HomeMy WebLinkAbout97-00251
PETITION H)It PRORATE and GRANT m' LETTERS
Estate of J.J:~!D.-'L';"L'. 6./'...__.... No, ~.d....._..._J;?l::::_ q 'l:::.s;L..:i~
also known as _._.___._._.d_ d_ To:
....__.___.__... ..._.....____.._..._ Register of Wills fonh~_ )
____ _.~ Det;j;Clsed. Count)' of Cl.\.Jn{~.UJJJ.!ll._ In the
Social Security No. UJ..::il.:.._.,L:L~l.:l.n.m Commonwealth of Pennsylvania
The putillon of the undersigned respectfully represents that:
Your petltloner(s), who is/arc 18 years of age or older an the execul.Q{J____ . ( n~l1)ed
In the last will of the above decedent, dated O( 1:;"1,,..- .__L_, 19~
and codlcll(s) dated __.____._______
(Alale relevant drCllmlllanCCI. e". renunciation, death or executor, etc,)
Decendent was domiciled at death In ~.."" b'i!.L!.~ _ County, Pennsylvania, with
h '1~/I^ I ~ast fJl.l11.lIy or principal reSI~elJCe al 13..-, L ~,' d, '<, /, VJ(, ~"? R,. /1'''~
_ " !l1l 17("/ j __"IRrE- TIlLt'>
(list 5 -.ell ;U"mber and mundpallty)
Decendent. then 7,J... years of age, died \" (V\', /1 ,..,19 '1'1
at tiel I h., 'I 1'1 <" ,.C::- ".j C "n /)I'tU Plh r;l [1) ,
Except as follows, decedent did not marry, was not dlvor cd and did not have a child born or adopted
after execution of the will_offered for probate; was not lhe victim of a killing and was never adjudicated
Incompetent: IV I A
Deeendent at death owned property with eSlimued values as follows:
(If domiciled In Pa.) All personal property
(If nOI domiciled in Pa.) Personal property In Pennsylvania
(If not domiciled In Pa.) Personal property In County
Value of real estate in Pennsylvania
situated as follows: .1J.A
$~~I 000. (lC'
~:; ~ ;;~:. :;',-~
$-O,n. _
WHEREFORE, petitioner(s) respectfully
pr..ented herewith and the grant of lellers
theron.
request(s) the probate of the last will and codicil(s)
i:..,i,c... ME',~"i.l.Jrl/..-
(lC~stamel1larYi administration c.t.a,; admlnlSlratlon d,b,n.c.l.a,)
--
t~ ~~n
'" C . . I
"lI~ e, .
~.~
~l!
~'o
~
iIi
. ~~:;f:::::;P:P-
e<1(
#i!it!$~
rA;17_'-", .: i~: .~-~~~. . ~-1j.
OATH 01<' PERSONAL REPRESENTATIVE
COMMO.NWEALTH OF PENNSYLVANIA } 88
COlJNTY Of' CUMBERLAND -
The petitioner(s) above-named swcar(n or afflrm(s) that the statements in the foregoing petition are
true and correcl 10 the best of Ihe knowledge und belief of petitloner(s) and that as personal represen-
tative(s) of the ubove decedent petitioner(s) will well and truly administer the estate according to law.
Sworn to or affirmed. and subscribed + j.~'f~1:~U~t~-I;,-.~:e/ ~
before me this 17 rH day of ~. / -' .. .-j-_____L l::12. PU't ,,;;'
7)l~ri-rM-b(~A:]~~}7nft &r--- . ~
M Y C LEW I S' Register'JJ.JJ- ~
15- IL,~- L\
n'IItPMoIT
~
"".....HlI."l
tlA(.KIt+Il.
w
~
I<
g
~
J
1111" I~ III {{'Itil\' 111,11 Iht' 1111111111,1111111 1\1'11'1')\('11 I~ lOII!'\lh 111111111111'111 ,lfllltl)',III,d" 11dll,H~' ld i1L!!I! l.lllh likll \\1111 III<
IIH.d [{I'I',I';!1.1l 1I11' \llj~',ill;d l(!tl!tl.llc wdll\{' Inl\\.1Ii11'd III 1111' \1.111' \'lId [''''\Iild IHIIlI 1111 Ili'll11,lII111; Idlflf',
WARNING: Ills II10gal to dupllcato thin copy by photonlat 01 photograph.
h'l' ltlf 1I1i\ \ l'llilk,lll', S!.OO
i,ii"ii"ilNn""
'ii"'~ ,\1" Of p(~;'"
/Il.~\.,l"; ,I(~'
I~'.',"~..~ '.~'" .' "~'\~~\J\
I~' .~ . ~
, .'( . ,. *
\ a' .". ';~l
,~,' ..;$,,:'
, .,.~ ""-"'"
'", ',\fENl ~\",!,."
'!7%'ftta/.I'J!l.WJJII
. rft,l::.{, j,b /.'1 loa.)
.....LL,.._i.<c..!,h '''I,l/ (
f),IIt'
IL "I.J.-'
.;rn~tNtI..) taUL" /,/.tf1'~U-1f
l'll ,d 1{{'gl,IIM (J
4087994
~~-r--~-'-
Nil,
:;:/"") II 'l
,hIJllld/l"lltf 1,)(11"18--3';<(.')'
Ti' .) - :;,," '/7
HIOllQfI,.. 2JI~
COMMONweALTH Of peNNSVlVANIA' OEPARTMENT OF HEALTH' VITAl FI&COADS
CeRTIFICATE OF DEATH
tWI''''",,'_^
,.:iiifli"'6iicI6....'iflii~~~--~'-_._--_.- ~."~nCvflliy'iNMii"".... O.ofIOl'w:...,H:M7...r;;;;----
,Jean H. S9!!.lilb . Fem~le ,201 18 - 3549 ,February 11. 1997
...."";;;;;;"1 """'''''"'''iliNCll''IDMlD;iT-.-OfiiiiUti-j--lIIIfHit.ACiii'tr4'-<l-- PlJoCIOI'/)fAII4 t.....~oY>t-..._.........""_..... .. . .---.:::--.
72 y~ 7 ~r~" 4~;;~(~19;~ P.;;;~~~'.l~~pa =~;_.~~-c;-- ~(~;-r~[J -=;;--i:~IO--'----
ffi:i'NWo;ooiiti- - -~iiOOi5TW riibfihr-- r"cirlvt'Ai.irW,;,i";,;iZ,.\J'---;;........'<I"';,;O;;-----~-.- '-'lllfCECNKTOf~ fHl ~~-:-~;c--
i ,..8] .....nMI..fI*"'C<IIl~ 1St........
Oauph1n Dt~rl'Y TwrJ, In verslty lIospHdl-llenhe~' Med.Ctr. ""'UWI~lIICatI,... . White
~ ~m~Uf!:l!LImli@!~ I.l!!'!2.~!ii@iillMf!I]l!jlijL VjrcCi:~iifoMtA~----oiCf6Elfl<<oOC:ilii5H '="~~~~ KiMWi1iiOOii----
I '.:..~...l,~~,'.1::r u ...,....1 r m 1..~=Jllt\llli,ll'~-- O"o,ud/8pto:;f\'1 Lh"~"""""'''''""
11L..!I!.!.!~~1~~ ____ l1L~ ~~ver~~~_ ___ !L ~'_~~ ~_:l __ t12 ~ 2 11~. Married tlarry~~j bb I Jr.
OliClDtlNlh'MlN(,lAt.lOl\llUr.,il.-NlC""f~_51""l~,C"'..1 ](;fDfH16 PennsylvanIa ~J onroe ' . ,-
1387 leidigh Drive ~~:::'j{;t 1116'."___ __ ___ ____ _=_ II. l'tt_IfvM..._~____.~..:...__.. .-----...""
Boiling Springs, Pa 17001 ~~~':::I'" ~I
It l!~~'!L~lJmb!!rl~nd _~_"------___ ",tJ:"'~=oI_ __'Il'l""""
iAii1:~'(~g1~~lza;PPle- .- -- - ~ ~ .--. uO"M:t1id;L.;'1wn~~;';~r
:!;r~:.~~'~~~1bb=-Jr ~~:.~~==~~~~.I--~~:~='.~..~:c:~=.~== ~~ilij~;1Adf9ho~f~ Bolffn
"'ltIU\JUII'6"O~OIlTlOH ..a <JI'[l151'O$,h..." (AtIUll'OI$f'(,SITIOli,NIIMQtC'IIIfIIl'j,C,""'\Orf
u.....ri C,,,,,,,,,,,,LJ fll"'<"al-'''''''''(] . """"" (",,-I 0I0\ht<1'I4o;.
~[_~.~_''':..L--:.:.::=--=__'----,-:.:;;;;:.::.:.:...:~ IJ'~!!L'.l~, .HE__ _.t1h_r:::Z1QI1.i.:\etery = Bolli Sprlng~,-.!'..Ll700L
~UMll\Altf ICI~" ~lAIlOtt......IIOOA'IUCH I!CENGfIIUW8CIl 1lA1ol1lA,NO SlOf'M:ll.lrY nY' mrfr;tIIC.
/ - ( . - - . _u .....f0.QI266~_:!'---__..__llL .31--EE.Main..5.l.r:ee1~'MW1l:hUJ;lj...h-1L05L-
......n. ........,"t "'fI....."""IO...."".lhO('...r..I"Il\fI""'...,...-.l~...lt<I L!ClN5eHUI<IlliR IlIIGN'ItI
""r.."n~....., ..,h...ol,"..~1o ......1...1 ~Oty....,
<o<I#y..,..<il,,"&I#I
ii<Nii~;r..-l>i~~t;-- MhorDt.i]Ii-- --- . FIPTKltlOlINciOfi[AliW"...---o.;-;;.q-- --~-_._. WI< ClSiWf.AAi1i1Oi;i(OICALfUW'iNiM; f'lr------
~"":'~~.,~_OIO><"".~~..~_ ___ ___ iL'Q_~'/f 11~.111 (Jd..~_!!'._C!? _ __._~____ __.. \Mfl .NUKl
II """'I 1"'"11>1.....".. ."'....,..romplo,~r_..""-n'._'".;jll'n (lu.....'~t1lhl"""""'a.-n.I t>Lft....'_OI'........u<,,,,... ..........1II..1ItU. ~....... MlllM OIhtIl"IJ"ICMI.._._-..no.._....
1....''''''''''t."..O<1...I..~ :=~.= 010I_".."'.-......_.....,"""""'1
/1.1.r/.I:, (YV,"', C.."o' I
11lJ~rOILfI""~Al:("M()<IUlC{(*1 r
,
:::,~":~ I oOtiiolr~IAS'~((i)'>IIJ<II'~.11l1 I.
""..!...,uttPtl'lL',"" r
CAlHl.I'......'"o"f-..
,....-...1'........ I ' 1lI111UI'1l~AC'-'''~('JiJt,,,[,., II' .
(~fi'-.IUIl
YliillAlIiOro-n ii~"iilfiOS-' ~~iiWH--"'------~-~ ----~-IO'-IHN;w---r'". ~..... -I~'""""'" iiiCIiiH-.;w;;"'''''.....'--
....Il....~ I'fUOlllO I""'" ("'I "''''1
COIM'\f'lOIIOf'CAU~1 [" [ J
DlN"'''' "'.,''',," ....,'..... II II
...,...'~ ( J r".....,~'''.,..,.,.,,, ( I ~ tlO
I I J [ J Nt. I. ~ iii, b 1IIt.. ~ _.-
_ t I ,,,,iXl .... t ...!) Moll i;'..It/,.~&.I....'''".'N ~A(ffl'''lIl.1t1~ ..........''''''..'.11'.-,... IOCA1011l$1r""""_'~
!.oM... "" '~I""<1
... I"'!! Mt *
Wi"II11,n...."';.,-.-:;"j -- - - - . ~- - .- IKlr1'~- ...,..OliTilfi,]tUii.ft1--- T-~--~- ~---
'~:~"~~':,':~~=~~;;;~.::~:,~~'::;::..:~:~~.jl;~~,~:';;';l(~~~~'W""""'.' '''''''''''.''''',,'Jl I J m. ~'p--' ..~ (.. ":"~~ . _ ___
IlCttl Ift"""-R 10001WItlLIIob., 0., lMll
.'IlOHO\.Iffi,;lllG...'OU"'I"IHU.U"ltIUI,I',....,'I.".......,.,,,,,,...,,,.,...'....)."..,.,,".,., I>> II,IvlT O<J t 7j'.. lIt 0) 1/-'11_
1'11\1_ .1.., ~""."""". ...lI> .<<Inl"'.l..... _...... ."" pi...,''''' "'" ""h. "~""I"o/ "..'",,,.. 'I"'~ NUlIl/JlI AOlJf.tUO'- PHiS"'" MtO(~1 lOCAllY Of OUIH
'1lI0lCAL IU~IN~"'COflO".R (1~'I'll""","'1n1 TllOllldS C, AS/lhy I~. D.
OIIltI.".I..,..."'ln.ll..n....."'ln...u~lIlon,'n""o..'nl,"'.<I..lh~"u".<I.,lh.W... ".1. .,,"pl.t,."oI"~"~lh.uu..I'I."<I II t M d I 1 r. l II t PA 17033
111",.nntt.UItIt<l I/t's leY I.! Cd .(Hl et', ers leY.
--.Rtt;,llflA<l iI."i'lliiiFit ..idlNLiY6f/1 ii~TI~lil,;,.~...: (";', "...:. -. ,. __.u....___._. .m'~"_'~___
-..:It.w~~.' (~,,~ I ;UI'V ,.<1 "rO"'wy /.11 flU
"
" ,
,
" ,
? 1 . 97 - 2r"
'iil
! "
I ii,
. , I ", I j, I I I' I,' I ,I" '"
' I I I' I I 'I' I ,I ,', I
"",' ,I' I ,I I 'I' "
'I' ,." I' '. ,. I'
, , "11':'1 'I" ,.. ill., '"II' ,', '11" ',;: '1'1'"
I 'I,lll' I I 'I 1'" LI I \1' I" IIII \ Ii I 1"1,,
I I'" I "II I 'I " I ' . ,. I
I I I' I" 'I' 1111"11111"11,1'1,1 'I "1,1" /1 "
I' , I 11'I 11t!" '1'1" I';' I I' ", 111'1'> 1111' il,l
I "'I "',' i:I,.II' il'lili'ili'idi '~'I;lli qi! I :!I';'.:' I'll' III!III., ill .1 I:i','
"" ': ,'!. '1'11 :"1:111"111111 1"1111"1111".11 I I: I Ii',!' 11'1' 'Iii ' 'I
. '. ,'1"1 III 1:111:' 'I" 'I'll' .!Iill 1.'I!'III'; "!il. Idl,,: 11'1 "I Ii,
" r I' :, I ~, I I ,:' "I II, ",II ':,. I',. I i I I I'd 'j ,";.1: 'I' I'
, 'I'" ./' I . 'I" I',' " 'II' 'I" I1II I' . '1'1,
" . 01 II,. '1\'1':': :'I.d :!:. '1I'if'l ; IIi! I i ,I II 'il" " I II! l'I!!II'j: /111 I i"I; I '
:' ": : I ,. ,I 'I"." .i1I' ,I!I .111.,'1 11.:1 II',!,. I" /:'1" I' 'I :,' 1,"1'"
, ",I'"'' I' '''III' ,. I' I, '. "I" . :1' . I II' I 'I'"
, "11 I I I" Ii/II 'I 'I' ''I I; I ,l I I I III II! I I,
. '," "1'1 I"" ''''''111'' /'11' 1"1) II '11'11'1 I' "'I j'l I 1,1'
I:' "'i! '!, ",.11':,:, j'!I'H' ,i.I:1 "liH:II:!I'1 i'lldl:',III'! 1111:1:[1,"11:11 'I ",f!'
'I " 'I 11,,1111 I 'I I !II 1'1111 : I ,Iq 1'11'1 "1'1'1 "', ,
,. ,I, I" I" ,,'I "i: I .' I"III!' I 'I'll I "I 1,'1 III ". I ill"'!' I' :: I 1 .:' 11::1 I
.,' I ,I! :':";:1'1 "i"l '!I!I: II::' il:' 11'1,111 I i'll I Ii ill II 1:ld 'II' 'I'!'''I' I ", i"I,!' '
I ;. II I' I I) I " 'I' ,',,, 'I' j J ~ 11 III' j II I III ' : I 'I 1'1 f I j I I ! II i' I'"
I. ,r,' :::' : : i' : i! , I, ,:! ,i !.III :! 1',1 Ill! 1.1111 i ! 1II,,'lljl ,II'I'! lilli,'! ! II!' i 1III i ',: III' i II~' ! i ! ' IIi, i ill' 11,1
" , ',' I' I' . I Ii" I I III I I'" .' jll,l, III' I' . 'I"
", '," I, I,:, """, II 'I'll I 1'1 'II 'II' ,'.. I" II' 1 ,"
, I ' I'; , . :! :: : I ',II: I Ii 1"'111 il,' III /. ~ I II .1 ,: II., II:' I I' , I!': i II II.: II III ': I' I, i, I': II '
.', , 1'1 ,I.'., "'11"",1 I" ,,1'1' I I' "I" 1'1'" " III "
Ii t',' ::: .;;; I' .:il: ::111,11:1 l'I'iil:;II,IIII;,1 1:1';1 ;: ~I'ii II,I,WI Ii'! ,1:,','1 II:;; illlll:, 1111' :.,1 '1'.1 :,1. Ii::,
I' , . : I ": I! " : 'I'; '; 1'\ II I ': . I II! '1" 11I1 ;'1' I I~III I "III'.', I ,: i i:1 '1; ii' , : II ':'1 ill' I: '
I,: ,'II, :11"';'111"';; ,'illll: i'ITI.; II :'il I. ill", II';; Illi:I:',I/! Ii 1'111 ':,il'I,...
, ..' '. '~' i " , ~ '~'" I: 1.1',,'1' . '11; I I , II :'/11 1.:III:t I,.P '1/:1 :'11' ill I'; II i II ; , I ~
: Ii, . I' 111.:'1 1,1' ",' I jj I 1"11:; ,I I, II' 11'11" I II 1 'I' '1,1[ II" 1'1 ~ 'I,. I. :, I,.. I. I.' :
'::f-';g (:jJ.'~;:"'lljmj<!":'::!I,li 1:1:1" 'IIV; ! [II ill Ii' 1'1;'1 1:11 l'I',li;'i iill; I ',:'11':11'11' ,', '
: ,: . . 111.I'ki. ' flt I", , . ~ :I I! II I II I i I" 1.1 ~! " 'I . ' .. I,' 'I : I I: '. : I' ",',
1".1'1' ti,:', "H","': ' 11,;11 1'111'1:' W ;, II 'I;' "I'.J 1'1. 'III ,', III" ;' I :'1' 'i 'I'
'I il,I"",: ,i . W:., !flilll'll;''!,l !pl I.;' I ~ 'II i,,11 :'1 Iii i \1 Ipi:: I :1:, .,'
"', :~'~'if,:: "I:II,,:~':I~;')j:l.i 'ii..I'III;:i' 1IIIi:.1 I (I 'I'II~; III', 1:,1, II il.',1 IIIII!': 1'1 1:'lill, I::!! ::,
' 1i. Hl' J d Iii ;'1 ,1:1 If,'; I :: I '; 1'1 ,,,] t' ,tllltlll '; lIt, 11 I I II :/1'
::', ,~: "llffil!'lill;'IIII; IIJ; 111:1j III.; 11,11 i,11 '111111111 ~i I "',.1. :II'ill
I, "'. 11:'1' I :': I,,' 1:1 ,'I, 'I !I' III III (III I!'!I r1L' di'I:' ',:1" ' I
)"'1..'1,,111 "!i' 11 1.li,.I,.'.I.I..II.i', 111,1. ,) I,I!I"'III 111".11 11:..':.1 .1..1,'.: II I:,.! i.' ,1.11: 1111.1. :'.'11:1.. ':.'1' . I,
. II 'I : ;.,. 'I'i I:' 'I'I!:II'I"';I'II:: 11"11 i i :'11111 ~ 1111'11:: '1 'Ii; I I "I'T !I,,: '1 ,\." 11:';, '1'1'
I"!'! lit I:il 1',:1: I'il~: I 'I ~:: III '1"1:: II I :.:1 II: I I ~:II :"
I....,I"I,,':I! 1:11 i, Ililll,.I.I..11 :,! ill,.I':II!!II:.).II." '.11 ;:1,1, Ii','.:' ,I. Ii,.'.!.., II.l...'.:...1 .Ii '.! 1.11'1' :! II nl. 'illi
II '" 111'1,1"1'11'1 i. " II'll 'I',' , ,II 1'1 1""1 '" I 1" ' "'Iii'
, ! p I, 1",..11..1 1.11 1,.',1 i.! i !"" 1.1.. '.'1. I".I,~"I.' i.!1 I ,i I 111;.,i II 1:.11 I I'".".'.. III...,:" '11,li,1 '1 : i III (iill i,' II. : .
. "'" i II I ' 1'1 "1111111 III I' i' "'1 II, '''I I' II' ',1/.'"
: i'.'.',"'".I.,.,,: II:: i.,'lll.IIII.I'II.,:, 1,....1.1':.111.1 i ',1.: I '.:.!I"I' 1..:.11, 11"'i'I.' Ii'.:, 1'[1: III: 11:1111 :III!:'
: I:: 'I! ;, iil'! i I! I' ,I ' ;1' I: I '\' i ,I'i li'll IIi:il ';'1 'I" I' II : 'III,' II' ' '.
",';:,11 ili!l! 'Iil! Ii'! II!i)! lir 11111; . ,111i 1 I, ;.I,illl IflIW: 'I"fl II ~I 'III ::1 i 11)1" !'. 'Iii: !I
,'i'llll: illl :.',..,11,1,1", 1'.:1,1.1.,.:111'1,.1"".1.1/11 i".'I".."I'. !.I ::,.!""I 1',.,,'1,,11111,1:,.1.111.:,1.111, I "III!i! ::1 i 1"li 'III! ,Ii"~,
,Ii , ,I" ,[ I: I ",I"" 1 I',' ""11111' 1:'11,,1. , '1' "I 1111' "1 I . '.
1:'.ilil.'1 il,l. :.'I:,:II'I:i,I.!.I'.I., [1',lli:I'1 I'.'!I:.i.I.!i, I,',:illlll!,!., 1111'1,"..::.11' ! I,!!I\I ;:11 '1'111:11' ::'['1','" I,: ,:1.
',", '1-' i , i!'t! -I j- _I 'III "III) ;';1 1,:-: !I ,:_',,1 II 11'17.1 I I 'II, ,
1,1 I.:' 'l-i.',1-: ': ". - 'I I" 'i', -"I,',','.' Ii,' - '; J. .'J I 'I '.',. ....
I r : , I I ' : - , -, , , : I, -" - - _ 'III i ~ - : ' : :.' 'i!' I I II: - , " I!~' i. '.' I ; ,
'I 1,'- "ii <' 'i:I:! I '<\ ".; , "I: I.j I; ,I;
;'. ' , i::'r i:- I"
'1,:'- I'
'I"l' ':il':
,I', iii' .
, , ,
" ,I,
, "
I I"!
:
, ,
'I '[
, ,
I'
,
RfY.II00 fX,+ (r,QAI
il
i I 'OR DATU 01 DIATH AmR 12131/fl CHICK HIRI
INHERITANCE TAX RETURN ~cfV::~U~:~DIYl5 CLAIMED LJ
(~~~~~~!~iT~E~~~~~{tlf . I:~::T:::)::'.. ...._y:;{~~_~~~~~R
--------- --- --,,-- -- flr,~ffli:il'f;\ 'ct)M;.irlfAf,(\ii[~r-~----~---~~--~
lY:'( J.olcl.l.,,;1t j)J.'.I.vo
)lollin{!, iJpl'ingll, PI\
''''''''r 1)llIIlbOl'lllllc1
....MOUtH ll:(CfIVED ISH IN!liilUCIIONSr-- - ---~ ------~-
:I: It, ?~Q_"_02 _ _ ______
I J 3, Rrlll'1C1lrldcH Return
Ifor dole. of deolh prior 10 12.13.821
I J 5. fed.rol E.lole Tox Relurn Required
Q B, Total Numl;>fH of Safe oepo.h Boxel
/
~,~
c
1/,
rOMMC)NW(A,lllt Of rrNtH,VIVANIA
1l~f'Alt'MEtil Of R~VENUf
()frl.2110601
II"RRtS8UIl.G, J'A I;' 1711-01.'>0 I
~~;;;;:':=--=----trtitr"N,;fij'^Mtlr~stlliH~';;~~il't;mtlrhtiini..tj-
.... i-H~,O.i HI', Snll11 11,
! '6~:~':~C~'~'i'~~;:;;:;--~_ r~ii'~.;'f/':;'1 ....1";:'1;;'"/;))1.
c .llt A~PlllA'll_I_.'.lI~\i_IVtfm \r(}uu'~. tM.Mr IlMo.1' 'll~1 MIl> M. IOllI1 IljlllAII[S(J(I^.1 Slll/IIIIY flUMlHR
_._______ m~C~rJlln. l1Ul'J'.:r]). (.TP.). ?11'l-T :'-"'j;'O
~ R:I 1, Odglllol R~lurn I ) 2, Supplemt\llldl Jtfllurn
..5'"
!i1fl:l [1 ., limited Eolole
uP~
~ Ii'J 6.
Ll do. fulur$ Inleretl CQwpromlt6
(for dolcu of dedfh oller 12,12.821
Dfu:edent DIed T ellotft [. J 7, Decedent MClil1lolned Cl living T fUlt
I^"och copy of Willi I^"och copy of T lUll)
-----... A~UORRES,.ONDENCE.AND CONFlDENTiALTAX-iNFORMATION SHOULD BE DIRECTeD TOI
NAM~ . -. - ----~~-~~-----------~~--WM~rffiMAiil~juAiioiifss
_.__;r-,__n_ol'-(~l'tr:tll\\rro)'. Att;y.. !lul'l(Ot :;(1\.1U1'O Bldg.
I!lEP"ONfNUMm !.lochanlcnbul'g, PA 1'(055
11.-1 -,'j~0,~!-,:'J,~J)'___=_.~-~= .' ---P-P --.~-.,.c;
(1/ 0,00 I
{ 2 I ____cd. _____Q tQQ
13 I ______.______...Q, 00
I 4 I... ..__.___...__.___Q...QQ.
151 _______._.__.?JJ.B3Q_.3.9_
161 ________2.! 822......2..2
I 71 ____________.hM.____O ~ .> cu_
I 91 .._____m..~~,18_~~.'J_
(101____B,~1~...CJ.Q..
f(\ffi
gje
co"'
...If
13.
14.
-_.
IS.
16.
17.
"'
52
~ 18.
19,
:IE
c
...
S 10.
If line 191. groaler than line la, enlel' the difference on line 20. This Is the OVERPAYMENT.
IILl
'"
c
5
~
hl
'"
1. Real e.tole (Schedule Al
2. Stocks nnd Bonds (Schudule OJ
3, Clo.ely Held Slock/Partnershlp Inlereul 'Schedule q
4. Mortgages and Not!s Receivable (Schedule OJ
5, COlh, Bank Depollll 8+ Milcel!aneout Penonal Prop'!rty
ISched"le EI
6. Jolnlly Owned P'operly (Schedule fl
7. Tronller. ISchedule GllSchedule II
8, Total Gran Autlll (10101 Unes \.7)
q, Funeral f.Kpensol, Admlnhlrallve Cash, Mllcolloneoul
EMpenset (Schedule HI
10. Debl.~, Mortgage lIabllille., lien. ISchedule II
11 , Total Deductions (ICltol lines Q & 101
12, Net ValutJ of Eslale (Une 8 minul Une 111
Charitable and Governmenlal Boqueslt ISch~dule Jl
1'700,!
,".i!
~'. '\!'( )-{;.
,.-.~
Net Valu!~bi~.:~.I!:~~.~~J~~~~_mlnul ~in._~L
Spaulol Transfers (for dotes 01 dOCllh oher 6.30-941
Seo Instructiont for Ar,plicobln PfJrcl!lnlage on Rl.....erll
Side, (Include valufls rom Schf!>dule K or Schedulo M,l
Amount of Une 14 taMable at 6% rate
(Include values from Schedule K 01 SchedlJle M,l
Amount of line 14 taKable (It \5% rote
ll"cluds values from Schodule I( or Schedule M,)
PrlnclpolloX due (Add 10K from limn 15, 16 and 17.1
Credih SpousClI povetlO :r~~ Pdor o:YB511'
.0....___--------------- + __0
-.0 .....'"
._.~
l.()
26.655.62...
181
(Ill
(121
{131
(141
1151 __.__..__.._...l~.LQQ?_!. .92 . x, ~.
(l61__._m... .~_,_?J3..~_,12_x .06 .
19,361.38
7,29!l!..lL
0.00
"-7~ 2_91~~- 31-
0,00
(171
_-2..9_2.. X T 5 .
12.h1Bu
_________..9~__QQ.
__~9'7!lB_
I1BI
Di,count
L___...!.QQ -
Intltresl
0.00
---"-----
(191
1201
.o_,-9Q_
0.00
nH~C~ hew if you cuo Icqucsllhg n tcfund of your ove.pavment .
19'7.18
... nu-------1J.Oo-
____..--==:~==-~=l.:ctl;I!1..
21. If line 18 Is greater Inon Une 19, onler the difference on Line 21. Thlt i, Ihe TAX DUE. (211
A. Enler the lnltmnl on Ille balollce due on Une 21A. (21AI
8. Enter the 10101 of line 21 Clnd 21A on line 21B. Thisls tllo BALANCE DUE, (2\81
_.___~~~~.!_~.!!.!~~~~.~t~~!!.!~!9~!!,!_~_~f Will" AU."1 ~_~_
~~J~';~n~~I;'. orp-;~,,~I~lq-,~h~~t;~~~%~~~r,~,i~~L~~~~~~~~50~~;~:,~~~S,~I~I~~f~,~+,?,-;~~~,~E(~~ ~-~;~~'.,I~~1l0.;r.Jg-;-o7,db-;iioi,
III. 'rut'l, correct and complftto. I df/clore thol all raol eltate hot bltl:lll '{lponed o! true markot VOIU6. DDclarotion of preparor otller than the porsonal fopreumlalive is
~I;~... dyG~~;~~~:K6:~:~i9f!~A~7i'~r;~itr;,~rr!:~~-0;rkll~A:~~.CI~~'qn '1 -Tol; () j'ijrijij;-{r---1TonCl--~-Gmi1.. :.ro""To------pJf--l ~-~. ---.------
?,jr~~"''':, .., """iU!, ~':o:~~:::;:f:j:~" ""'1""" pj)176rr" 1L...m
CjJ2r"'-----"-.' ... IIouI H\1l0l11qll'LL 1'1\ i'(o;);) ..m ...Z.'_u~:_rl..__
"",'"'' '" I'w, .
COMMONweAlTH Of PfHNSYlVANIA.
INtuRITAHCf tA.X RETURN
R!'&IDf.NT DfCEOENT
=
-.
ESTATI OF
1
SCHEDULE F
JOINTLY.OWNED PROPERTY
FILE NUMBIR
_.____._._~lJ.;;Al~}i!... i)~~_lQn ._._.___
Joint 'o.a.t(.),
___.____ NAME _..___
A. SllAl10N J. HONN
B.
C.
21-97-0251-Stn1:
12.n-OO?li.k.QO\l11
_.._~~~5S ____
.....- ..,
RELATION~HIP TO DECEDENT
Daughter
Jol.tly.awnod praporty.
ITEM LEnER DATE
POR TOTAL VALUE DECD'S DOLLAR VALUE Of
NUMBE JOItjJ' MADE DESCRIPTION OF PROPERTY OF ASSET % INT. DECEDENT'S INTEREST
TEN A T JOINT
--.
1. A. 9/1.11/ Farmers Trust Company,
1994 Carlisle, Pennsylvania,
Savings Aooo\mt No. 1- $ 5,650.77 50'~ l~ 2,825.39
3()9322.
TOTAL (AI.o onlor on lino 6, Ro,apllulalionl
._--~~._-------~._---------~--_.__._._-_.
(If more .poce i. needed Inser! oddiliona/ .heels of same I;lll)
$
2,025.39
"'"'' '''':;1~:~~mm'''~. ._A~~~a~]~~;;g1~~~~f 1_ ~'". P"., ., TyP'
UfAffl5f-.-'-------------.------.---n-.-----JIL'-NUMBIR 21-<)"( - 02Y1 ~Cl t u'to
.. _ .. _ ,rEM'.. IT. SQ1JI'\J~ _. n___ ___._.____..!997-002;;1~~~~!!.ty
ITEM
NUMBER DESCRIPTION AMOUNT
____.._._.___ ,."'_._..__. "m__.___~__.~_.__..__... ...-..--- ..-.._- -.-..--..--..-- _._~---~....__._._------- --_._--~--~--
A. Funeral hpenae..
1.
Hyers l?unera1 Home, rno., J1ecl1aniosbul'g, l'ermBy1~
vo.nJ.a, funeral oJCponses.
Gingrioh Hemoria1s, oemtltery monument.
&1
7,000.00
$00.00
2.
B. Admlnlalratlve Caall,
1.
Porsonal Ropro.on'atlvo Commllllon. - None
Social Socurlty Numbor of rorsonal Ropro.enlatlvo,
Voor Commllllonl paid
0.00
2. Attornoy Foo.
3.
Family exomptlon
Claimant Harry p.
Jr.
Squibb/ Rolallan.hlp
Husband
.3,500.00
Addroll of Clalman' 01 docedon". doolh
S'roo' Addro.. 1307 Leidic;h Drive
City ~oilin(L~.r..F-!.!1~~_._._S'ale .FA ._. Zip Codo 17007
4, Praba'o Foo. negister of \'iills of Cumberland Oounty,
pennsy1 vania, Letters Testllmentary. 66.00
C. MI...llan.oua hpen.o..
1. Cumberland TJUW Journal, Estate Notioe. 60.00
2, The Sentlnel, Estate Hotioe. 62.40
3,
4,
5,
6,
7,
8,
_._---_..__._.._.._.~-_..- -----
TOTAL (AI.o onl.r on line 9, Recapitulation) 5 11,1.00.11.0
(II mar. .pace Is needod, In..rl additional ah.o" of .am. .1..,)
/5-/00" 'I
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAMES
INHERITANCE TAX DI\lIfllDN
DEPT. 1I0601
HARRISIUftU, PA l1Ue'0601
NOTICE OF INHERITANCE TAM
APPRAISEHENT, ALLOWANCE OR DISALLOWANCE
OF DEDUCTIONS AND A5SESSHENT OF TAM
10-27-97
SQUIBB
02"09-97
21 9'1-0251
CUMBERLAND
101
r _ AMaunt,..!!!MlttO: - -j
MAKE CHECK PAYABLE AND REMIT PAYMENT TOI
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
CUT ALONG THIS LINE .. RETAIN LOWER PORTlON FOR YOUR RECORDS .....
R'Ev:is4i-EX"AFP -[o'ij':97Y.'NoYicr-o';-YNHEifiTANCE-YA'x-i\PPR"AisEHENr;-ALi:OWANCE-Ori--um----- - ----
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
JEAN H FILE NO. 21 97-0251 ACN 101
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
J ROBERT STAUFFER ATTY
MARKET SQUARE BLDG
MECHANICS BURG PA 17055
ESTATE OF SQUI B8
TAW RETURN WAS, (X) ACCEPTED AS fII.ED
RESERVATION CONCERNING FUTURE INTERES'r - SEE REVERSE
APPRAISED VAtUE OF RETURN BASED ONI ORIGINAL RETURN
1. R..l Ed.t. (Schedule Al
2. $~ook. and Bond_ (Sr.hadull B)
5. Clo'lly Hald st~ck/P.rtn&rship Intar..t (Schedule Cl
4. Hortgag../Hot.. Rlc.ivable (Schedule OJ
S. C..h/B~"lk Deposits/Hila, Parlonal Property (Sch.dull E)
6. Jointly Owned Property (Schedull Fl
7. Transfer' (Schedul. GJ
e. Tot.1 AII.flit.
( ) CHANGED
(lJ
(2)
(5)
(4)
(5)
(6)
(7).
,00
.00
,00
,00
23,830.30
2.825.32
.-.M.
(a)
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expan.../AdM. COltI/Hi.~. Expen.ee (Sohedule H)
10. D8bts/Hortgag. Liabiliti.s/Liens (Schedule X)
11. Tot.l Daductione
12. Net Valua of Tex Raturn
l~. Ch.rit.bl./Gov.rn~.nt.l aequ..t'J Non~el.ct.d 9115 Trult. (Schedul. J)
14. N.t V.l~ of e.t.te Subj.ot to lex
NOTE:
RECEIPT
NUHBER
AA21l517
DISCOUNT (.)
INTEREST/PEN PAID (.)
,00
<. ~ -,
*'
tly.lh1f1mcn."1
JEAN
H
DATE
10-27-97
NOTE I To insure proper
or.dit to your ICCOunt,
lubftit the upper portion
of this for.. with your
tax paYHnt.
26,655.69
11,188,40
8.172 . 98
Ill)
112)
(15)-
114)
(91
110)
19.361 38
7,294,31
,00
~,294,~1
4,008,02 M'OO. .00
_.3,286.29 M.06. 197,18
,00 M .15. .00
l1a)-- 197.18
AHOUNT PAID
197,18
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST AND PEN.
--.---
TOTAL DUE
If an aBBeBBment waB iBBued previouBly, linel 14, 15 and/or 16, 17 and 18 will
raflect figuree that include the total of ill returnl alleBBed to date.
ASSESSMENT OF TAXI
IS. AIIlO~lnt of Un. 14 .t Spoua.l rat. US)
16. AIIount of Un. 14 t.xlbh at Lin..l/Cl... A rat. (16)
17. Allount of Un. 14 taxabh at Collateral/Cla.. 8 rat. un
11. Prinoipal Tax DUI
TAX r.REDlTS:
'-PAYHENT
!lAH
--07"10-97
197.18
,00
.00
.00
. IF PAID AFTER DATE INDICA'fED, SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
IF TOTAL DUE IS I.ESS THAN f1, NO FAYHENT IS REQUIRED.
IF TOTAL DUE IS REflECTED AS A "CREDIT" (tR), YOU NAY BE DUE
A REfUND, SEE REVERSE SIDE OF THIS FORH FDR INSTRUCTIONS. I
i'
,
,..:)0
~1E~ATIONI E.t_ta. of OtoIdtnt, dvlnJ on or baf~ra Dea.-blr 11, 19.1 *M If InY future Intara.t In tn. ._t.ta 1. t,,".f.rrtd
In po.....lon or enjo~t to Cl,.. I [oollat,r'l) beneflcl,rl.. of thl dlGedlnt .ft., thl ..plr.tl~ of any ..tetl for
llf. or f~r ~"r', the r.~lth herebv ..pr...l~ r...rv'l the right to IPPr,l.e Ind ...... tran.flr Inh1rltenol riM"
et tht lawful el,.. . (coll,t,r.l) r.t. on InV IUch future Int.r..t.
PlMP01l! OF
HOlICr, To fulfill thti r...dr...nt. of 'HUon 2140 of the Inhlrlt~. end E.t.t. Tlk Aot, Act 21 of 1991, (72 P,I.
SlaUon 9140),
PAVtENTI Detlteh ttMl top portion of thlt Notlo;. and .ub.1t with YO\lr pIyunt to the Rlahtlr of Willi printed on tM rlvlr.. llde.
-*IWlI oMclk or _oney ordlr plylbll tal REGISTER OF MILL., AGENT
REFUND (CfUl , refund of . ta. aredlt, whloh WII not reque.ted on thl rl)( R,turn, I.Y ~ raqu..tld by COIlflI,Unt an "AppllalUon
for R.fund of p.nnnlvanll Inherltancl ttnd htat, TIM" (REV~151Sl, APftlloaUon. Ire ,vIIlM" It thtl OffiCI
of thl R..llt.r of Will., Iny of the 23 Ravlnul Ol.trlot Off loa., or by c.ll~n. thl 'Plolal Z'"hour
~....rlne ..rvlcl ~Ir. for far~' ord.rlngl In Ptnn.ylvlnl. l-aO~~!62~20S0, out.lda Penn.ylyanl. Bnd
within 10011 H.rrltburll er.. (717) 781-8091\, TOOl (117) n2-U!i2 (....rln" hlpllrH OnlY),
O.JE~rIDHlI Any p'rty ln Intlr..t not ..tl.flld with th. apprlt.oaent, allowanc. or dl..llow~. of dedUction., or ......-.nt
of tIll (Including dhoount or Info'rlltl .. ahown 0I'l thh HoHc. lIU.t objlct within .lMt~ (60) dlY' of rK.lpt Ilf
thlt Katie. bYI
--wrlttln protut to the PA l,t1partl.nt of Alvlnue, laIrd of ApP.1I1., D.pt. 281021, HlrrhtNrlJ, PA 17121-1021, OR
ulllOtlc,n to h.". thl ..U.r deh,..lned ,t audit of the IHlCOUl'\t of the per.onal reprll1llntltlv., OR
--tpPMIl to the Orphan,' Court.
ADMIN
1,1AATlYE
CDMECTIONSI
F"tultl arron dhoov.rld on thh it.......nt .nould b. add"..1d In wrltlng tOI PA OIaplrtltlnt of AIl,ltnW,
aur..u of IndlvldUll hu., "lUll Po.t Au.ulteMt Alvi.w Unit, Dlpt. ZlU601, Harrisburg, PA l1ltl-0601
Phone (717) 1a7k650S. SI' plaa 5 of thl booklmt "Instruction. for Inh.rltancc Tell R.turn for I R..ldent
DMldlnt" (REV~1501) for Wi .wpll1N1tlun of IIdtIln!ltrltlvllv C1nrraot~h "rot"..
DIscou,n,
If any t.M dUI I. Plld within thr.. (1) c.lender ~th. .ftlr thl dlcldlnt'. delth, , flvl plrclnt (SX) dl.count of
thl t'M PIld 1. .Ilowed.
PENAL TV 1
The IS).' t.. ..,..ty non-p.rtlcipltlon pan,lty II oOllPut.d on thl tot.l of thl tlM and tnt.rllt IIIII.U.:I. and not
p.ld tJ4,fort JIf'IU4Iry 10. 1996. the Ur.t d.~ .ftar the Ind of the till ItIlfIlIttv p.riod. This non-p"tlcIPIUon
f*Oaltv It .,.pllll1bl. In thl .... liMn." triG In thl tha .... tI.. plr led .. yOU would 8PfM.l tilt> tlM Md Inter..t
thlt h.. bfMn .......d .. Indlc.tad on thl. notlc..
INTEREI'r I
Inter..t 11 charged blalnnlng with Hr.t dlY af delinquency, or nine (9) ItOtlth. .,-.d 0flI (1) day frOll thl dltl of
dalth, to the d.t. of p.yaent. TllIx., whIch bee... delInquent b.for. Janulry 1, 1912 ~.r Int.r..t .t the rftt' of
.IM (6JO ~rClent fMr annul cllculllltld It III daily r.ta of .000164. All talC.. which No... ctIltnquent on ~ Iftlr
January 1, 1911 will balr lnt.r..t at III rltl whlah will v.rlt fr,\IlI cll.ndtr y..r to elland.,. Yilt with that r.t~
Ilnf'IOUnclId bit' thlll PA Dlpart.ent of R.vtlnUI. Th. lIPPllclbl. lntlrut r.t.. for 1912: through 1997 .ral
tm Inter..t R.ltl O.lly Int.r..t FBctor ~ Intlr..t Mat.. o.lh Inter'llt Factor
198' lOr. .00054" 1917 OX .000lU
1985 16X .0000. 19M-1991 m .000101
1914 m .noosol I'" OX .OOOU7
1915 IS' .GOnS6 1995-1994 7X .000192
10" m .000274 1995-1991 OX .000247
--lntar.1t 11 calcul.tld .. foHowlI
INTEItElIT . BALANCE OF TAX UNPAID X NUHIER OF DAYI DEl,INqUEllT X DAILY IHTElElT FACTOR
M_Any tfotlo. I..UId _fter thti tlM bacOlll. delinquent will rlUeet trI Intlr..t c.loulltlon to flftMn US) dlVI
beyond ttMl dlt. af thl ........"t. If pltYlllf\t h ... If tar thl Int.r..t cOllpUt,Uan dlt, thcMfn on thl
Hotlc., Mtdltlon.l Inter..t lIIJ.t be cfllcul.ted.
.
f---~+-
STATUS REPORT UND!lli..BULE 6.12
Name of Decedent I . .J " (if' H,
Date of Death: '-(II ( en
Will No. f..1:11 .0<-";).5 {
S:Zw'bh
Admin. No.
Pursuant to Rule 6.12 of the Supreme Court Orphans'
Court Rules, I report the following with respect to completion of
the administration of the above-captioned estate:
1. State whether administration of the estate is complete:
Ye5~_ No___.__
2. I f the answer i8 No, state \~hen the personal
representative reasonably believes that the administration will be
complete:_
3. I f the answer to No. 1 is Yes, state the following:
a. Did the personal representative file a final
account wit.h the Court? Yes No )(
b, The sepan~te Orphans' Court No. (if any) for
the personal representative's account is:
c. Did the personal representative state an
account informally to the parties in interest? Ye~___ No______
d. Copies of receipts I releases, joinders and
approvals of formal or informal accounts may be filed with the
Cerk of the Orphans' Court and may be attached to this report,
Oatel-1/.t:J/ ;j..OO(/
/)~r'/;A'-"I9-4tAv.ei/ _____
Signat.ure
St~pr~(' .J. ~.'t L' h /,
Name (Please type or print)
'3/1 I'1Cc.."J" (" p. Ct.j
Address
(In I )ll )-~ fj{
Te 1, No.
Capacity: ~___Personal Representative
!
___Counsel for personal
representative
(MAH u'mf I AM3)