MlsceUaneou, bpense"
Cumberland Law Journal
The Sentinel
TOTAL (Also onter on lin. 9. Recapitulation)
(II more 'paco I, needed, Inser' additional sheets 01 sam. ,ix..)
AMOUNT
6,500.00
3,000.00
135.00
60.00
51. 71
S9,746.71
. .
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(ow.IrIONW1,ll'" 01 "N~"I""'HI'"
IH"II.'ANU u.llIlt.ll..
l"IOIN10IeIDIH1
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES AND LIENS
Ploa.. p,lnt or Typ'
filE NUMBER
21-96-1013
ESTATE OF
ROBERTSON. BRIAN K.
AMOUNT
DESCRIPTION
ITEM
NUMBER
4,049.85
1.
Commercial Credit - Personal Loan
Account No. 357632
775.00
2.
Discover Card Services, Inc.
3,656.03
3.
Members First Federal Credit Vnion
Loan Liner Account No. 35486-02
3,162.50
4.
Members First Federal Credit Union
Account No. 4121449998354869
57,352.65
5.
M&T Mortgage Corporation
Balance as of 12/96
TOTAL (Also ,nle' on line 10. Recop;lulolion)
(Ir mOrl~ spoce is needed, inser' ocldilionol sheels o( soml sin.'
$68,996.03
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.. -- .------~-
LAST WILL AND TEST~~ENT
OF
BRIAN KELLY ROBERTSON
21-96-1013
I, BRIAN KELLY ROBERTSON, Social Security Number 1B3-50-6099, of
the State of Pennsylvania, declare that this is my LAST WILL AND
TEST~1ENT and I revoke all other wills and codicils previously made by
me.
FIRST: I appoint my Hother, J. THERESA EDHOllDSOlI as my Personal
Representative concerning this 3ill.
a. I request that my Personal Representative be permitted to
serve without bond or surety thereon and without the intervention of
any court, except as required by law. I direct that my Personal
Representative act in unsupervised administration so as to administer
my estate with a minimum of court supervision. If it becomes necessary
to have ancillary administration of my estate in any jurisdiction where
my Personal Representative is unable or does not desire to qualify as
ancillary legal representative, I appoint as such ancillary legal
representative such individual or corporation as my Personal
Representative shall designate, in writing.
b. I direct my Personal Representative to pay the expenses
of my last illness, the expenses of a funeral appropriate to my station
in life and custom of living (including a suitable monument or marker
for my grave), and written charitable pledges which I have made. I
grant my Personal Representative the power to extend or renew any debt
for such time as my Personal Representative shall deem appropriate.
c. All estate, inheritance, succession and other death taxes
with respect to all property passing under this my will shall be paid
from and borne by the principal of my residuary estate, without regard
to reimbursement, as if such taxes were administration expenses. l1y
Personal Representative may pay such taxes at any time deemed
advisable, whether or not then due and payable.
d. l1y Personal Representative is requested to settle my
estate as soon after my death as may be practicable, and to payor
deliver every legacy or bequest to my beneficiaries without waiting any
time that may be believed to be customary in probate matters.
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PAGE I
OF 3 PAGES
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e. I have served in the Armed Forces of the United states.
Therefore, I direct my Personal Representative to consult with a Legal
Assistance Attorney at the nearest military installation and with the
Department of Veterans Affairs and the Social Security Administration
to ascertain if there arc any I:enefits to which my family members arc
entitled by virtue of my military nervice.
f. I may leave a letter of intent with the executed copy of
this Will for the purpone of giving guidance to my Personal
Representative concerning the distribution or sale of certain items of
my property. I request. but do not require, that my pernonal
Representative honor my wishes therein exprensed.
SECOND: 'ro my Brother, P.~.TRICK InCHAEL ROBERTSOlI, I give my house
(including all furniture) and land, located at 20 East Columbia Road,
Enola, Pennsylvania.
THIRD: I give, devise and bequeath, absolutely and forever, all
of the rest, residue and remainder of my estate and property of \~hich I
may be seized or possessed, or to which I may be entitled, at the time
of my death, wherever situated or of whatever nature, be it real,
personal, or mixed, to my I.lother, J. THERESA EDHOllDSOlI as her sole and
absolute property if she shall survive me.
FOURTH: Except as othen-lise provided in this Will, I have
intentionally failed to provide for any other relatives or other
persons, whether claiming to be an heir of mine or not. Insofar as I
have failed to provide in this will for any of my issue now living or
later born or adopted, such failure is intentional and not occasioned
by accident or mistake.
FIFTH: Any beneficiary \,'ho fails to survive until one hundred
twenty (120) hours after my death shall be deemed to have predeceased
me, and the gift to that beneficiary shall be disposed of accordingly.
SIXTH: The term "Personal Representative" as used in this will
means Executor, Executrix, Independent Executor, or any other title of
like import which is used to describe such a fiduciary.
SEVENTH: In addition to any powers granted by the laws of the
state in which this will is probated, I hereby authorize and empower
the fiduciaries named in this will, to the extent of the discretion
herein granted, to sell, exchange, convey, transfer, assign, mortgage,
pledge, lease or rent the whole or any part of my real or personal
estate, to invest, reinvest, or retain investments of my estate, to
perform all acts and to execute all documents which my fiduciaries may
deem necessary or proper in regard to my property. If any of my
fiduciaries elect to receive compensation for services, such
compensation will be that allowed by law.
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3 PAGES
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EIGHTH: If any part of this will shall be invalid, illegal, or
inoperative for any reason, it is my intention that the remaining
parts, so far as possible and reasonable, shall be effective and fully
operative. My Personal Representative may seek and obtain court
instructions for the purpose of carrying out as nearly as may be
possible the intention of this will as shown by the terms hereof,
including any terms held invalid, illegal, or inoperative.
IN WITNESS WHEREOF, I have at Carlisle Barracks, Pennsylvania,
this
this
each
._ .1
::. .. day of t-':"J_~/;",,,:,<.. , 1996, set my
my LAST IHLL il.llD TESTANENT, consisting of 3
page bearing my handwritten signature.
hand and seal to
typewritten pages,
This document was prepared under the authority of 10 U.S.C,
section 1044, and implementing military regulations and instructions,
by Robert P. Formichelli, who is licensed to practice law in the State
of New York.
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BRr.:m KELLY ROBERTS N -
EAL)
The foregoing instrument was, at Carlisle Barracks, Pennsylvania,
, _ ..,., r ~; _
this .;J - day of ,..'S.:::,.::.,....:..I , 1996, signed, sealed, published and
declared by BRIAN KELLY ROBERTSON, the testator, to be his LAST WILL
AND TESTN1ENT in the presence of all of us at one time, and at the same
time we, at his request and in his presence and in the presence of each
other, have hereunto subscribed our names as attesting witnesses, and
we do so verily believe that the said testator is of sound and
disposing mind a~d memory at the date hereof.
OF
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cmlMONNEALTH OF PENtlSYLVANIA
COUNTY OF CUHBERLAND
ACKIlO\~LEDGHEHT
I, BRIAN KELLY ROBERTSON, testator, whose name is signed to the
attached or foregoing instrument, having been duly qualified according
to law, do hereby acknowledge that I signed and executed the instrument
as my Last I~ill; that I signed it willingly; and that I signed it as my
free and voluntary act for the purposes therein expressed.
Jr;~, ~~}-" %?~j~ lQt:~~ -- (SEAL)
'BRElN KELLY ROBEifl'SON
.~.FFIDAVIT
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and
G. 5 Ie r:. (;t;c:;..;[ tS,.- , the witnesses, sign our names to this
instrument, being duly qualified according to law, do depose and say
that we were present and saw the testator sign and execute the
instrument as his Last Nill; that the testator signed willingly and
executed it as his free and voluntary act for the purposes therein
expressed; that each subscribing witness in the hearing and sight of
the testator signed the will as a witness; and that to the best of our
knowledge the testator was at that time 18 or more years of age, of
sound mind and under no constraint or undue influence.
.~ "1'-/ .', ,,-/ '-;' .
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Nitness 7 Witness. J V _':,I~itness
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Subscribed, sworn to and acknowledged before me by BRIAN KELLY
me by
ROBERTSON, the testator, and subscribed and sworn to before
)f{;{/ ? ,;t;;;0/~'/'/'/ , Jot,;? 11- ledl'lri ,) (" 2- , and
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, the witnesses, this /:5 ~ day of
este?
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,1996. ~ .
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NOTARY BLIC U My Commission
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Nolallal seal
Kim C. Guyer. Notary Publlo
Ca~isle BOlo. Cumbe:land CounlV .
My Commission Expires Nov. 10, 1997 I
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IN Wl1'NBSS WlIBRKOr, tho odd GRANTORS havo to thODO
pros ants sot thoir handa and oaala dated tho day and year Urat
above vr 1 t ton
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COHHONllEALTJI or PEIINSYLZIA
/JA~~A DO.
COUNTY or m1{1 ,If'
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ON TillS, tho ." dllY of ~ , 1995,
bofore IlIO . Notary PubUc, tho undersJgned aUlcur, paroonally
appearod MJchael J. Mood and Kimberly L. lIootot.lar. now known 110
kimberly L. Wood. known to me (or oatlofnctorJly provon) to bo tho
persons who.. naalOO IIrG oubocrJlJod to tho withIn inDtrumont, and
acknOWledged that they executed tho aama for tho purpolJo therein
contained.
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notadel seal.
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Th'I IOO'n1UfOI. mod" hOWING', ,ublocllO Ih.I~U\II\I1U clMI"anll, caudlUons, aU'OOINtIlII And
,UpU.lIont..nd Ih.!-'orlUlUor covonanl, "Id '0'1t01:
t. Thlllho MortO.gOl wIIl)foml)lly I)lV Iho prlncllNtl 0' ,md 1nI,olns' on Iho U1tJubloonoSl ovkJoncud
by IhI uld Not., .1 IhIllmtl .nd In lho mlnnaf Iheloln pmvldotJ. wuh I""'DUO I.'ONIJ() tu IW'IWSV'1 any
Um.. without punnlum Of ,.., Ih, anU,. Indebledn... Of Any pitt 111011101 nol 10llth4n lho AmoulIt 01 ono
Insl.lmonl, Of one hundred doll4l1 (1'0000), whlthO'lor 1110". p,opaymonlln'lJIlhllll bo uodnod on
Iha dala 'KIlNod. Partla' pfopaymonl. oth,' Ih4n on AnlnslaUmonl duo dolla, need not hu tlothlod unt.
1110 next follow\no kutDDmonl duo d.u. Of (hilly days ahar such plCllhl)111011l, whlclul'o1If I. parllal.
2. To mor.I~V ptotoc.llha leaJflly oIlhls MOI1gago. 1ho Mor1gagOf ,hall pay 10 tho MOIluagco al
lrualll (urd.r tho "nns of Ihlllrust al hClfolnahOf IlallKJlln olkJltlon 10 A~ concurlonlly with. oach
monIhlV lr"taDmonI 01 prlnclp.1l and WO"II Unllsald Noto I.,~.,. pakf, Iho loII(WIing lum.:
(I) A.um equal 10 lhe glOUf'd flmll, II anv. no_I duo. plus Iho premium. Ihal will no_I
bKomI duo and pI)'Ibla on poIlckrs oIlke and oihur hAlArd ,"SurIUlC.. plus 10101, Ano.lnlonl..
end .....,er and WlI., renll, nell duo on lhO promise. COVOltKJ b., lids MorlQIIUO (aU as esUrnnloo
by lhe UOftgagOtll. and 01 which Ihe MOftuaoor Is nollllot.l) Iou 011 sums alloadv (NlId Ihololor
dMded by lhe numbe, 01 monthllo oIapso 001010 ono monlh prior 10 Iha dala whon such glound
tlnll, pr.mlums.I..... I"e"menll. and .owvr and walo' lonls, will bocomo duo, such IUnlS 10 ho
held by Mor1gage.1n tru'l to pay uld ground ,onl., promlum., 1..0', a"essmonl.. and .ower and
Wllorlonls..
(b) Th. 'OOregall 011110 amounll payabla plIrsuanllo lubrWiloroph (a) and Ihoso pavablo
on Ihll debl.hIllI bo paid In. .lngIo poymenl .oth monlh. 10 be appllot.110 tllo loIIowInU Iloms '"
lhe orda, Ilaled:
(I) ground rentl, tall.'. e..OllmOnI., lower and waler r01l11, fllo and olher hazard insur-
ance premium.;
(II) Inte"st on Ihls dobt; and
~II) ._~.11on Dllho ptlnclpal oIlhla deb!.
My derldency In lho amounI oI.ny luch aOgrogal1 monlhly payment lhaB con~~UlO an evont 01
dofall1 haround" and under said Noll. unlolI made good by MOO()o'lgOt prlot 10 lho duo dale or Iho
1MIll1 .uch payment. At Mor1gagee', option. Mor1gagOf wi! pay a "\alo chargo- not e.eoodlng IOUI'
PG'Clntum (4%) oIanylnllallmont when paid morolhan liIloon liS} days anor Ihoduo dalo
lherlOllo cove' the II1r. ollponlO InYoIvad In handling dollnquonl paymenl', but luch "lalo charge'
shall not be payablo out 0I1ho proceeds 01 any salo mado 10 IAlIsI., Iho lndobtodooSllltcurocJ horuby.
unIo.s.uch poneds 01 any salo madalo satisfy lho Indoblodnoll IDCUlod horebV. unIoss .uch pm.
cledl.re lurOclctntlO diKhargo lho entlr.lndebtedness and on propor cosls and 'Ipen..s IOcurod
'hereby.
3. Illhe 100aI oIlho payment. made by MOl1gagor. undo' (a) 01 paragraph 2 pre<:odlng.lhall
exceed lhe amounl 01 paymentl acluallV made by Mor1Q3goe as IIUIIDO lOt ground renl., 11)1'01, IISOII-
monll, .....,., or WlIDI renl.. or Insur.nc. prem!ums. IIlho CAsa may be. .uch O.eoll lhall bo crodnod
on sub.equent paymenCllO be made bV Mor1gagDffor .uch lIoms or, al MDllg",geo'l option. os Iruslee
thai be r,'unded 10 MorlQ8gor. II, how9Yer.such monthly paymanls Ihall not be &ulUclonllo pay luch
.ems when ,he lime shall bocomo due and payablo, lhon Mor1g.1gor lhall pay 10 Mor1gagoo as trusloo
anv.mount nK8IlIry 10 make up tho derlcloncywllhln Ihlrty (30) d.ys allor wrlllen nollc. horn
Mortgago. Ilallog Ihe amounl oIlho doflclancy, which nolle. may be glvan by mal. lIal anv limo
MortQlgof .haIIlendlf10 Mor1gaglt.1n ,cCOIdance wIlh Iho provtskJnl horool.lho 1La'! payment of Iho
Inllrllnd.btedness repreltnlad hereby, Mortgagee, ISUusteo, shall In computing lho amounl 01 such
Indoblednels. aedlllo lho accounl 01 Mortgagor any CIc<Ji! balanco IDmaln!ng undor Iho provisions 01
(I) of paragraph 2, Illher. IhaII bo a dola~1 under any 011110 provlslonl oIlho NOlo ond IIlIs Moo.
gagl securing Ihe IIml. which ".!JI.1n a public sail 011111 premlsos coverrod Ihereby, or U 11110 10 Iho
properlV" otherw\ll Icqulrod by lho Mortgagoo .nor Iha dera~I, tho Mortgagoo, al trusloo
shall apply, allhellmt oIlhl commencemlnt n1such proceedingS or allho limo Iho properlV II other.
wi.. acquired by Ihe MorIgagoe, Ihe bDIanc:o Ihon remaining 10 tho Cledll or Mortgagor undor la) or
plIIgnrph 2, II. Cfedll on IhllnlarestlcClUed end unpaid, and Ihe balanc:o on lho prlnclpallhon
flmalnlng unpaid on IhI NOle.
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4, MorIgagor lhaD pay 10 Moogageo all ground IInI',I'IOS, a"ollmont..lowar.nd wale, renll,
.nd an olhor thargOl.nd clalml ."ellad or l8Ylod el.nv limo bV any lawhJ authorl1y upon Iha
premises COYIrad by IhI. Mor1gaga which. by anv pre"nl or IUlulllaw or IaWI, lhalI havo prloll1y
In IItn or payrnenllO ,he dDbI fDpl',..nled by said Nolo.nd IUCured bV Ihls Morlgaoo, and provl.lon
for lho payment or which" not olherwlse mado IWlloln, such paymonlto bo mado bV MOIlgagor wUhIn
lh1rty (30) dapaner domand by MorIgageo. slollrlU Iho amount
5, The prlnelp3llndoblednell horoby uvldoncod anti soc:ulod rnJlfoSCnl1 monoy oCluaU.,. used lor tho
acqwlUon 01 Of' lor ImprDYImenllto Iho promlsos locurod by said Mor1gago.
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6. Mortgagor wi! continually malnlaln hlllard Insurance. oIluch typo or type. and amounlslls Iho
MorIOIO" may from IlmIlo lme requlr.. on Ihl ImprDYomenl' now or h".an" on sold premls",
and ,llCepl when plyment for.1I luch prOmluml h"llhorolo'nro boon mado undor CI) oIl)llragraph 2
hllool,.... plV prompUywhan duo anv promlums Ihorelor. AllnsurDnco shall bo carrlod '" com.
panlll epproved by MOttgag.. and Iho pollclol and fenowalslholool shall be hold by Mortgagee and
havo aUachod IMfllo lOll pavabll claUS.lln lavor or and '" 101m acceptable to MorIgageo, In Mill
011011, Mortgagor wII a"" lrnmodlalo noIJeo by mal 10 Morloagoe, and Mortgageo INIV mall. prool 01
1011. noI made promptly by Mortgagor, Elich ,"suranee company cOI'ICllfI1od II hereby authorllod and
dlrecled to mak. paym.nt for luch lOll dlrocllV 10 Mortgagoo ,"~oad 0110 Mortoagor and Morlgagoo
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by MOO0'g" 'a lodo. lulQn,lrAnafor, 100 doltvof unto Mortgagoo InV I,uno Of '01110"'''. and locdlod
and ItClMiaa lenll,lnuo', Ind profU of IIkllOOltgnged pr.mla" and Cl'YltfY pIIrt IhaletO'; lor all ell
whIth u\d NoIe ,hall be a Iuf'lltloflt WIIf,,1t wholhol or not ,uch 101'0 Ullubloaio hat hoon ualQnod,
and 10 mallel,oln time 10 limo" Ie.IOf\lble IUellllona. fD'IOVOllonl. 'Ollllrl. and loplacemOnl,lIlftfOIO.
Aller doductlng Iha COlt of auch allorollon.. ronovaUonl, IOI!lo1IrI, lelJlacomonl', Dnd Iho olllOn.Ol Inct,
d.nllo tailing Ind flll\nIng JlOllonaon uf Iho nKltlgauod I)lOIKH1Y. Iho lnanagol'llont Alld 01)01011011
thallOl, and 10 .o.plng Ihl tamo prol"utV Inlured,lo Aftl"V Any 10lllJII0 oIluch 101111, IIIUO', and
prof.llo thl payment of III aa gfound IIntl, la.... CholIUOI. dalml, a"."monll, 'lMot and walor
"ntl, Ind Iny Dlhlr llenllhat IMV bet 1)l1ot In lion nr payment 10 Iho debt IOCllled bV ItMI MorIUoiIOO
wIIh k\ltt'llllllreon. (bl premium. lor ukllnlUla"co, wIlh ."Iololt th(lI00n. (e) tho 1I1I0lost alld
prlnclpol due Ind lecured by Ihl. MOflgagl with all co.11 and .1101110(1 1001; ", loch Ofdol or
prklt.y II MOI1g.gOlINY d.lonnlne. any Ilalole,l.tw, CUltum, 01 U'O 10 lho cuntrary llolwUhMalldlnu
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Tho 'ailing 01 poIlllllon oIlha mortgnuoo fllllmlslls by Morln.10CO, al hCIOIII plovkJod, ,11.1111101
fellevt any d.Ja~1 by MOI1gagot. Of prevenllhe .nl'orcomont oIlny oIlho romodle. Ilfovktod bV
IIId Notl Of Ihll MOI1gago.
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The tll11CIdlol provldod by pld NOli and IhI. MOtIongl or any olho, lndolllcdnoSl IhOlOlll Jlfovldod Ot
l.cured by Ihll MOI1gago, and 1001h. ptllormancl oIlhl covonarlll. conditions. and aglOllmontl altaid
Notl Of' 'his MOI1gagl 01' currUlllve and concunenl, and INlY be PUlluoej IlngIy. orluccoIINoIy, or 10'
Ollhe'. II the 1010 dllcrollon 01 MQI1gagoo, and may be onlclsud.I ollon as occallon lhololor
..... OCCU<'
.'
PROVIDED. lhal In ClIII dlla~llhall be mad. In tho paymonl 01 any Inslallmont 01
principii and Interos!. or any other plyment horelnabovl orin tha conditio", altaid IIcllod
Noll prOYklId lot. Of In tho ...plng IInd perfonnancl by Iho Mortgagor 01 any cQY.nant 01 agloemonl con.
talned 1t",.1n Olin this MOI1glgllo be by 1I\d MoogagOt hpland peflonnod.1n tho maMI,.nd al
lithe Urn. .peclled IOf lIlI performanco lhelool.lueh dol....t wi! .nUllo Mor1gageo lOI1~h to bring
and IU. out an Action of Mortgage Forldosurl upon Ihls Indenlul. of Mortg.lgo. Of 10 Inllhulo any olho' appro-
prlale action Of' prOCledlng to loroclo". mortgago, and 10 procoed IhotOOO 10 ludgemont and a.aeollan,
10f' rleover( oItald pdnclpal dobl 01 luml and al InIct10.1 tholoon and all olh., SUI11I hOlobV IllCtllod, 10'
oothe, with an ouolney'. commllllon lor coIIocllon. III alOlosald, and co'II and ..ponlo, oIllICh
proceeding, and to purlUI Iny and all othor Ipptoprlalo loga! 01 aqullatJIo romodlcs In such casal pravklod
wtIhout IUtlhtr Ilay of Ixecutlon Of othe' prOCOI', any law. USlQO. or custom 10 Iho conlrafY nolwUh.
Itlndlng. MOI1gagor elpte..'v walva. and ,ollnqul.hel aD bonolilll\al may accruo by virtue or any and
mry law made or 10 1M made exempClng lhe mortgagod premllos OIanv other promlSOS or prOllOllY
whalever. ,"1 Of perlonal.llom allachment.lovy, 01 &alo under oxocUl\on, or any pall oIlho proceeds
.rllIng I,om .ny sallloorool..nd II bonolll 01 any Ilay 01 oxocullon 01 OIhor process. MorIoaaor
hettby walvo. and rol1nqulshes unlo and In lavor of Iho MOI1g4g00. 011 bonofll undo, aD laWl now In
.1l1CI Of horGllhor pallod 10 rollovo Iho Mortgagor In any roaMer from tho obIlgaUon, assumed In Iho
NOIelOlwhlch thl.lndenlur.Is IllCurhy.
BUT PROVIDED 1J.WAVS. novollhctaSl.lhal U saki Mor1g<1gOl shall payor CAUSO 10 bo paid unlolho
"k:I Mor1gagol. Iha IfOl',..\d dGbllClCUl'od by IN. Mortgago. whon and ", 1M tnaMOr horolnbolOlO
mentioned and appolnlod 101' paymonl oIlho tamo. logolhOl wlIh Woro.t and aU 01l1Or luml horeby
..cured, lhen and from thencolorth. Ihls Indenlurll, and Iho oslalo hereby grantod, as wclI os laid
ItCbd Nol.. lhall c..... d,I,rmIn8. end becomo void. anything hOfolnbolOfI Of In laid Nolo conlalnod
10'''- conlrary nolWlIhllandlng,
II tN. MorIgag.II execuled by moro Ihan ORD petiOlI 01 MortgagOf.lhallabllly 01 oach shaU bo
loItt and IMrll.
The ctMlnanl.. condltlonl. and provisionS conlalnod In Illld Nolo. Olin IhI. MOrlg.lgO. 11131I bind.
and IhI benel.. and advInlagollhorool thllllnura to.lho lOlpeclNO holrl, o.OColarl, admlnlll18larl.
.uceeSlOl'1. vond.....nd IlIlgn. oIlha portlos horolo OIlhololo; and whonovt!' u.ud In said Nolo orin
IhIs Mortgaoo. lhe alnglAar number lhall lncIudo Iho p1ulal, lho p1wallhO IInQUlolr. Iho u.o of any
gender shall be Ippllcablo 10 all gondell. and lho 101m .Morloauoo' shalllndudo any payeo oIlho
Indebtedne.. roprolOnlod by IOId Nola. OIlocurod by Ihl. MorlgagO. Of ony Ilonsleloo IholOol, wholhor
by operlllon of law 01 othaM'lso.
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IN WITNESS WHEREOF, MOftyaQUI IlGlounlo ,,'I hllllo1lltl arM) I'MI Dolled Ihotl.1Y and 'tltlll hnl
holtINboYl W\'llln.
~ _ y;,1/J._L-.
'1:<M,-I(,,tifi'l~~S."1
llRlAlncnooCOTSON ,Dol,,,,,,,
I CERTIFICI',TEOF RES~CE
I. j1/AlI?-'lt ~~
coned addlOIl oIlho wIlhIn.narnvd MOttgagOI is
15."1
.Uolluwor
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. DorrOWOr
. do horoby cortlfv lhallho
WlIneu my hand Ihla 3111
davol
October
. ,....
Agon' 01 MOfl'Q'.g
COMMONWEALTH OF PENNSYLVNlIA
COUNTY OF DAUPHIN
}..
,A, D., lDOS .001010 mo. 0 Notary
OnUlI, 3111 day 01 Oelobor
Public came the oboVe-nlmod ORlAN K ROBERTSON
.nd Ickno'ltildgod IhI wIlhln loo_murl 01 MortQllgo 10 be hls/hot/lholr .eland dood. and
dtlltod lhl IImllo bo ..corded II such.
MV cOl1vnllSlon a_pilos
TIII,oIOltlc"
l~i';.-);::. ':::~--
LINDAU UI.I~kll:' .-, 1..!II(
1l."I,t,,",.I,.-!.~i+a I', ....!.,,\ .
U, CClI.llr:l"~}IlI.'\"',: :\1 t. JI. l~ ;.
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N.J. ",^T ccrrf^1II1ul or lllcco or fJrumc1 wllh i",J((>v~nln thereon orcclCtJ nilunl.o
In I'.41t. rcnnaboro 'l\o'p., CUIllbcrland County, rcnnnylvnnla, boul'\flcd IInd dcacrlOOd
in lIt."COrdance with Durve)' IMda by Hlchoel C. DtMrjolo, It.S., doted Hay 6, 19'17,
.. follow, to wi t.I
DQ:;UIUlIJ at a point on tho DOUtharn aldo of Colurllllla flo;kI, sold (lOint bolOl]
216.19 teet Walt of DlOla 1tUk!, thence along proptrlY numbor 10 Columhla ibM,
Soulh 11 degrooa 22 1Il1nuUo 5ti GOccnla Weal, ill dInt.once DC 15~.SJ Coot lo ill
poInt' thence Ibrlll 10 do9rooo 31 minuteD" seconds 'lent, ill dlst.ance of 25.00
Ceot. to a (OInt, t.hence alonrj proporly mnbcr 22 Columbia Jb1d. forth 11 degreos
22 mout.OD S6 GCtcondll cast, II distanco of 150.Ul [cot to a point. on tho GUUlhorn
aldo oC COlumbia lbOd, thence olontj tho tlMO, alOf'll] 0 curve ooaring to the rlCJht.
havl"'J a radius of 502.G8 (oOl an arc dlatanca of 17.47 (eet:. t.o a loint, thence
c:ontinuir'llJ along tho DOUthern Dide o[ Columbia 1bDd, alDn9 an arc bcarlr1l] to t.ho
rl9ht, having a radius of 425.00 [col, an arc diDtanca of 7.60 [eet to a l1Oint,
the point end placa o[ DIXiIHtlUK;.
I,^VIIIJ t.hereon erectccl 011 : story aluminUl1& sldi"'.) c.Jwcllil~, ooill'J known 000
.......,ed .. 20 CDl_1. Ibad.
0&100 tho SAllllt premIses which l-:ennoth D. Deck 01'll1 Oiub,UIIl L. Deck, his wHe, t1J
Indenture datoo Harch 30, 1990 and recorded at carllale in the County o[
ClInborlaoo on ^rrll 3, 1990 in DaOO Dook H..34, l)3(jo 418, 9rantoo 11100 conveyed
unto MIchael J. \obxJ aoo Kimberly L. Ib!ltetler, In [ceo ,he said tcimbcrly L.
Ilnstaller Intormarrlcd wlt.h Michael J. W:xxJ 000 is known DS KImberly L. \bOd.
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DUREAU Dr INDIVIDUAL 'AXES
I~ttl ",UNlI IA.. \lIVI~I{j1ol
11I1". :"0"U1
ItA""nP;UJlG. I'A III:" IIhOI
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
(\. 'II-
\~"'~"L!r..
,i~i'~~'C;:'-':i.,\'"
r'r."::.~~'J""'I'
._,.;-}i3"i.,.t.:'~
( ;./
tmllCl or INlllHIIANtl TAX
AflPNAI5tt1l.NT. AllOWAtlC[ OR DISAllOWANct
or nrDUCTIONS AND AS~[SSH[NT or TAM
.j, 10/ It ,., .n.HI
LINUS E FEllICLE
REAGER 8 ADLER
2331 MARKET ST
CAMP HILL PA 17011
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
08-18-97
ROBERTSON
12-01-96
21 96-1013
CUM8ERLAtlD
101
ORlAN
K
~-_. --- ---A;;oun t-R'~" itt.d ----.--.~
l.,-"""C,,-,_~-=~~.c;.;o,~"-'-' ,-.c;-..,-co-;".=. ,~..._.:..;.=c:...~=~
i
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUM8ERLAND CD COURT HOUSE
CARLISLE, PA 17013
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS .....
Rifv:is4-j-Eif-AFP--ioji:97i--iior-icE--OF-i-NHER-iTANCE-riiX-A-PPRiiisEif€iiT~--Aii-oWANCE-CiR-----------------
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF ROBERTSON BRIAN K FILE NO. 21 96-1013 ACN 101 DATE 08-18-97
TAX RETURN WAS, I X) ACCEPTED AS FILED
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGWAL RETURN
1. R.al Est.t. ISchedule Al III
2. stocks and Bonds (Schedule 81 (21
3. Clol.l~ Held stock/Partnership Interest (Schedule CI C3J
4. Harts.gel/Notes Receivable (Schedule OJ 141
S. Cash/Bank Deposits/HIlc. Personal Property ISchedule EJ (5J
&. Jointly Owned Property (Scheduh FJ (&J
7. Transfers (Schedule GJ (7)
8. Total Assets
CItANGED
NOTE: To insure proper
credit to your account,
subnit the upper portion
of this for~ with your
h. paynent.
57.900.00
,DO
.00
.00
4.975.74
.00
.00
(DI
62,875.74
APPROVED DEDUCTIONS AND EXEHPTIoNS:
9. Funeral Expenses/Adm. Costs/Hisc. Expenses (Schedule H) (9J
10. Debts/Hortgage Liabilities/Liens (Schedule IJ (lOJ
11. Total Deductions
12. Net Value of Ta. Return
13. Charitable/Govern.ental Bequests CSchedule J)
14. Net Value of Estete Subject to Tex
9,746.71
68.996.03
llll
U21
US)
U41
78.747 74
15,867.00-
. DO
15,867.00-
If an assessment was issued previously, lines 14. 15 and/or 16, 17 and 18 will
reflect figures that include the total of ah1 returns assessed to date.
ASSESSMENT OF TAX:
15. Anount of Line 14 at Spousal rate
16. Anount of line 14 taxable at Lineal/Class A rat.
17. Anount of line 14 taxable at Collateral/Class 8 rate
18. Principal Tax Due
TA>: CREDITS:
i-.PAYMENT I
r-- DATE
NOTE:
U5)
UbI
U71
.00 X' DO:
.00 X .06:
.00 X .15:
UBI
.00
.00
.00
.00
RECEIPT
NUMBER
DISCOUNT I')
INTEREST/PEN PAID I-I
AMOUNT PAID
I TOTAL TAX CREDIT I
IBALANCE OF TAX DUEl
INTEREST AND PEN. I
TOTAL DUE I
.00
.00
.00
.00
. IF PAID AFTER DATE INDICATED, SEE REVERSE
FDR CALCULATION OF ADDITIONAL INTEREST.
I IF TOTAL DUE IS LESS THAN .1, NO PAYMENT IS REQUIRED.
IF TDTAL DUE IS REFLECTED AS A "CREDIT" ICRI, YOU MAY BE DUE
A REFUND. SEE REVERSE SIDE DF THIS FORM FDR INSTRUCTIONS.)
'-.JC,
AESEAVAtlONI
Est.tos of docod.nts dying on or boforo nocoaber lZ, 1~8Z .- If any future intorost in thl a.tato is transflrrod
In Po.so..lon or Injoy.ont to Cia.. a (collatoral) blnoflclarlo. of thl docodont aftor thl o.plratlon of any ..tatl for
llf. or for yoar., the Co..onwlalth horlby o.pro..IY ro.orvo. tho right to apprai.o and .s.... tran.for Inhorltanco Ta.o,
at tho lawful Cia.' B Ccoilatoral) rato on any .uch futuro Intoro.t.
PURPOSE Dr
NOTICE;
To fulfill the roquiro..nt. of Soctlon ZI40 of the Inheritanc. and E.tato Ta. Act, Act Zl of 199~. (7Z P.5.
S.ctlon 9141:11.
PAYHENTI
Detach the top portion of thl. NotlcD and sub.lt with your poy..nt to tho R.gI.t.r of will. prlnt.d on tho rov.r.. .ld..
--Ho'" chock or "onoy order pllyablo to: REGISTER OF MILLS, AGENT
AEfUND (tA)1
A r.fund of a to. crldit, which wa. not roquestod on tho Ta~ Roturn, nay b. roquo.t.d by coopl.ting an "Application
for A.fund of P.nn.ylvania Inhorltanc' and [stato 'a." (AEV-1311). Application. ar. avallabl. at tho Offlc.
of the Aogl.tlr of Will., any of tho 23 A.venuo District Offlco., or by coiling tho spocial Z4.hour
an.worlng ,.rvlco nuob.rs for for.' ordorlng: In ponnsYlvanla 1-800.36Z-Z0~O, outsldl Ponnsylvania and
within local Harrisburg aroa e7111 lBl-8094, TOOl 11111 17Z-Z2SZ IH.aring lepair.d Only).
OBJECTIONSI Any party in Int.r..t not .atisflod with tho apprals...nt, Dllowanc. or disallowanc. of d.duction., or also".ont
of taM (Including dilcount or Int.ro,t) a' shown on thl, Notic. .u.t object within sl.ty (60) day. of receipt of
this Nolin by:
--wrltt.n prot..t to tho PA noparte.nt of A.venu., Board of APpoals, Dept. 2al021, Harrisburg. PA 111Za-l021. OR
--ol.ction to have tho eatter d.tereinod at audit of tho account of tho per.onal r.pro,.ntatlv.. OR
-.appeal to tho Orphan,' tourt.
ACHIN
ISTRAIIVE
CORAECTIDNSI
Factual .rrors di.cov.rod on this ass.ss..nt should b. addr.s,ed In writing tal PA n.part..nt of Aov,nuo,
Bureau of Indlvidual Ta"" AllNI Post Auus..nt Aelli.-' Unit, O.pt. U0601, tlard.burg, PA 11128-0601
Phono (7171 7Bl.6~OS. So. pago ~ of tho book lot "Instructions for Inh.ritanc, Ta. R.turn for a A..ld.nt
Ooced.nt" eREV-l~OI) for an ..planatlon of ad.lnlstratlllalv corr.ctablo .rror..
DISCOUNT I
If any ta. due I. paid within thr.' IS) calondar .onths aftor tho d.c.dontO, d.ath, a flvo p.rcont (~X) dl.count of
the ta. paid Is allow.d.
PENAL TVI
T~. lSX ta. a_n.sty non.partlclpatlon penalty I, co.put.d on the total of tho ta. and Int.re.t a......d. and not
paid bofora January la, 1~9b, tho first day after tho and 0' the ta. a.nolty p.riod. Thls non-participation
panalty I' app.alablo In the ,a.' eann.r and In tho tho sa.o tla. p.riod as you would app.al tho taM and Intor.st
that has b..n I".ssod a. lndlcat.d on this not Ie..
INTEREST:
Int.r..t I. charg.d b.glnnlng with flr.t day of d.llnquoncy. or nln. (,) eonth, and on. (1) day fro. tho date of
d.ath, to thO data of payeent. fa... which becaa. dOllnquont b.foro January I, 19BZ be.r lntor.st at tho rat. of
,I. (6~) p.rc.nt p.r annu. calculatod at a dally rat. of .000164. All ta.os which b'c." d.llnquont on and aft.r
January 1. I~B2 will b.ar Int.r.s\ at a rat. which will vary fro. calondar y..r to cal.ndar y.ar wlth that rata
announc.d by tho PA n.parte.nt of R.v.nue. th. appllcablo Int.r.st rata. for 198Z through 1~97 arol
'!!!! Int.,.st Allt. Dally Int.rut Fllctor ~ Inhra.t Allh Daily Int.ro,t Factor
198Z ZO:< .000S48 1981 91- .000247
1983 16X .000458 198B.l~91 11~ .000301
lU4 l1X .000l01 199Z .~ .000241
1985 UX .000l56 1993-1IJIJ4 n .00019Z
19a6 lOX .000Z14 1995-1IJ97 .~ .000Z41
.-Inton,t Is calculated .. followS!
INTEREST = BALANCE OF TAX UNPAID X NU"BER OF DAYS DELINQUENT X DAILY INTEREST FACTDR
--Any Notlco Issuod aft.r tho ta. b.coe.s d.linqu.nt will r.fl.ct an Int.r..t calculation to flft..n liS) day.
beyond tho dato of tho D....s..nt. If pay..nt Is eade aftor tho intor.st coeputatlon date shown on tho
Notlco, additional Int.rost .us' b. calculat.d.