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PETITION Io'on PHonATE IInd C,HANT 0... LETfEHS
BIOI., of _J.?LtU__JL_j...LIJu--- No, _'bL:!Jlc_~_'7 J
also k"o",,, 01 _L\J-M_ ___~_ _ ___ To:
__________. ___ ___ Register or Wills for the
_________ __, /)"1'1'1/11'11, County of in the
Sod,,1 Sl'l'lIrily No, ~/J2 __ iL,'_'.!I-1J~':" ..____ Couullouweahh or I'ennsylvolllia
The pelitiou of Ihe undelsigned lespeclfully represcnls thai:
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Your petilionerls), who is/,ne IH years of age or older authe execuLL'iLJ/Jl.' NIJ . \ ,/ I l J: named
in Ihe last will or Ihe aho\'e decedent, dated ____,lJILJY---A, _ _, 19~
and. codicil(s) dated fiLlJ'JJLV_/JLi:. .'JLiL_l~___WJlJ7:c:!.lct.':J_L~ r~/1 ItA \
;_'/,'(: lJlfl'l/::lrll iL:'[L~'___DEC-~f:'J~ "I'll '
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(\Iiilt' rdt'\anl dr'l\n1\lalJ'~". t',~, fcnunci;uitm. t!eath uf C\C'cutof, (1(,)
Decendent was domiciled al dealh in C{l1}J Rr~LJJJlJ2__ ConlllY, Pennsylvania, with
It " r last family or principal residence al _--S-1.~~_JllI1 / N "-T
J.J,r11<tJ /161l1:f_oE ___~SilLiSl;jJ:lJ1111 \"tCJI:l!JJL / /II / 7/J 1/
tli\{ met'I, nUlIlhrr Jill! mUI1CIJMlil)')
Decendent, then --3.3- years of age, died _ Df (!, l, ,19 ?". , ),1
al 1Il//<;,1Nlc_ 1-laJ11F~--LbJJJj)j[J~11bY"'LV LI'IN,.~I<;i/: (;J Go, ,1'/'1'
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Excepl a-s follows, decedent did not marry, was not di\'orced and did not have a child born or adopted
after execution of the will offered for probate; was not the viclim of a killing and was never adjudicated
incompetent: Nil
Decendcnl at dealh owned properlY witb estimaled values as follows:
(If domiciled in Pa,) All personal property
(If not domiciled in Pa,) Personal property in Pennsylvania
(11 not domiciled in Pa,) Personal property in CoulllY
Value of real estate in Pennsylvania
situaled as follows:
..0
$
$
$
$
'1-0 If ztU ,
.
WHEREFORE, pelitioner(s) respectfully
pr..ented herewith and the grant of lellers
request(s) the probate of the last will and eodicil(s)
iT~'/lfYlrNTj/i:V
ttt'\lilmCnlary; admimmillion ~.I.a.: adminimalion d.b.n.c.t.3.)
theron,
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OATH OF PERSONAL REPRESENTATIVE
COMMONWEALTH OF PENNSYLVANIA ) ,.
COUNTY OF cUMBEHLAND J $:;
The petitioner(s) above-lIamed swear(!) or alTirm(s) thattbe statements in the foregoing petition are
lrue and correct 10 the be't of the knowledge and belief of petitioner(s) and lhal as personal represen-
tative(s) of Ihe .bll':e deceJ,'nt pctitioner(s) will well and truly administcr the estate according to law.
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7, ~; ?-11 ,.--J' {'l Ll, ,-..f/;;, .1/; -
Sworn 10 or affirmed o!nd subscribed
lJ5ffiA'EEl#s 26th __ day 016
..---.. 19 .',
'Hkll" (~I.1d~ 0--t''l1_'1j,!J ,
M wi C. I.E\ll S Rl'gisru
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No. lJ.q/JJ -10'7 J
Estate of
nhlll. Il LEIlO
, Deceased
DECREE OF PROBA n: AND GRANT OF LETTERS
DECEMBER 27 96
AND NOW 19_, in consideration of the petition on
the reverse side hereof, satisfactory proof having been presenled before me,
IT IS DECREED that the instrument(s) dated MAY 2. 19 B 5
described therein be admitted to probate and filed of record as the last will of
DARL R LEBO
'l't;5'1'AMt;N'1'I\KI
and Letters
are hereby granted to
RAMONA A STEELE
~ C't.tl..~~0::IJ.nl,~t({i) ()~<f-
MARY C. LEWIS Rogisler 01 Wills_
70.00
Probate, Letters, Etc. """.,. $
S\tDrp~'G~wates(3 ) ., . . . ., , ., $ 2~ : 8S-
Rerruncialion ......"",..". $
JcP $ 5.00
TOTAL _ $ 108.00
Filed..,. DECEMBER, .27", ~99.6".,.,
FEES
ATTORNEY (SUP, Ct, 1.0, No,)
ADDRESS
"HONE
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LE'rTERS AND ORDER MAILED '1'0 RAMONA A STEELE
WMINING: IT IS Il,LEGAL TO ALTUI HH!; copy Oil
TO OUPUCAH IlY PIIOTO:;1/.1 Oil PHOIOGIIAP",
COMMONWE"AlTH or pumSYI VANIA
OEPA.HM[NT Of ltlAl1ff VIUt IIlCOJIUS
LOCAL REGISTRAR'S CERTIFICATION OF OEATH
CERT. NO.3259584
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Name of Decedent
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n!u:J__ ,.."RlI t h
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Le\>fl
- .-,..-. ---.-.----.1..,'-.-----
Sex Female
Social Security No.__-.ll0-,otO=41122
Dnte 01 Death __..Df:-ceJl1!2er 6. 19'16--
Date of Birth .JRnURry 22 , 19t:l Birthplace--'!Q9_Vl'f~\fU 1<', PA
Place of Death
Masonic Home
I.Rncllster
"('~I,N_
( [)"~'I
,_____,,, 11.tlhetptolID
;,'I,Il-,)o"'Q"'" """''''1'
Pennsylvania
Race Whl te Occupation TeRcher _. Armed Forces? (Yes or No) --1'IlL-
Decedent's
Marital Status Widowed Mailing Address _LM!1~onic_Driye,Elizabethtown,_EA_H022
"~,..r., '.'-, ", elf D' '(.... ~f"..
Informant I)eRn I.ebo
Name and Address of
Funeral Establishment
Funeral Director, ...JRmeS.A, Reed..Jr.
Part I: Immediate Cause
ReinhArd FunerRI Home.t-llIc,." ~12,. MRrket.:U ".J!HleISbur&,,-E'A..17061
I nterval Between
: Onset and Death
(a) Alzheimer's Dement iR
(b)
(c)
(d)
Part II: Other Significant Conditions
,"
,
Manner of Death:
Natural [!I Homicide 0
Accident 0 Pending Investigation 0
Suicide 0 Could not be Determined 0
Doscllbe how inlury occurred:
Name and Title of Certifier GerR I dR. RRer , lot, n.
(MD.. 0,0., Coroner, M,E.)
Address MRsonic Home, 1 MRsonic Dr, , EI i7Rhe'hto~J}-L-'~A,J702]____"u
This Is to certify that the information here given is correctly copied from an original certificate of
death duly flied with me as Local Registrar. The origin:11 certificate will be forwarded to the State
Vital Records Office tor permanent filing, ~ '
__~f;;'::~~_ -d.~/~~ 22-219
7-~ I~('''~ I"I'-'!"""~ o.tl.<{",,,,o
l)ecemher 9, IQ96 1:~2 We,!~ j~,'-._Millershurg, PA 17061, Mifflin Twp.
0.'1 fI~1wt(I try LOCII n.g,,,,., 0;"_1 "',<1'_ C,,,", Ooru."g'" T~,p
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of
DARL R. LEBO
I, DARL R. LEBO, of Millershurg, County of Dauphin, and
Commonwealth of Pennsylvanin, being of sound mind and disposing
memory, realizing the uncertainty of this life, hut with
confidence in God and trust in His Son, my Lord and Savior, Jesus
Christ, who died for my sins upon the cross, and rose again to
justify me and give me eternal life, do hereby make, publish and
declare this to be my Last Will and Testament, revoking any and
all previous wills and codicils, and hereby will and dispose of
all the property which I own at my death in the following manner:
FIRST: DISPOSITIVE PROVISION - I give my automobiles,
jewelry, clothing, household furniture and furnishings, and other
tangible property, together with the insurance policies on such
property as well as the rest, residue and remainder of my estate
real, personal, or mixed of whatsoever nature and wheresoever
situate to my husband, ROY R. LEBO, if he survives me.
Page One of Nine Pages
:--
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A . .~Jiql
DARL R. LEBO
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SECONIl: DISPOSlTIVE PROVISION - In the event that my
husbnnd, ROY R. LEOO, should predecease me or die within
within sixty (60) days from the date of my death, or we should
die in 0 common disnster,
herehy nive, devise ond bequeath my
entire estnte os follows:
A. ';\;enty-Two and One-Iinlf (22 1/2) percent to ny
dauahter, Ramonn A. Steele. In the event thnt
she may predecease Me, her shore sholl be aiven
to her living issue, per stirpes.
B. Twenty-Two and One-Half (22 1/2) percent to my
son, Harold R. Lebo, or to his livino issue,
per stirpes. If my nforesnid son predeceases
me, lenvino no issue, I wish this shore to be
divided equnlly among 011 my children who nre
living at the time of my demise.
C. Twenty-T\;Q and One-Half (22 1/2) percent to r.1Y
son, M. Ileon Lebo. In the event that he may
predecease ~C, Ills oiluTe 5110]1 l)c ~ivcn to his
living i5SU~1 per stirpes.
D. T\;enty-T\;Q nnd One-Hnl f (22 1/2) percent to my
daughter, 9ancy C. Trask. If she predeceases ue,
Pnce Two of Nine Pages
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DARt. ~. LEBO
of this trust for this suid heneficiury
shull be puld over to his snid Issue Iler
stirlles; provided, however, thot if ony of
soid issue be under the oge of 25 yeors my
soid Trustee sholl opply the income ond
principol of their respective shores, in
my soid Trustee's sole discretion, for the
benefit, support, mointenonce ond
educotion of such issue, without the
intervention of 0 guordian.
7. If the snid beneficiary shull die ut any
time during the continuance of this trust,
leoving no issue then surviving, the
principal and occumulated income, if aay,
of this soid trust for this soid
beneficiory shall be poid over to my soid
Trustee, in trust, for the benefit of my
surviving child or children or their
issue, subject, nevertheless, to the
provisions herein obove.
8. Should the shores of 0 beneficiory, in
the opinion of my Trustee, be or become
too small to warrant the placing or
continuing such find in trust, or should
its administration be or become
impractical for any other reason, my
Trustee may pay such share absolutely to
the person or institution maintaining
the beneficiary, or may deposit such
share in the beneficiary's name in a
savings account of my Trustee's
choosing, payable to the beoeficiory at
majority.
9. At the discretion of my trustee, income from
the trust, and principal, if necessary, may
be used to pay up to fifty (50%) percent of
any expenses directly related to the post-
high school education of sold beneficiary.
Page Five of Nine Pages
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DAIlL Il. LEnO
I hereby nomInute, constitute and appoint Hid Penn Hank of
Hillershurg, PenusylvanIa, or its legal successor as Trustee of
the aforementioned Trust Fund.
THIRD: SPENDTHRIFT PROVISION - No interest In income or
principal shall be ossignabIe hy or avaiIahle to anyone having a
claIm against a beneficiary before actoal payment to the
beneficiary.
FOURTH: PAnlENT OF TAXES - All Federal, State and other
taxes payable because of my death, with respect to the property
forming my gross estate for tax purposes sholl be paid out of the
principal of my residuary estate under this Will, as if they were
my debts; and no one having 0 beneficial interest in such
property sholl be required to refund any port of such taxes.
Taxes on future interests may he prepaid.
FIFTII: POWERS OF FIDUCIARIES - In addition to the
authority conferred upon fiduciaries by low, 1 authorize my
Executors or Executrix to retain any property pending
distribution hereunder, to compromise claims without Court
approval, to lease without limitation as to term, or sell any
real or personal property at public or private sole for such
Page Six of Nine Pages
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DARL R. LEIlO
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'and appoint my husband, ROY R. LEBO, as Exccutor of this, my Last I
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prices nnd upon such tcrms os to cush and crcdi t os for as rClll
'cstatc J s conccrncd wi thout I Inbl I fly on the part of thc
i.purchascrs to scc to the application of thc purchllsc moncy,
also to invcst in 011 forms of propcrty without rcstriction to
investmcnts authorizcd by fiduciarics and to distributc in cosh
'or in kind.
SIXTH:
APPOINTMENT OF EXECUTOR - I nominatc, constitutc,
Will and Testamcnt.
In thc cvcnt that hc foils to qualify or
,
"
ceases to oct, I substitutc and appoint my daughter, RAMONA A.
STEELE, os Altcrnatc Exccutrix.
In the cvent that shc fails to
qualify or ccascs to oct, I substitutc and appoint my son,
HAROLD R. LEBO, as Altcrnate Exccutor. I direct that no bond or
other security sholl bc rcquired of my Exccutors or Executrix,
"any law or rule of Court to the contrary notwithstanding.
I
I, DARL R. LEDO, tcstatrix, whosc namc is signcd to the
'forcgoing instrument, having hccn duly qualificd according to
,law, do hcrcby acknowledge that I signcd and executcd the
,
!instrumcnt as my Last Will and Tcstamcnt; that I signcd it as my
frcc and voluntary act for thc purposcs thcrcin exprcsscd.
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llARL R. LEBO
'Pagc Scven of Ninc Pagcs
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DARL R. LEBO
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CIW'l'II' I ~~~:r~llU,!-I::}I()'I'ICli lIN!J1W /llll,I-:~,.ti(ill
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Name of Decedent: ^. a '( ( __j~_,,-\.LLL _______,____'___
Date of Deatln l;_j;_Lc-~~L~LLj/-:..nnn
Will No. ,)./_<;(..,IL''/I ^dmin. No.
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 t.he abllvc-capt.ioned estate on
'11ui.'cr"J, /.~~ 1'/17=
Name
^ddJ'l~sS
~7/1l ;'dy !fl,,{i ,-/ 1/ Idie-I; .r! (f;':/l1I0"-::.t: 'II/aw J{ t t~!J,r LII~,.,.//~/2 (/o-Z!J
Clllf~[t, fi~' f-{)"I'l 1'1" ,;:d;"j 1f1li',1/W".:- _'i:!!ifl}~ur/~ (t,'ll;llI'J, ;I.h/i,!?",.ul, l}/-, .13lf(-3
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,1':bt (I/!ti /t" ';/' 1/;'."'11"" j rift 1~Ill-tfJ.J~<-hU,'LJ..LU:di (I." ,9 S:S()
Notice has now been given to all persons entitled thereto under
Rule 5.6(a) except
Date:_J ,(l'1 ,~:; /ciCi '7
11aJl~1 Y/LCLJ-i;: )
u3 f(dL~im, ,/J/l '1/(cd:t;'Juula(q M-;
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Signature
Name 7~h LJJ.CLUl.. ({' J I" I' /, /
^ddress r').:( .]1,;/,,',/ POliti
!-I, j " .. / ' /' j) IN" ,'r;-
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TelepholleJ712- {!&L~ - ,:;f,Qc"
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I3t) No 1){djJ.Jtl'((~ Iii I 'j '1';.3
, . Cilpacity:_ 1.-/
Personal Representative
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.,JI:j_v~n'hl >lJ-it'u.-N; I.e
Counsel for personal
rp.IH-C5en till i ve
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l..;,aJiI,'JUL IJLc,L(.'
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'ry 1IOO,I"II"19,~~" jlNHERITANCE TAX RETURN ~~::~J::~:I~:HC:I:.I:'~191 CH'CKHU
'tifIIJ RESIDENT DECEDENT flU HUMI..
COMMONWIAIIH 01 PlNNmYANIA (TO BE FILED IN DUPLICATE 11 0 I /07/
OtP.ulMfHf 0' IIV(HUI e1'--- I 0
HA'"S:'J:~. ~~b.<lOO! WITH REGISTER OF WILLS) , C9~UN,!~COOI YEAR NUM.,.
I 10 H' NA.MhlV.', II' . AN ""DPtllNltlAll f) OlelbINI" COM'IIU ADOIIU
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pf ""01U! IUI'tI'l't..c) V'OlJW' ~"I."" 'f'" 010 oI'~II"'lIAlj SOCIAl UCUltlY ~'U,l,l.1 . MlOVN11(((lvlD IU IN$TlUCTIOH$1
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I8J 6. O.ud.nl Di,d hllOl'
(AHoch copy 01 W;II)
AHa COHfID
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o 2, Supplemental R,turn
03.
05.
Remaind.r Relur"
(101 dol.. 01 d.olh priol 10 12,13,82
hd.rol Ellol. To.. R.lur" Required
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FUIUI. In I.,. I' Compromit.
(for dol.. of d~lh ohtr 12.12.821
o 7. Dtcedent Moinloin.d 0 living T,u.t
(A"och copy of T,u.l) r.'
N OH SIlO LD.81 RECTmTOt"<' "."1" ';-q',~}.,~. .J!
(OMPU t( MAIliNG ADOIU$ " f)
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1. R.ol fila" IS,h.d,l. A)
2, Slo<k. and 80nd. (S,h.d,'. 8)
3. Clo..ly H.ld SlockIPannlnhip Inl.,..1 ISch.dul. q
4. Mongo".. and NOI" RI"ivobl. (Sch.dul. OJ
.s. Ca.h. Bonlr. Dlpolill & Mil"Uoneou. Penonol Prope"y
ISchod,'. E)
6. loinlly O"n.d Prop'''Y (Sch.dul. f)
7, Trond", (Sch.d,l. GIISch.d,l. I)
8. Tolol G'OIl Au," (lolallin.. 1.7)
9. Fun.,al E.p.n.... Admini'Iraliv. CO,". Milulloneou,
Exp.n.e. (Sch.dult HI
10. a.bts. Mortgagt liabilities. li.n. (Sch.dule I)
11. Tolal O.dudions (Iolallines 9 & 101
12. N.t Volu. 0' Eltal.llin. 8 minus line 11)
13. Charilabl. and Goy.,nmental 8equ.." (Sch.dul. J)
14. N.t Valu. Subj.d 10 TOll.lline 12 minus lint 131
15. Spousal T,anlf,,. ('or dOl" 0' d,olh oh.r 6.30.QAI
S.. In",udianl lot Ar.Plicobl, p.,unloge on Rtvt,.,
Side. (Include valu.. rom Schtdule I( or Schedule M.I
16. Amounl of lint 14 loaabl. at 6% rol.
(Includ. volu.. f,om Sch.dule I( or Schtdule M.I
17. Amount of line 14 loxobl. 01 15% ral.
(Indud. volu.. from Schedule I( or Schedule M.)
18. Principal tax due (Add 10.. from line. 15. 16 and 17.)
19. C,.dill Spoulol Poverty Credil P,ior Po~menh
+
(11 0
(21 tfLS'J-hr~
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I~I 0
(51 )J...~~, 0...
( 61 ()
(7 ) 0
(~ft.3g (8 )
(91
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(10)
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31J../r: ~ 7
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(19)
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20. If line 19 i, greole, Ihon line 18, enler Ih. difference on line 20. Thil is the OVERPAYMENT.
DO
Check hfr.-if'you.Q" requolling a ,,'und'o' you, overpaymtnU' . .
~ J.. 3./,., ~ 0
:/- :J... ~J,. 10
(211
(2tAI
(218)
21. If line 18 is grea'" Ihan line IQ, onler Ihe difference on line 21. Thi. i. the TAX DUE.
A. Enler Ihe intll"t on Ihe balance due on line 21A.
8. Enl'r Ih.lolal of line 21 and 21A on line 218. Thi. i, Ihe BALANCE DUE.
Make Check Payable 10: Regl"., of Willi. Agent
~ ~ liE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND TO RECHECK MATH -< -< -
Under pInelli.. of ptrjury. 1 dedo,. fhal I hay. examined Ihi. 'elur". including occompanying schedule. and .slalomenll. and fa ,he be.t of my .nowl,dg. and b..li.~.
il illtu.. co"ect and comple't. I d.c1ore thai all ,.01 ..101, has been reported of true morke' value. Oedotohon of pr'porer olher Ihon Ifl. personal npr..,nlollv, II
bo.ed on 011 information of which pr'por.' hal any .nawl.dge.
~~O"USON'U'ONSIII('OI'I'ING, 'HU'''' _-.. . ADOIUS ,,'- ,0 , ~ _ 0'" t- Jr:., '1 'I
~O""U:' ?~!-~~t~':t~~~~t:1~~1f 1~~'~~J~t:}t~~~~:~r:_~~~~'LQ 0:: _~=u~ (- !J_
U'I.UOI'H (ntl
!~
SCHEDULE C-'
CLOSELY HELD CORPORATE STOCK
INFORMATION REPORT
COMMOHWlALOt o' PlHH$YLVAHIA
IHHllltANCl YAI IlYUIH
AIIIDIH' DICIDIHI
-.UTA" Of
A. Delailod d..aipllon .howlng the m'lhod of computation utilized In the .aluotlon oIlhe dtcodtnl'. dod<o
a. Campi". capi.. ollinancial .taltm.nl. or compl.1t capl.. allh. Fedtral To. R"urn. (Foderal Farm' 1201 lor the y- 01 dtolh and A
precoding yoo...
C. Slat_t 01 dl.ldend. paid ooch y.ar. U.t tho.o dociared and unpaid.
D. U.t nom" 01 affico.., .alario., banu... and any olher b.otlitt rec.l.ed from Corporation.
E. II the Company owned roolo.tato, .ubmit a li.t .howing Ih. compl.1t add..../.. and ..rimated Fair Man" Value/..11 RoaI Edat. Appnlltol.
hove b..n ,ecured, plea" a"och copill.
f. U.t principal .tod<holdors 01 dot. 01 doolh, number of .ha... hold, and ..latlon.Mp 10 dtcodent.
G. Any olher information relative to the valuation of the dlCedent', interest.
Slate olin<.
1. Nom. of Corporation
Stroot Add....
Dolt ollne.
City
Slalt
Zip Cod.
Total Number 01 Shartholdon
Bu,i",e" Reporting Year
10
2. foderall. D. Number
(Same A. Foderal Form 1120)
3. Typo 01 Bu.ln...
Produd
STOCK
TYPE
TOTAL 'SHARES
OUTSTANDING
PAR VALUE
, SHARES OWNED
IY DECEDENT
A.
Common
Provide all right. and ...tricllon. plrlalnlng to each. don of .tock.
5. Woo decodenl employed by Ihe Corporation' 0 V.. 0 No
II Y'" Po.illon Annual Salary S Time Dnoled 10 bu.in...
6. Was Ihe Corporalion indebled 10 tho decedent! 0 V.. 0 No
If Y'" provide amount of indebtedn.u S
7. Wa. therelile in.urance payable to Ihe corporation upon doalh 01 decodent! 0 V.. 0 No
II Y'" Ca.h Surrender Value: S Nel Proceed. Payable: S
Owner of Policy
8. Did Ihe deeedenl ..II or Iran.ler .Iock of thl. company wilhin one year prior 10 d.ath il tho dolt of doolh wa. on or aher 12/13/82 or with'
Iwa yea.. il.he dale 01 dooth was prior 1012/13/82' 0 Ye. 0 No
II yes: 0 Tran.ler OSole '01 Sho... Tran.ler.. or Purchaser
Prelorred
Con,ideration S
Anach 0 separale ,heet for addilional tron,fe" and/or SOIIl.
q. Did Ihe corporation ha.e an Inte...t in olher corporallon. or partnership.! 0 Ve. 0 No
II y... report Ihe neee..ary inlormalion on a ..parole .heel. including Schedulo "C. I " or "C.2" lor ooch inte..d.
Dale
10. Woo Ihere a wrl<<en .horeholder'. ogreemenl in oHod 01 the lime of Ihe decodent'. doath! OV.. 0 No
If ye,. provide a copy of the agreement.
11. Woo Ihe deeedent'. .tock .old! 0 V.. 0 No
If ye,. provide a copy 01 the agreement of sole, ,tc.
12. Was ,he corporolion dillol.ed or liquidated aher ,he decedenl" deolh! 0 V.. 0 No
II .... pro,ide 0 breo.down of liquidalion di.'robu.ion.. ele. Alloch 0 .eporole .heol.
irv.1N....lI.1I
.
SCHEDULE C-2
PARTNERSHIP
INTEREST REPORT
(()M"M()HWlAI.1lt 01 PlHNIYLYAHIA
IHHlIlIYANCl YAI IUUIH
AUID1H' OICIOIH!
Pi.... Ty or Print
fiLE NUMBER
d- -fl- ID1/
UTA"Of ~ L
- -. - .JJ It t..
Dotoilod description ,hawing tho mothod of computation utilized in tho valuation of tho docodent'. intoroll.
Complote caples of linancial .tatomenl' or completo caples of tho Foderal Tax Return, (Form 1065) for tho yoar of death and
A preceding years, including a balance .heet lor the year of death.
C. If tho Company owned Real E.tato, lumilh a li.t .howing the complole addre../e. and e.timated Fair Marleot Value/t. If Real
E'tote Apprai.al, have been secured, plea.e aHoth cople,.
D. Any other information reloti.e to tho valuation of the docedent'. intere.t.
1. Name of Partnership
Federal I. D. Number
(A. per Farm 1065)
Dato Bu.ine.. Commenced
Add....
Bu.ine.. Activity
2. Decedont was a oGeneral Dlimiled portner. II decedenl was a Iimiled parlner, provide initial in.estment 5
3.
'1'0 OF INCOME '1'0 OF OWNERSHIP
SALARY
BALANCE OF
CAPITAL ACCOUNT
PARTNER'S NAMES
A.
B.
c.
D.
A. E.timaled Value of decedent'. inlere.t: 5
5. Was the partnership in deb led to the decedenl! oVe. DNa
If ye., provide amounl of indebledne.. 5
6. Was thor. life in.urance payable to the partnership upon tho death of Iho docedont! DVe, DNa
If ye., Ca.h Surrender Value: 5 Net proceed. payable: 5
Owner of Policy:
7. Was there a wriHen partnership ag..ement in effect at the lime 01 the decedent'. deathf oVe. DNa
II ye., aHath copy 01 agreement.
8. Did the partnership ha.e an intere.t in any other partnership. or corporation.! oY.. DNa
If ye., report the necenary inlormation on a .eparate .heet, Including Schedule "C.l" or "C.2"lor each inte...t.
9. Did the decedenl'. intere,t in the partnership change in the year belore death ilthe date 01 death was on or alter 12/1:
or il death occurred prior to 12/13/82 in the lo.t two years! Dv.. DNa
II ye., explain:
10. Was the decedent related to any 01 the other partners' DVe. DNa
II ye., e.plain:
11. wo. the partnership di..ol.ed or liquidated alter decedent'. death' DVe. DNa
II ye., report all the related inlormalion, including copi.. of the Sal.. Agreement and/or Settlement Sheet.
12. Was the decedenl" partnership inlere.t .ald! DVe. DNa
. .
.4__' _t ._1... .....
In-UOIlh 11.a1'1
~
SCHEDULE E
CASH, BANK DEPOSITS AND
MISCELLANEOUS
PERSONAL PROPERTY
Plea.e Print or l e
fiLE NUMBER
)./- 7/- 10 7/
COMMOHwrAUH o. IlHHSytVAH1A
INHllftANCI fAX lnul"
IISIOIHT OKIDINT
.ESTATE OF
IAII ~ fol.~r-..d wi'" ,100 light 01 Svrthronhlp mVlt be dl.d..... o. Schodvlo "
jt1~L
R.
L~ 110
ITEM DESCRIPTION VAWE AT
NUMBER DATE OF DEATH
C HG.c k ".I Ir t't ~Ll".J /JA Ii k J
I r- 03 y: r-r
I
J.. V\^. ~il , c. ,vL R-e. r- u ,J13 J- 7. 0 f
3 / ,J c. 0 I}.'- -=. It\ 'J.... ~ eo rlJ rJ l:J /9r'.oO
i
Mo.
TOTAL (AI.o enter on line 5, Recapitulation) S ~ ~ t. (~
- ....&~ \
.",...... ,11"
*
(QMIoIOHW1/ollSl 01 tlHH1nV........
'HHle,,,,HCI W UIUAH
UIIDIHI DlC1D1HI
UTAlI O'
..-.~ -
~Attl
Jolfll t.nonlle\1
IIA"'I
A.
~ "it!-
B.
C. .-:.
....I'.l....
--
--
DA"
MADE
JOINT
SCHEDULE f
JOlNTL Y .OWNED PROPERTY
fiLl NUMBER
j. I' 9~' 10'/1
R.
L ~ do
RELATIONSHIP TO DECEDENT
ADDRESS
~/)~f-
DESCRIPTION Of PROPERTY
TOTAL VALUE
Of ASSET
DECO'S
qI, INT.
DOLLAR VALUE Of \
DECEDENT'S INTEREST I
\
I
-
~
TOTAL lAhO enter on Hne 6. Recapltulationl
s
~ . .._ ,I. ..-to ,;...'
-----
-<':
...,
=-,
~
-
.:.
';.1;:.
.~
:..0'
~
....
-.....
't"
. ....
-
.-
.~
AIV.lltO 11+ 11"11
~
(()M,M()HWIAlTM Of HHNSnVAHIA
"'MIII1'AHCI 'AI .nuaN
IWDI", DlC1DIHT
UTA" Of
h~R l
Ie
I- ~ rlo
SCHEDULE G
TRANSFERS
PlEASE PRINT 01 TYPE
flU NUMiE.---~-"- O. .~-_..~
THIS SCHEDULE MUST BE COMPUTBl AND flLID If THI ANSWIR TO AllY Of THI QUunoNS ON THIRIVIRSI SlOI Of THI COVU SHUT IS YD.
))-91-/01/
ITfM DE5CRIPIION Of PROPERlY TOTAL VAuiE DECO. DOLLAR VALUE
EXCLUSION ,~, Of DECEDINI'S
NUMIIR IncNdo __ 01.110"-'-.".... -hip 10 _011. dote 0I1fofti1e,. Of ASSET INTEREST
;/DJt--
. ,
;
. TOTAL (Alia en.... on Un. 7. Rtcopitvlottoftl S
,-
."
.-
,,, mor. .poet i. "..g.d. inl." oddihonol dlMfI 01 101M 'in.'
.-
,
"'I It II II. I''''
.
J SCHEDULE H ~J
FUNERAL EXPENSES,
ADMINISTRATIVE COSTS AND
_ MI~~~~~~S ~SES PleaA' ~~p.
I '" JJ 0 fill HUMBlR
1-. p u J. - 9J .../d
cQMMONWlAUH O' rlNNUWANIA
IHHIIITANCl tAxUtUIH
U\IDlHT OIClOINf
ITEM
NUM8ER
A.
I.
8.
I.
2.
3.
A.
C.
I.
2.
3.
A.
5.
= 6.
7.
8.
~A ~l
AMOUNT
DESCRIPTION
If-~ t ..,..lftl
1./3,'11
r-r:- va
Funeral bp.nl":
fv N t1,,~L Co S T J
b ( 157 ~
~~frJJI~~ iOj\4.~.JY;;Je
Admlnistratlv. COlt I:
Personal Represontotive Commissions
Social Securlly Number 01 pOllona\ Reprosenlolive:
Year Commissions paid
Altorney Foe.
Family e.empllon
Claimant
Addre" 01 Claimant al decedent'. dealh
Slroel Addro..
Rolotionship
Zip Code
Slale
10 g.(!) 0
City
Probate Fe..
100.00
sJ-.J. (1
I ^, 00
I fJ {. 91
ML;:I~nea1.E~r;Ci~ _ /~ lD ""," Ik ll. fp..~f(rl.(r'TI4.J
Mt:!6rJtL. )t~tAP~ ~ ~\Jnl~ (p~Ts
.h.l j<. ..! oIL J I"~ ( I\-j. ~s - !>-f 1.-7< t\- <tOO ii
-:(J!1 },1 M . f Ih~c..,.L S <LV' "I'd
TOTALlAlsa en,er on line 'I, Recapilulotion! \s Sf (t. '3 t
IIvIIIJU. (1'11
'*'
((JMIIIONWtAlfH Of "NHSn~AHI.
INNItffANCI 'A. lIMN
ItIIOfNt OIC1DfN'
ESTATE Of
'.,"",
NUMBER
1.
J-...
3.
ITEM
NUM8ER
I.
SCHEDULE J
BENEFICIARIES
fiLE NUMBER
btt~l R.. Lr8e
1-96 - /6'1/
NAME AND ADDRESS OF 8ENEflCIARY
RELATIONSHIP
.
AMOUNT OR
SHARE Of ESTATE
t.
A. Toxabl. Boquutt:
"'1f2UN ~. ~pJ"
3 "J t7.! r V"'-F' ~ .fr fl
-Sffrf.r..N/J.J'JO()JN fir 11'"
~ ~c.. 1 (I.. t\:S K I
b ~ tfd.l~ -h~.
I"r1Gc:tf,1;1'/1($ ~u(. t.. lit 111ff
i/-H- 0 JJ. .1 to; ~ 0
& Cl ~ I ~ 0 ,~
Klll...)svIJlc:, TA /It/l1J
~f\w..dtJA -rr~!?Lc
6?J.. F,.f H~12.. ~ ~.
r-E'-,-fH-tJ/crAu/.(,.,/A /10)'t' lJ/ruIrH,.F(I..
~~o3.7~
,
So J
11u3.11
I
J )-11 (ysf '():;t-..
1303'77
,
S6 tJ
~3()3.17
r
NAME AND ADDRESS OF BENEfiCIARY
AMOUNT OR
SHARE OF E5TATE
J...
B. ~~o:~ a~;r..rnU~.a; T;u~"1: }L\p r& Q I-! T c Jf Jf.. ~ II
efr~T M/rnJ ,fTrlceT n
?\-I z.A 6fJn+JI)/~ fir /10).3
cltt.I..l7ltrrl ~f?",A:.'pck!0rJlr ~f-T'wo~k: /1-\(,
177 CFNT7{l.vl/lc. 11i~IIlPIk'e
V I f-lr/~/k A~t{, Vlt J_?y-n
/tE.c,J C /HIt GNk lP-frflJIIJ i- Cr.t-ll~
~b"- 9t
R f3 H lL~ A J ~t-, PA- / 1 ( (tJ
If
J- 3 r-3. ~ 7
,
1/1t93
3.
/17&.13
TOTAL CHARITABLE AND GOVERNMENTAL BEQUESTS IAho .n'.' on line 13, Recopi.ulo'ion)
S rf107.13
(If more 'pac. is nllded. in,.rt additionallhee" of sam, sin)
tfV.lIl. h. Pf1I
w
SCHEDULE K
LIFE ESTATE/ANNUITY/
TERM CERTAIN
COMMONWIAlTH o. trNNsnVANIA
INHUITAHCI T,U InUIN
'1SIOlHT DICIDINT
.STAR Of
tl PILI NUMBER
~/H.. L f\ Lf-(J~ ~;Je:.. }--/~?''-1()71
Thl. .<h.dul. i. 'a b. uttd for 011 .ingl.'if., jainl or .ucce..iv.li'. "'0'.' and lerm certain calculation.. For dol.. of dealh all..
12-3' -61 and beforo 5.1.89, actuarial fa,!ors for .ingle lif. calculation. can b. found in R.vinu. 8aoklet (REY-1S0' 8). .for dol..
of d.oth on or oller 5.1.89 actuarial factors can b. found in IRS Publicotion' '.tS7 Actuarial Yalu.., AI ha Volume. .
Th. in.trument creating th. life int....t is a: (PI.a.. aHach a copy of 'nllnlm.nt)
o Will 0 In'e",ivo. Deed of Tru.t 0 Olher
_......~..~ .
Namol.J of Uf. T.nantl.J
Dot. of BIrth
'....nt Ag.
INoa"d BlrthdayJ
T."" of Yoon Ufo Eotcrto 10 Payabl.
o Ufo at 0 Tenn 01 Yoo..
o Ufo at 0 Tenn 01 Voo..
o Ll. at 0 ~enn of Voo..
o UI. at 0 Term 01 Voo..
l. Yalue of Fund from which Life E.ta'e(.) i. payable: ........:................................................ s
2. Actuarial Factor per appropriate Table .........................................................................
Interet' Table role. 0 31'.% 06% 0 10% 0 Variable Rate %
Value of Ufe E,'ate (Un. 1 x L1n. 21.......................................................................... S
Nam'I.J of Annultantl.)
Oat. 01 Blrlh
P....nt Ag.
(N....d BIrthday)
T.rm of V.." Annuity I. Poyobl.
...
o ur. at 0 T.rm of V.a"
o Ufo or 0 Term 01 Y....
o Ule at 0 Torm 01 Voors
o UI. 0' 0 Term 01 V.."
l.
2.
3.
...
S.
6.
-.
:~ 7.
:.
Value of Fund from which annuity i. payable ................................................................. S
Frequency of payout. 0 Weekly 0 Bi.weekly 0 Monlhly
o Quarterly 0 Semi.Annually 0 Annually 0 Other
Amounl of poyoul per period.......................................................................................
Annual payment................................................................................................. ........
Annuity Factor (..e in.tructians)
Interest Table role. 0 31'.% 06% 0 10% 0 Variable Role %
Adjuslmenl Factor (..e in.tructian.) ...............................................................................
Value of Annui~ . If u.ing 31'.%, 6%, 10% or if variable role and period payout i. at end
of period, calcu atian is: Un. 4 x L1n. 5 x L1n. 6........................................................
If u.ing variable rote and p'eriod payaul i. at beginning of period, calculation is:
(L1n. 4 x L1n. 5 x L1n. 6) + L1n. 3.
NOTE: The voluo. of the fund. which creole the above fu'ure inlere.l. must be reported o. port of rhe Ello'e Assel., Line 1 through
Line 7. Tho Re.ulring Life/Annuity Inlerell(') .hould boreparted ollhe appropriate tOXlole on Lines 13, IS and 16 o. required.
1h'.16U (1(. "'''1
*
COMMONWEALTH Of PENNSVLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEOENT
INHERITANCE TAX
SCHEDULE "L"
REMAINDER PREPAYMENT OR INVASION
OF TRUST PRINCIPAL
)/-9/-/0'1/
Estate of ,;.;. 0 J "
(Lall Nomo) (fill' Nomo) (Mlddl. Inlllot)
this schedule Is appropriate only far eatates of decedents dying on or before December 12. 1982.
This schedule is 10 be u.ea for all remainder relurn. when an eleclian 10 prepay has been filed under Ihe pravilians'
of Section 714 of the Inheritance and Estate Tax Act of 1961 or 10 repartlhe inva.' n of lru.t principal.
Remainder Prepayment:
A. Eleelion 10 prepay filed with the Register of Wills on
(a"ach copy of election)
B. Namo(s) of Life Tenant(s) Date of Birth
or Annuitant(s)
C. Assets: Complete Schedule l.t
1. Real Eslate
2. Slack. and Bands
3. Closely Held Slack/Partnership
4. Mortgages and Note.
S. Cash/Misc. Personal Property
6. Total from Schedule l.t
O. Credits: Complete Schedule l.2
1. Unpaid liabilille.
2. Unpaid Bequests
3. Value of Uninciudable Assets
4. Total from Schedule L.2
E. Total value of tru.t assets (line C.6 minus Line 0.4)
F. Remainder faelar (see Table I or Table II in Instruction Booklel)
G. Taxable Remainder value (line E x Line F)
(Also enler an Line 7, Reca itulalion)
I.
..._a.. ,.
II.
cr.:..
I
,
I
.\
I
It';;:;.
.~
,
I
\ ."
,
,-
I
I
III.
Invasion of Corpus:
A. Invasion of corpus
(Mon.h, Day, Vear)
Date of Birth
Age on date
corpus con.umed
Term of years income
or annuily i. payable
B. Name(s) of Life T enant(s)
or Annuitanl(')
I;;'
filE NUMBER
11 }J r...
IDate)
Age on dale
01 eleelion
Term 01 years income
or annuity is payable
S
$
$
$
$
$
$
$
$
$
$
$
$
C. Corpus consumed
O. Remainder faelor (see Table I or Table II in Inslrudion Booklet)
E. Taxable value of corpus consumed (line C x Line 0)
(Also enler on Line 7, Recapitulation)
S
Atv.IUllh V.t.Sl INHERITANCE TAX
'*
SCHEDULE L.l
COMMONWfALTH 0' PENNSYlVANIA REMAINDER PREPAYMENT ELECTION J 1-9b-lo 71
INHUITANa TAX .[TUIN fiLE NUMBER
.UIDINT DICIDINT .ASSETS.
I. Estate of L f.:~') ~"t\l f{.
(t..IINo...' (rill' N....I IMlddl. Inlflol)
.. II, Item No. O..cr/atlon I Value
A. Real E.lale (plea.. deteribe) tJ{)~6- .
T 0101 value of real e.tale S
O~dude on Section II, Line C.! an Schedule II
B. Slacks and Bands (plea.e li.tl
Tolal value of .Iock. and bond. S
Unclude on Section II, line C.2 on Schedule l)
C. Closely Held SloclcJPartnership (a"ach Schedule C.! and/or C.2)
(p~se~ .
Tolal yalue of Closely Held/Partnership S
(include on Section II, line C.3 on Schedule l)
D. Mortgages and Nole. (please Ii.t)
Tolal yolue of Mortgages and Notes S
(include an Section II. line C.,s on Schedule l)
E. Ca.h and Miscellaneou. Personal Property (plea.e 1i.1)
T 0101 yolue of Cash/Misc. Pers. Prof,erty S
(include on Section II, line C.S on chedule l)
III. TOTAL (AI.o enler an Seclian II, line C.6 on Schedule II S NoJt:-
1lH.
..:
(If more 'pace i. needed, altach additional BY, x 11 .heel',)
"Y.'.,,,.. Ill.... INHERITANCE TAX
. !~ SCHEDULE M
COMMONW!AlIH 01 P!NN~YlYANIA r/ - 9& ./6 7/
INHUIIANC! TAX ~!TU~N FUTURE INTEREST COMPROMISE filE NUMBER
~nIDfNT OfCfO!NT
I. E.lale 01 J.. r<-ev .l1 /ht L R
--.'. . (lOll N....' I'in. Nam.) (Middle 'nilial)
Thl. .ch.dule I. approprlale on.'~ lor E.lal.. 01 decedenla dyIng after Decemlter 12, 1982. .
Thl. ,chedule I. 10 be uled lor olllulure ;nl""I' wh..e Ihe role ol'oK which will be applicable when the luture
;nl...., Y..I. in ponenlan and .njoyment canna 1 be IIlabli.hed with c.rtoinly.
I ~
II, Beneflelorl.. iliA
NAME f SEX AGE ON DATE
Of RELATIONSHIP (M) Mal. DATE OF BIRTH
BENEfiCIARY (fi femal. OF DECEDENT'S DEATH
1.
2.
3.
4,
5.
III. Explanallon 01 Campraml.. Offer:
,
IV. Summary 01 Camproml.. Offer:
J. Value 01 Future Interett: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . S
2. Amount of Line I Exempl from Tax ........................ . . . . . . . . . . . S
(01.0 ent.. on Line 13, Recapitulation)
3. Amount of Line 1 T o.oble at 6% Rote . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . S
(01.0 enter on Line 1ST o. Computation)
4. Amount of Line 1 Taxable at 15% Rote. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . S
(0110 .nter on Line 16, To. Computation)
(II more ,pc,. i. needed. cltnch ndditioncl BV, x II" .h..,,)
. .
1. Ta.able Anot.latal from lin. 8 (cover .~..tl................."""""'"'''''''''''''''''''''''''''''''''''''' 1.
2. In.urance Proce.d. on life of D.ced.nl ............................................................................ 2.
3. Retirem.nt 8.n.fit. ............. ............ ....................................................... ....... ......... ......... 3.
A. Joinl An.1S wilh Spau.. ................................................................................................. A.
5. PA lo<<ery Winning. ...................................................................................................... 5.
60. Other Nonta.abl. An.ls: li.1 (Altach sch.dul. il n.c.llary).. 60.
'. .'
...... '.
.,
...~... . "\.:
,y';:::. '.~. " .
(~~":/-':'.
'~Y'}, ':
~ .
6b.1
6c.
6d.
6. SUBTOTAL (linot 60, b, c, dl......................................................................................... 6.
7. Total Gran A...I. (Add lin.. Ilhru 61............................................................................. 7.
8. Total Actual Uobiliti.. .................................................................................................... 8.
9. N.t Valu. 01 E.tol. (subllactlin. 8 from lin. 7)................................................................ 9.
" Ii,... 9 is greater ,lton 5200.000. STOP. J'h, ..rol, II no' ,'igibl. '0 claim 'h. credd. " no', con,jn~ '0 Pori fl.
. . . ..
Income: 1. TAX YEAR: 19 2. TAX VEAR: \q 3. TAX YEAR: 19
a. Spou........................ 10 20 30
b. Doc.d.nl................... lb 2b 3b
c. Jainl.......................... lc. 2c. 3c.
d. Ta. e..mpllncam...... ld 2d 3d
e. Other Incom. not
li,t.d above ........... h. 2.. 3..
f. TotaL........................ If. 21 31.
A. Averoge Joint Exemplion Income Calculation
Aa. Add Joint Exemption Income from above:
(Iij + (211 + (3f) =
1+ 31
Ab. Averog. Joint E..mption Incam. ..................................................................................... =
/I line 4(b) i. grealer lhan $40,000 . STOP. Th. e,'o'e i. no' eligible 10 claim 'he credil. /I not, cantinu. 'a Pori III.
. . I I I.
1. Inserl amounl olla.abl. 110011... 10 'pause or S 100,000, which.ver i. I............................. 1.
2. Multiply by cr.dil p.rc.ntag. (... iOltruction.I.................................................................. 2.
3, This is the omounl of the Resident Spousal Poverty (,..-: -lit. Include this figure
in the calculation of tolol credits on line 18 of the cover \hl!el. .......... .... .." 3.
4. For Nonresidents. enter Ihe ratio of the decedent's gran eSlate in PA '0 '''e ....alue (.If Ihl!
decedent', gross eUcle
;,";--1:;":.1 - /.A
COHMDNWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
IHta:AIYAHC[ fAil DIVISION
D[PY. lellUI
IIARAISlURC, Pi 11118-0601
NOTICE OF INIlERIlANCE TAX
APPRAISEHENT, ALLOWANCE OR DISALLOWANCE
OF DEDUCTIDHS AND ASSESSHENT OF TAX
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
10-13-97
LEBO
12-06-96
21 96-1071
CUMBERLAND
101
RAMONA STEELE
832 FISHER RD
MECHANICS BURG
PA 17055
AftDunt Ae.itted
( '~
*
"'.lItI III" ItI.t'l
DARL
R
MAKE CHECK PAYABLE AND REMIT PAYMENT TDI
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE. PA 17013
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~
iiE'y:is4rElCAf:P--foi-=9:n--NorlcE--ciniiHEiiifiiiicin'-A'iC-APPRAysEHENr;-,u.DiwAijcE-oli-----..----------
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF LEBO DARL R FILE NO. 21 96-1071 ACN 101 DATE 10-13-97
If an assessment was issued previously, lines 14, IS and/or 16, 17 and 18 will
reflect figures that include the total of 6hh returns assessed to date.
ASSESSMENT OF TAX:
15. A.aunt of Line 14 at Spou..l rate CIS)
16. A.aunt of line 14 taxable at lln~.l/Cl... A rat. (16)
17. A.aunt of LIne 14 tex.bl. .t Coll.tor.l/CI.o. B rete (171
18. Principal Ta. Du.
TAX CREDITS:
PAYHENT
DATE
06-26-97
TAX RETURN WAS I (X) ACCEPTED AS FILED
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. R..I E.t.t. (Schadul. AJ
2. stock., and Bond. (Schedule OJ
3. Closely Hald stock/Partnarshlp Int.re.t ISchedule C)
4. "artg.gal/Hate. Racaivable (Schedule DJ
5. Cash/Bank Depolits/Hilc. Parson.l Property (Schadula E)
6. Jointly Ownad Property (Schedule F)
7. Trensfers (Schedule G)
8. Totel Assets
APPROVED DEDUCTIONS AND EXEHPTIONS:
9. Funeral Expanse./Ad.. Costs/Hisc. Expense. (Schedule H)
10. Debt./Hartg.go Ll.bl11tl../Llen. lSchedule II
11. Total Deduction.
12. Net Value of Tax R.turn
13. Charitab1e/Gov.rnMental aeque.t. (Schedule J)
14. Not Velu. of E.t.t. Subject to T..
NOTE:
RECEIPT
NUHDER
AA211464
DISCOUNT (.)
INTEREST/PEN PAID 1-)
.00
. IF PAID AFTER DATE INDICATED. SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
( I CHANGED
11)
(2)
(3)
(4)
15)
(6)
(7)
.00
42,522.56
.00
.00
5,256.62
.00
.00
(8)
NOTE: To inJure proper
credit to your account,
sub.it the upper portion
of this for. with your
t.x pay.ent.
47.779.18
~ .R~6 38
41.922.80
4,707.73
37,215.07
.00
2.232.90
.00
2,232.90
2.232.90
.00
.00
.00
( IF TOTAL DUE IS LESS THAN tl. NO PAYHENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR). YOU HAY BE DUE
A REFUND. SEE REVERSE SIDE OF THIS FOR" FOR INSTRUCTIONS. I
191
IIDI
5.856.38
.00
(111
(121
1131
(141
.00 X,OO=
37.215.07 X .06=
.00 X .15=
(18)
AHDUNT PAID
2,232.90
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST AND PEN.
TOTAL DUE
"'StRVAIION. E.t.t.. of d.c.d.nt. d,ln. on ., b".n D....... 12, ".Z .. If .,,, lutu" Int....t In .hI ..t... II t"n.lm.d
In ......tlon a' onJ.,nnt t. CII.. . (c.ll.t...11 b_II.I..I.. .f t'" doc.d.n' .ft.. .hI ...I"tI.n .f on, ..t.t. fa'
tlf. ., f.' '."" t'" C........lth ...,.b, ...r...t, ,...,... .h. ,Ight to ...,.1.. and ...... t,on.I., 1"""lt.... T....
et thl 1..ful C1..' I (ca118Ur.1> nt. on IM1Y luch future Interut.
PURPOSE IW
HOTlCE. To fulfill th. "quln.ontl .1 S..tlon ZI'. 01 th. I"""lton.. '"" E.t.to T.. ..t, A.t U of 1995. m ..5.
SICtion 91"0).
...ItENII Dotech .... ... ..,tlon .f thll Notl.. and ..o.1t .lth you' .....n. t. th. R..ht.. .f Will. .rlnt.d on tho "..... lid..
.-Haka chick or .onlY order payable tOI REGISTER OF MILLS, AOENT
REfIlHD (CRll . nfond 01 . to. .ndl', which ... not "quut.d on tho Tox R.tu,n, ... b. "qu..t.d by ....I.tln. III ....II..tlon
for Rlflltd of pennsylvania Inherltanc. and E,tate Tax" CREV-UU). Appllcatlon, .r. avanabll at thtl OffiCI
a. thl Rllllttar of MUll, any of thl 2l Rlvenu' Dhtrlct office., or by caUlng the ,plclal Zit-hoUr
answlrlng ..rvlel ~.r. for for.. orderlng: In p.nnlylvanla 1_800_162_2050, outs Ida Pennsylvania and
within 10cIl Harrisburg ar.. (717) 787-8094, TOOl (717) 172-2252 (H..rlna laPllred Only).
OAJECTlOHS. Any ...ty In Int....t not ..tllll.d .lth tho ...nl....nt, .11...... ., dl..ltowon" of d._tlon., ., .......ont
of tn (IncludIng dhcOU"It or lnhr.'U .1 shown on thll HoUca ...t object within dKty (60) day' of ucelpt of
thlt Hotlce by:
--.rltten .,otut to th. .. D..ert..nt .f R...nu" Aoerd .f .....1., Do.t. mOZl, Herrl.bu'., .. \7IZ.-IOZI, OR
__al,ctlonto hava thtl .aUn d.tsraln.d at Bucllt of thl! .ccount of the p.r.onal r.pr...ntatlve, OR
--app.al to the Orphan.' Court.
ADMIN
ISTRATtVE
CORRECTIONS'
Factual error' dl.cov.r.d on thl. ........nt .hoUld b. .ddr....d In ~rltlng to: PA D.part.ant of R.v.nue,
aur.au of Indlvldu.l T.xe., ATTN: po.t A.......nt A,vl.w Unit, O.pt. Z80601, Harrl.burg, PA 17128-0601
Phone (717) 781-6505. s.. page 5 of the bookl.t RIn.tructlon. for Inherlt.nc. T.x R.turn for II R..ld.nt
O.c'd.ntR (REV-ISOn far an explanation of edalnhtraUvelY corr.ctabl. .rrors.
DISCOUNT'
If any t.. du. Is p.ld within thr.. (S) cIII.nda,. .onth' efhr the d.cadant'. d.ath, II flv. p.reant (5X) dhc~t of
thtl t.. paid ,. allowed.
PENALTY:
The 15% ta. ....e.ty non-perUclpaUan p.nlllty is coaputsd an the tot.1 of the talC end Inten.t .......d, and not
paid b.for. Janu."y 18, 1,,6, the first day aft.r tha .nd of the talC ...,..ty p.rlod. Thl' non-participation
....lty h .....1..1. In thl .... .llMI' and In t'" tho .... tI.. porlod .. you .ould _.1 t... t.. and In.er..t
that hn b.an .......d .. IncUc.t.d an thlt noUce.
INTEREST:
Int.re.t Is ch.rgad bqlmlng with first day of d.llnqu.ncy, or nine (9) ""th. and ana (1) day fratl the deh of
de.th, to the d.ta of pav-."t. Taxa. which bee'" dallnquent bafon January 1, 191Z bear Intar..t .t tM rata of
.1. (6X) percent per ~ c.lcul.ted at II dally rat. of .000164. All ta." whIch bec..a d,ll~t an and aft.,.
January I, 1911 will ~ar Int.ra.t at a rate whIch will vary froll cal.ndar y.ar to calendar year with that rate
ennouncad by the Pi Depart.ant of Rav.nue. the appllcabl. Int.ra.t rata. for 1912 through 1997 are:
'!!!! Intarast Ret. Dan" Intar.st rector !!!! Intara.t Aat_ DaU" Intera.t ractar
1912 zOX .000548 1987 9X .000Z47
1915 16X .ooooa 19M-I991 lIX .000501
19" lIX .000301 1992 9X .000Z47
19B5 nx .000556 1995-1994 r.c .000192
1986 lOX .000Z74 1995-1997 9X .000247
--Internt I. c.lculat.d a. fallow"
INTEREST = BALANCE OF TAX UNPAID X HUHDER OF DAYS DELINQUENT X DAILY INTEREST FACTOR
.-any Notlc. I..ued .ftar the te. baC~' delinquent will raflect an Intare.t calculation to fIfteen (IS) dlY'
beYond the date of the e.....Mnt. If pa.,.ent Is aede aftar the Intarnt CDIIPUtaUon data shown an t.ha
Notlca, ecldltlanal InUra.t MI" be calcul.ted.
~:!~!I_T'J:;_ 1\I':I'lJll'I' IJNIlI-:H 11\11,\0; Ii. 12
Name 0 f Deceden t : 4 ~'._"'._~__-B
Date of Death: IJ... '_f~--7~-
Wi I I Nn. __._____jJ -9 ~ - ( d I
-~_.---.,_.-~--_._.
(ISBa
^, hili II. Nil.
....---.------.- -_._-~.-
pursuant to Hill.. Ii. 12 01 1.1", SlIpremo Court Orphans'
Court Rules, I ['eport the lullowillq wil.h respect to completion of
the administratiun 01 th.. "llIlv\,.",'pl iOlled r,state:
l.
State ~he\.h..,r "dmini';ll'ation of the estate is complete:
Vel' V Nil
2. It the answer j:< Nllr ,;1.<.11... when the personal
representative reasonably ~!)ieves tha\. the achninistration will be
complete: - -------
3. If Lhe answer 1.0 No.1 is Yes, state the following:
a. Did th.!.p.!rson'll .1:ep9,,;nntative file a final
account with Lhe Court? yl!,;.______ Nn -~-'
l.. 'I'h.. "1'1'''1','11' 11'1'11.111:;' ('''111'1. No. (if any) (or
the personal rcpl-escnlaLivl":; 11CI'11\1l\t i~::
c. Did Ihe l'''I':;un.11 reprc,;pntative stiJ'te an
ar.count informally 1.0 I.h.. 1',11" j",; III illterl'st"? Ves./ No
d. Copies of receipts, releases. joinders and
approvals o( (ormal or informal ar:cnllIl!.:; may be filed with the
Cerk of the Orphans' COUL'\' alld may be attached to this report.
l r ~
72z.'Xl-U-?U~(' {i. J:tJ d,./
Signature /
_ !\/r't{o,.JA A.rTf~LE
Name (PleaSerltype 9r print)
f 3;J... f'IS .~ ~4. fl
/Vq;c. ~IC" 8v~ "" IA 170{(
^~f(ll-cs;;-- ---
Date:
N
-;
u,
171_7L_.z.~L'--_~- 010
'1'1.-1. N.I.
~
~..; \
,~ ;;.
...,..
'..Jv
Co'p,Jl'ity: _~personal Hepresentative
___counsel (or personal
l't.!prcscnta t i ve
( MAil: rmfll\M3)
.'
,...
".
.""
.-.
~ ..,
.. .
,"
.:
"""
.....
.-'
; ,:;. ,. 'iJ,f' ~"'i,.~,,;;.,... . "
",1 vI!. I' Of\' .,
.....t'!..);:.~ .'1.l'J(."il'''"":~!,,,
" 1;,t,......,.:t;,~ j!.' ~~!'I. ~,.
-- '.' ...,.',
..,-~
.11' I
Register of Wills of CUMUKRLAND county, Pennsylvania
certificate of Grant of Letters Testamentary
.~;~i...);JI:J;)J .
"". 'J ~ :1_)
.\.....-:'t "; "oJ; :..,~ .
~::t'.J."\~ -:"'~':-....:/.1 J~:'
J. ~'~..4 /.:.-:-", .." ~
'~'::"I" AI . ~~ ..~ ~
." . .. " r. \. ,'.-
s"""""I.~,.~,,~ \'..:"..;\
!1:....t I'",." ;~. .~' li..:::
-......... #l.~.I, '.:!....:....._,~ _,. ~
\( ...... -l'.""'..- ".'''' .. .~
. .,.. ,. '\: \1" .,,.... ~l. :a
j~ "\\l~\\::;:1, .I~,~
:,~. \~J ~ "'~r:lflo,....
'~"riI',,~... "'~~'.lliJ.~
~%.v~,._~~,~
..~,<r<t.\;;. 'l,1-lf'
'!\'~ht"tf".11J ,
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No. 1996-01071 PA No. 2196-1071
ESTATE OF LEUO DARL R
ILI\~T, rll<ST;IMTDDL~)
Late of
SIIIREMANs'rOWN BOROUGII
CUMlj~KLI\NU l.;UUNTY,
Deceased
Social Security No. 210-40-4822
day of December
192i an instrument
WHEREAS,
fated May
4as admitted
on the 27th
2nd 1985
to probate as the last will of LEBO DARL R
(LA~T, rlK~T, MIUUL~I
,
CUMBERLAND County, who died on the
late of SHIREMANSTOWN BOROUGH
6th day of December 1996 and,
WHEREAS, a true copy of the will as probated Is annexed hereto.
THEREFORE, I, MARY C. LEWIS , Register of Wills in and for
~he county of CUMBERLAND in the Commonwealth of pennsylvania, hereby certify
:hat I have this day granted Letters TESTAMENTARY
~o RAMONA A STEELE
4ho has duly qualified as Executor(rix)
lnd has agreed to administer the estate according to law, all of which fully
lppears of record in my Office at CUMBERLAND COUNTY COURT HOUSEr
:ARLISLE, PENNSYLVANIA,
IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed the seal
)f my Office the 27th day of December 1996.
'1) lU,1 tX"tuu.P
g
**NOTE** ALL NAMES ABOVE APPEAR (LAST, FIRSTr MIDDLE)
.~,~tIUllt~~.
1I111l
1~l.t~!~~lJ\lnl~!\t~l~t:
of
\lAHI. I:. I.EI\II
I, IlAlll. H. 1.1'::\0, or 1.1i I I "1'"hlll'l: , COlln!.y 01 Ilallphin, nnd
Commonwenlth uf I',,,",,,ylvania, h"inl: 01 :;'"11111 mind and disposing
memory, realll'inl\ !.he uncel'!."in!.y ur this I ife. hut with
confidence in (;od an,1 trust in lIis ~un, my I.ord ,,"d Savior, Jesus
Christ, who died lul' my sins npun the I'ros'" and rose again to
justify me and ~ive me eternal life, do hereby make. publish and
'I
I'
': "eclare this to he my Last In II ,,"d Testament, revoking any and
II\all previous wills and codicils. nnd hereby will and dispose of
~all the property wllich I own at my denth in Lhe foll~wing monner:
!I
'I
I
.\
I,
iI jewelry, clothlnl\. household Inrnitnre and fnrnishings. and other
!i tunl\ihle property, !.ollet.her wi th I he insurance policies on such
,
!;
t~roperty as well ns the rest, residue nnd remainder of my estate
II real, personal. or mixed uf whatsuever nature and wheresoever
i\situate to my hushand, ROY R. 1.1':110, if he survives me.
I
,I
'I
Ii
1! Page One of Nine Page,s
'\
Ii
.,
,.
"
,
"
;
D1SI'OSIT1VB I'IWVI~ION - I give my automobiles,
\
I
\
,.. ) '. ': ..
..', . . " i A- ~ ..,; ,. r'
Ll
Il^ IU, R. I,EIIO
\'
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II
SEeOIIll: DISI'OSITIVE 1'1.:11'11:;111:1 .~ I" 1111' pup,,1 IlInl. lilY
lI"nhn"cl, !lOY II. I.ElllJ, :;1I""ld I'II'd,'"I"!:;<' ,"'. 01 dit' ~1it:1l"
uilhin !ii:<ty (r.O) ""\':; 11'11111 Ih.. 11:111' III' lil~' r1(~:lth, or h'C nhoulll
tlie in a COI:lI!IOll di:fi1~;t(111
111'1"l'ltr g i Vf', df.'v i :;c~ :11111 hCflucath lilY
entire cHinle n:; flJllllI":;:
h. ';"'I'''I.j'-Tllo ,,,"l II,"'-II"I! (/:' I/Z) 1'''1'1:''''1. 1.0 my
dUUllhl:cr, !:;\l'IO11 il ^. ~;tpPlp.
I" I.he cue,,!. thot
Hhe lIIay pr(~llpr.f!:I:;P hII'. IIpl' :~hilrc :;hn 11 he given
to her livinH iB:;II(!, per !jl.irpcs.
Il. Twcnty-'I'lw and 0",.-:1" I r (21. 1/1.) pcrccn!. to my
30", lIarold 11. l.e!IO, ',r !.o his livin(J issue,
,. \
'.
.'
il
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I,
I
!.
Ii
Ii
.
:1
'I
JI
:;
I.
il.
,
"
"
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"
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r
.1
!'
per stirpca.
If lilY aroresaid son predeceases
r.lC, lcovinn no jH:iIl(~t I HiiJh this share to be
.
divided eClua 11 y ''':long n I I my chi Idren who arc
Ii v in (J 11 t the I. i "l!! '. rillY .1 em i. s e .
C. Twenty-Two nnd O"e-II"lr (221/2) percent to r"y
non t. [.1. Deau 1.['110.
I" 1.11,. event tllnt lie mol'
predecease me, hin :iiHlre Hhi'lll he uiven to his
livi.ng in~;lle, l'cr :;til"IJeR.
D. 1'''enty-1'\~O ,,1111 .One-nnl r (22 1/2) percent to my
dau(Jhtcr, flnncy C. 'I'l'n:;I(. If she predeceases r.1C,
Pngc '(\/0 0 [ N i lie Pagp:;
~~-(
), ,/ /
{i \: /', r.
j)AI~!. R. LEna
I:
ji
Ii
I wiuh lhin :;hHI'C' 10 lit' llivilll!tJ llfilOIlH
all IIII' chi 1<11'('11 WillI ;'1''' livilll: ;,1. I.he
lilill' of lilY llpllli~;t'.
E. Flu (' (r,) I)(~ I' C r' III I." T I' ; 11 i I I' 1111; I ,,<I /.11'1 h 0 <II Ill.
Church, Eliz;,h"l.hv;II,., I'r'III1"l'lvIllliil, or ILl;
Icnal BllCCc:;:;or, for l:PIIP"..r ,'!lurch tine.
F. Two IIl1d Olle-half (~ J/~) p"l'celll. to Teell
ChullellHc Tra i 11 lng Celll.pr, f~phrcrt;blJrH,
PcnnsyLvnnin, or j lB legal HucceBBors.
G. Two alld Olle-hlllf U I/~) pel'celll. to thl!
Christian Broadcastillu Network, IIIC.,
;j ,
Virgillia Bl!ach, Viq:illlil, or its legal
./ SIlCCl!ssor.
.'
., .
"
':
q Howl!vl!r, 111 thl! l!Vellt thilt illIY hl!lIef iciary is under agl! 22
I'at the timl! o[ IIII' dl!llIise, thell I Hive, dl!vIsl!, IIl1d bl!qul!ath thl!
,
sharl! of each such child ill trust lIl!vl!rthl!less [or the following
i
"
I: pu I' pOSl!S:
:i
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Ii
:1
Ii
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Ij
Ii
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"
I.
To apply thl! illcome illld/or prillci.pnl
[or hl!alth, llIaintl!lInllCe, sllpport,
l!ducation and cnrl! of l!nclt such child
until such chil~ nttallls thl! ngl! o[ 22
Yl!ars, the corpus o[ thl! rl!spectlvl!
trusts shall be pai<l dlrl!ctly to each
such child.
"
"
., Pagl! Thrl!l! o[ NIIIl! Pnlll!ll
fY ( .cd- h ,J i (-<.
111\'1/. II. I.EIIO
,;
I
II
.
,
.'
I h"l'I'hy 1I0millall', "011:;1'1"'" a ,"I al'l'oilll lIi,l 1',,"" IIlIlIk or
III 1 1I!I',.III1I'I\. 1'l!lIl1:;ylvallia, 01 ,I:; 1I'l\al ,;,,,,,";';01' II:; 'I'I'III1I.1'1! lJr
lilt' a ful'l'llIell I. iOlll,,1 Tl"lInt. FIIIIII.
'I'IIIHIJ:
~;"I-:tIIITlIH I FT I'IWI' I:; 11IN
110 ,,"1""':;1 i II IIIClJlII1! or
prillcipal :;hllll I", a,;:;iI\lIalll,' lIy 01' avall,,1I11' I'll IIIIYlJlI" hllVlllgll
Clllillllll\lIill:;1. a Ill'lI"llcial'Y 1",1111'1' ".1",,1 I'"YIIIl!lIt 1.0 the
hellefjclnry.
FOIIIlTlI :
"A\'IIENT OF 'I'A X I.::; _ All 1'1',11'1',,1, Sl.lItl! olld other
'lnxl!s pllYllhle beClIlIse or lilY "1'"lh, "ilh 1'I'''I'I'CI. lo the property
I' lJ I' m 1111: III y g I' 0 sse s llll e r lJ I' I" X 1"" I' I"'" I!:; s h II \I he pll i d 0 u I. 0 f I. h e
:nrillcipnl of my residllory Cslllll! II lid I! I' lhis lilli, us if they were
I' .,
lilY debts; olld 110 olle hllVillG n """l!flcllll illlerest ill such
property shllll be re'illil'ed III I'('rulld IIIIY 1'111'1. or suell taxes.
Ii Tnxes 011 future illlerl!sl:; IIII1Y III! pl'Cpll i,l.
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'j 1'11''1'11: I'OIH:HS OF FIlJlJCIAltlES - III addilioll to the
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