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IJETITION Hm I-ROllA n: lllld GRANT 011 LETTERS
.Kcu1?,e. /J1;i;e/d No.~' - ,qq'7- Olf~_~_.
To:
Kegisler 01' Wills I'or Ihe
..- , 11"(.",,.\'1'11. C(lIll1ly 01' .kL'lIi3.&/tJt.!.L in the
Sod", S<'<'lIrlly No. .S.,'i"E'.16.":>/'r.Z.-.-_ _. Commonwealth 01' Pellllsylvania
The relilion 01' Ihe IIl1d('rsi~lIed r,'slweIILllly repre.selns Ihal:
YOLlr pelltioner(.\), who i.\/1II'e IS years 01 H~e llr lllder anlhe eS\:elllag"..... ._...~.__.. named
Inlhe last \\'ill 01' Ih,' above dee,'dellt, daled.____. i2_JCj".r.r:''''.~'('?..m.....__~__, 19..2'2-.
, and e\ldieil(s) dated . .__._ _~__._____. ...___... '_'m._.
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c.~P:JA M IAt I-rl ..,~
DC,,('ndl'lIl \l'lls domiciled at dealh in ,),rl.l(.JtiJi _.,.' L_..,~ollnl~, Pennsylvania, with
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Oeee'lIdelll, Ih;:n ..1>.,'/._..___ yeurs or age, died..L;j_~_.!:Y.Y__--"...-....-~.~-, 192_.
lll';"'llii<fe...un.((}~..0)fJc<..Q(}4jLII~_.._~~_,. ' ,
Esec'plas follows, del'edenldid nol marry, wus !lot (.lIvoreed nnd did noi have a ehild born or adopted
after "sel'lIlion of I hO\\ ill "I'fered for probate; wus !lollhe victim or a killing and Was never adjlldicated
In,'olllp,'I"III: ~..____k'Oke..__.....,,_~__..,,",,____. .._
Deeeild"ilt al dealh owned rroperty wilh estimaled vallles as follows:
(If dl1mkiled In I'a.) All rcr.\onal property $LJ!P..). 00 f)
(If UOI domiciled in I'a,) Pmonal properly in Pennsylvania $
(II ilotdolllkiled in I'a.) Personal property in COllnly $
VHlul'ul" rcull'slillc iI11\'I1Tlsvlv<lnia . / $
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IVIIEKEi"ORE, IWlitioncr(,) rl'speelfully reqlle'l(s) Ihl'pro"ale of the last will and codlcll(s)
presenled herell'ilh aud Ihl' granl of iellers.~_..._ -1'I:"T'1l't~___.__~.. .
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OATH OF ()ERSONAL REPRESENTATIVE
COMMONWEAl.lll 01' I'ENNSYI.\'ANIA I '8
COl'NT\' 0... CUMBERLA~,?...~_u_..... J H.
lhl' p~'liliolll'r(\) HhO\\'.llillll.:d~wl'llr(S) or Hrrtrm(...) that thl' .stnll'mCllh in th(' foregoing petition arc
!rlle dud L'onn:l 10 111\' hL.'~t l)f Illl' ~11ll\\k'dgl' and IIl'lil'l' of pCliliollcr(s) und that liS personal reprcsen~
Inli\'l'('1 "llh" a I""". dll'l'l"'"1 1'<'lIliollerls) will \\1'1I;:'.I.rr~lI.)iI.' ~\{.I.I1l.in.l.\1~.' )IC.' 'i:.,e ~[."ding 10 law.
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1~KY C. LEWIS 0 /i<,('illl" 1 u___. ......._____.. 2
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OF
11~)!,I s .X(!E~!' )J~.l-0-:xF}.L~,n
I, DOlUS ROSALIE MAYFIET,I), 11 n"d dent of 2119 Wentworth Drive,
Cllmp Hi 11, CUlTIberland Countv, Pennsvlvania, bein~ of.ound mind and memory.
do make, pllbliBh sn<1 <!ecVlrl' th1 H t:o be lnY Lllll!: \,11 11 an<1 Testament, IHlreby
revoldng all Wills and Codicils heretofot'c InIlOtl Lv me,
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I direct that all of my just debts,
my funeral CXpel18flS inclucling a suitable monument at my grnve and the cost
of adud.nistrllt1.oll of my estate be paid as soon aa practicable after my death
T direct thn tmy Ilxecutor 1M)' Ollt of my eEl tate, liS a p,enerlll charge thcreon,
1111 inheritance, catnte, Rllccessio~ and other taxes together with any inter-
eat or penalty thereon assessed by reason of my death with regard to all
properties and A8sets !lub,lect t.O fltlch tAxes, whether or not stich property
ond a8sets pass under this Will.
TTF.H IT,
I give, devise and ber/ueath all the
relit, residue and remainder of illY property, rllal, personal or mixed, tllngi,.
blf' nnd intanp,inle, of whAtsoever nature and wheresoever located and all
property to which I l1lay be, entitled to or over which I may have any power of
diepoll:ltion or appointment and whflt;,hfJr e.c,qu1,rfld during or after my lif.t:t.me
to my flve children, KI\I1'H ALAN MA~J1lELD. KYLE DEAN MAYFIELD. KEVIN RICHART>
HAYFIELD, KRISTIN LYNN MAYFIELD, nnd KAREN MICHEtE MAYFIELD, in equal aharea
per capitll, abor:Lutely and in fee sJrnple provided that he or she survives
me bv ninety (90) dava.
ITEM In.
.~._,._-----
I rleolare that it is my intent1.on that
the pre'\\'1 ~ionA of th:l.!l inlltrumllnt: be Ilppli~nhlE' to my children now living,
and not a~ to nlY ch1.1dren hereafter I,orn or adopted. i.f any. I declare it
my intent1.oTl to make no furthet provIsions for any child afterborn or adopted
ond t:he pnw1.n ton marle herein fot' ~l\ITJ[ ALAN MAyrIll1LD. KYLE DEAN MAYFIELD,
KEVIN Rl(~HARD ~j^YF!F.Lr>, KP.ISTIN LYNN ~lAYF!HLD and KAREN MlCHllt.E MAYFIF.LTl
shall not be abnterl or otherwille affu.cted hv reason of the birth or auoption
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of such chUd.
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,Iin the event: th.t 1CftIST'.E~ LYWN MAY.
Fn~U) and KAREN !lICHEU~ HAYFIELD are mtnora at t1." tillie of lilY ,leach, t!l8t:
is to Bay, under t:he age of RiRhteen (18) yeAre of age, then their rnHpnr-
tive 8harcs of my entate nh/111 be held in trust: by KI'ITIl ALAN MAYFH:LD, my
oldellt !l~n, The 91l1(1 KFTT'H AIM,! MAYFTF:T,n nhnll hnvp th(~ power t:o invest
said ahare of my oattlt:l' 1m II to ut11.1 w thp. income and principal for the
care, maintenance, education /lnd /lupport of either or both of !laid minor
childrel1. It being m)' intentl.on th!!!: KF.ITH ALAN HAYFIE!.)) act Illl guardian of
Baid mt,nor children until they each the ago of eighteon (lll) yearB of age.
Upon the minor children reaching the afl.Cl of eil7,htee,\1 (18) respectively.
thon the halance of my eatllte held in trust as tho'lr share Bha11 be paid in
,
full to the reBpective ch:f.ldren, to be their sole property therewith.
]TEtLY.,-
For all purpOBeS of this Will aT1d the
diBposition of my eBtate hereunder, adopted children of mine and their IsBue,
whether or not adopted and adopted children and their isBue, whether or not
adopted of any descendant of mine shall be conBid~r.Qd Bnd treated in all re-
Bpects the Bame liB children bOlon of marriage and thier iBBue.
I'rEM VI.
I hereby nominllte, cons ti tute and ap-
point KEITH ALAN MAYFIELD Ill! Bole Executor of thh my tast Will and Testament.
In the event the sdd KEITH ALAN MAYFI1ltD refuses or is unable to act for any
reaaon, J then hereby nominate, constitute and appoint I<YI.E DEAN MAYFIELD 8S
Bole Executor of thb my Last Will and Testament and I direct that no bond
be required of my Executor.
In.ili...Y1L
I authorize and empower my Executor
Ilnd 8111\1 Trustee to compromise, ad.luBt, release and discharge in Buch manner
as 10\' EXOCllltor ma~' cleem proper, all clehts nnd cla:f.Pls owed hy or to me 01:" my
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Estate: to "ell, leBBe, or exchanRe, at public or priVAte !IaIe or in su~h
manner, at, Auch prices, ~nd upon aqch terms of credit or otherwise, as my
,
E,tect1to/" or Add Trustee mav de~m proper, n 11 or nny pnr": 01' my property, real
or pD~BDnal; to execute, n~knowlBdRP Rnd delivor inatrllment9 of COnVeYAnCe,
inc'J.\l.Hnp; deeds in fee simple: to I'>orrow money for t:he purpost! of paying,
,
e'Atat~, inheritance or other taxes .which are required to he p/l1.d and to'
.,'QUt~.~Y
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such loan by pledge or mortgage of all or any part of,m~ pr~perty
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'n.c....ry irt.trumenti to carry out such powers; to ,!fA-
trihute ray estate In kind or pHrt.J v in monev or f!lll.t Ly lnkld.nd, ,1nd to (Ie-
termine the fair value Ilt which Ilny property /HI di8tt:ihuted in kind shall
be received by the di8tributf.l<Js; to conouct any busineea in which I have
lIn intereFJt at tho time nt' my rll'(:cuIH., (OJ /11(['11 pnr10d 89 he m.,,)' til\em p,.'n..
per, power to borrow mOTley Hnd p1n(lg(> tlw 1l/llJf;tn of the hUflin(,BR Clnd the
power to do all other /lcts that I, in my lifetime could have done I to dele-
gate Buch POWL"" to any partner, mllnt/f!:(lr, or employe!! without Hahility for
any loos occuring therain and to organlze a corporation to carryon sll:l.d
business by itself or jointly with others and to contribute all or part of
said business as capital to such corporation /lnd accept stoel< in the corpora-
't10n in lieu thereof and hold such stock f:or the uaes of this my Hill, and
to vote said stock or to sell the Bame as to him may seem best; to retain
1111 stocks, sssets, bonds and inv/!stments owned by me without being confined
to what is known ss legal investments; to execute any options to purchase,
to apply for stocks, bonda or other investments, to purchaae or otherwise
acquire real estate Ilnd to execute the saTTle pm'1(\rs theroover. as hereinbefore
provided; to retain indefinl tely any part of my aRsets, real or per!lonal,
wh:lch is or may become unproduct1.vo or to make salo thereof; to ray carrying
charges and expanses of the property out of other principal or income of my
estate. . The powers hordn conferred shall be to my named Executor and said
Trust'}!! and all SUCC8SROr.a thereto,.. /lnd shall bl!llnaddition to and not in
ltml tl'1tion ~f other powers llonferred on said fiduciaries.
IN lI'ITNESS WHEREOF, I I IJqRTS ROSALIE MAYFTEI,D. hava to thh my
LUBt lvi]:1 !lnd 'l'~stament, tvP(!wr:l.tten on four (4) sheets of paper. numbered
cOntlec;utively, signed my name at the bottom of all paRes hereto f.or the pur-
pose of :l.r!lmtlfication Rnd at: the (md hf.'l'eof. eln nagf' thl"E'll 0) have let my
,
hll'IJd and seal this / ?
day of ~~J,1Hf- , 1977.
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MllIt"' :OSAT.IE ;!A1FTn~
SIGNED, sealed, pubHshe(! a"d declared by DOR!B ROSALU.; ~1AYnEl.Dj
THE above named Testatrix. on the If( day of . 5~J,s"- ,1977, 88 and
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CERTIFICATION OF NOTIC~DER RULE 5.6/a).
Name ot Decedent I :J)/Jt(}.S
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I'1Avhdd
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Date of Death: if 11A," /1f1'7
Will No. .':J.I9'1.0'l.J.J_.__..Admin, No.
To the Registerl
I certify that notice of beneficial inter~st required by
Rule 5.6(a) of the Orphans' Court Rules was served on or mailed to
the following beneficiaries of the above-captionec\ estate on
~ hAY '97'J I
Name
Kyle V. /1-tyhd)
XtW/~ 1<. l"1V~/J
Kt<,{'{;A/ L. ftt,1yf,JJ) ~,II
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KII/lP.V ;1. (ft,yf: cU I &),/1 11)
Addr!,!!
,oj /?II1At1/J1I.. I .AleM cl/l"1g,l"I.!Jo</d 170 'J()
A'~~ .~();(..2~/ ;1/dltllorr;-; ftf, 1'107'/
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5/7 ff'ltsr. MoIC"113#1./04~~. /7,,'10
7/.$~ h.sJ.lt;y (peeK I). HeJo/ Cv"'&.4.~&
Notice has now been given to all persons entitled thereto under
Rule 5.6(a) except #/,4
Date: JJ'"tuy 199'1
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Name ~,Ih A. 11.4",hJ~
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Address 7()R'3 ~c,.$'&t. I'~
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Telephone (30/) 7J7. \'J().l.8"
Capacity: / Personal Representative
Counsel for personal
representa t 1 ve
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",V "00 "'110011111 '. REV-1500
~~\(COMM(JtfflEAllll of PENNSVLVANIA INHERITANCE TAX RETURN mr HI'Mar"
"/ DErARIMENI OF REVENUE ,{ I I I! '} I Ij.r, 3
IIAl1f11Sn~~[.r ~~O~~,'200601 _____RESIQ~f'nJ~~c;IPJJ~T_,-='-.>_o~'.!rL'9_QJi~L ~!.IL
I orcrrrE'N'l"'rfTlOOrllA5 " fIRST, AmrmOlltt1mTtM1tiift""'ilitili\-lilOi:""TOt.ji.I.I.' i~olir,' ._.._u.._"." -~- -. ----~--
MAYFIELD DORIS R.
~tlAI.. ~ WJM8E11 [iAfE07 nfKfll - - - -- - -- ---- J--OAli"Of-in~-- I
355-30-5147 I 05~ 15- 9') 09-30-32 -L
l'~r~li~~urSUfMVlt1G srousels N^MEl~^N()lS(l(lAl s(clfnii;t N. lIMn!Ji - - -.-----r;;..-;;;;;;;;;; Mu~r II miD IN DU""CATI WITH ~.--
N/A L REGISTER OF WILLS
j:! [1'] 1.0rlgln,llIttuHl [] 2, supp~",.nt'I~:;:------- [:~ J.llllllllnd.r Re1um (d.l. oj d..lh prlOl' to 12.138~)
~ ie [] 4, llnlll.d est.tl [.~] 4a. ~utllrs Inlllllt COmpf(ln\Q, (d.I, III <ru,h .11. 12.12 Ul [~~: 5 fed.,.1 htl', T,. R,lum R.quir.d
~ ~~ ~~,] n. O".donl O~d 1..1.,. I"'" "". '"'I [] 7. D.codonl M""IoI",,, . IM"g Trull ",," '''' of """I _. J 8, TM'I Numb., of 5,1, Otpotlt Boil'S
~ L..l 9.lrtfQfllOn Ploe..d, R.cllvtd [..J 10, Spousal Povlnv Cr.dit ldll.Qfdu'hb.fWtj/\ 11.JI'li,nd ',1.") L: II. EItc:tIot1 to t&llllnd., S.o. 911J(AllAll.IcIl5c1l01
THIS SECTION MUST BE COMPLETED, ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
I NAME COMPLEIE MAlllNO ADORESS
KEITH A, MAyrIELD
FIRM NAME (If AP\lI~lbl.1
Z 16.
o
~ ~ 17.
..~
8 IB T.. Du.
__ ~ CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
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0"1(L4I. Uti ONLY
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THEPHONElWm-ER
130117:07-302B
70B B CAR?ENTER ?ARK
?ATtJXENT RIVER, HD 20670
1 Rill Estala (Schedule Al
3, ClosolV Hold Corpollllian, Par1neuhip 01 Sole-Proprlelolship
(11
121
131
1--
141
151
1-.
161
(71
~-
84.900
17,640
O"IClAl. use ONL v
2. Sloch and Bonds IScherlule 8l
z
o
~
E
~
C.l
w
a:
4, Mongag!!! & ~Jotes Receivable (Schedule OJ
6. Cash, B~nk DepOSits & Miscellaneous Personal Property
ISch,dul, EI
6. Jointlv Ownfd Pfoper1y (Schedule Fl
7 Inte,.vivot. Transfer & Miscellaneous Non.probah~ Property
(Schedule G or L)
8, Tot'" Grollf Anetlllo!.1 Lines 1.7)
202.524
(61j
9. FUnllutl Expenses & Admin~Walive Costs (Schedule HI
191
26.770
242
1111
1121
27 012
175.512
10, DobIs 01 Decedent, Mortgago Ullbilities, ~ Uens (Schedule II (10)
11. ToteIO.ductlon. (Iolal Unes 9 & 101
12. Net VelUM of Eotllt.lLinll 8 minus line 111
13, Charitable and Governmental Bequests/See 9113 T,UsIS for which an election 10 181( has n01 been 113)
made (Schedule Jl
14. Ntt Velull Subject to Tlx (Line 12 minus Lift. 13)
(141
175.512
--
16. Amount 01 line 14 talCable
.t the spousal tllC rale
See instructions on revelle
Amounl 01 lill" 14 tall.ble
at 6% rala
Amounl of Une 14 IUlble
a116% rile
-ere
1151
""I
1171
1191
'jj
10 531
sidfl
lIybl"
PlI,ClIfIIll!lll
175/512
.06
.15
ADDRESS ? , O. BOX 662
LEONARI2.'!'OWN, MD 2.Q.65 0
"'iiAii
V~ft!
lW46n 2 000
Oeoodont'm Completo Address:
~C/~' ~~:i:~nA;~A~ ~Y~~'_~~,-[J -- ______n
708 B CARPEN'rER PARK
,IlY ------ ~e ~
f~Ty,!(!'J:I:r. RIVEH ________~_________J!!Q.______ 20670
Tax Payments and Credits:
1. Tax Dll' (P,g, 1 Line 181 111
2. Crodlt,/Paymentl
A. Spoll.al Povarty Cr.dlt
J
10,531
B, Prior Paym,mts
C, Di.count
9,000
450.
Total Cr~dlt. (A + a + CI 121
9,450
3. Intarllt/Penalty If applleabl.
D.lntar..t
E. P,n.lty
56
Total Int.r..t/Penalty (D + EI 131
4. II lin. 2 I. gre,ter th,n lin. 1 + Ilno 3, .nte, tho dllf."ne., Thl. I. th, OVERPAYMENT,
Check box on Page 1 Line 19 to requost a refund 141
56
S. If IIn, 1 + line 3 I. groater than line 2, anter the diff."nea. Thl. i. tho TAX DUE.
161
1,137
A Enter the interest on the tax due.
(SAI
B. Enter tho total 01 Lina 5 + SA. This i. tho BALANCE DUE, ISB)
Make Check Pavable to,' REGISTER OF WillS, AGENT
1,13~
PLEASE ANSWER THE FOllOWING QUESTIONS
BY PLACING AN X IN THE APPROPRIATE BLOCKS
1. Did decedent make a transier and: Yes No
a. retain the use or income 01 the proparty transferred; .'".,....,..... .D [K]
b. retain the right to designate who shall use the property trans/erred or its income: ILi [XJ
c. retain a reversionary interest; or ......,..., t , . , . . . , . , , . . . . . , . C [K]
d. receive the promise for life of either payments, benefits or care? ".,.... , . . [, [K]
2. If death occurred 011 or before December 12, 1982, did decedent within two years
preceding death transfer property without. receiving adequate considoralion7 If death occurred
after Decomber 12, 1982, did decedent trans/E1r properly wilhln one year of death without
receiving adequate consideration? .......,...",.,.....,.............. C [!]
3. Did deced9nt own an -in trust fori or payablo lIpon death bank account or securiw
at hi. or hor ...thl . . . , , , . . . , . . , , , . , . . , , , . . . . . . , . . . . . . . , , . . .'['J [l<]
4. Did decedent own an individual retirement account, annuity, or other non-probate property7 . ..C ~
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES,
YOU MUST COMPLETE SCHEDULE G AND FII.E IT AS PART OF THE RET1JRN
72 P.S. 89116 (a) (1.1) lil provided for the reduction of thll tax rate impoS€ld on the net value of transfers to or for the use of the
5uIVivlng spouse from 6% to 3% for datos of dOilth Oti or aHer July 1, 1&94 al1d befora January 1, 1995.
72 P,S. 99116 (al (1, 1l (ii) provided for the roductlon of the rate impClslld on the nel valuEJ of tr&nsfen to or for the USE! of the surviving
spouse from 3% 10 0% lor dat9s 01 death on or aftfH January 1, 1995. The statute does not exempt a transfer to ar surviving spouse
from tax, and the statu10ry reqwrIJmen1s lor disclosure of assets and lilmg a tax return aro still applicable even if the surviving spouse
is tne only benefiCiary.
FOR DATES OF DEATH ON OR AFTEI1 JANUARY 1,1995. PI.." .nswar tho lollowlng quostlon by placing an "x' in th,
appropriate space.
Did the decedent create. trutH or similar IIrrnngomoflt which ill solely for th8 surviving spau..'a boneftt fo~ his or h., entire
nlotlme7 Yea [] No [LI
It you answerod Yf\r. to the. above question. tho tax on the trust or similar arr~ngoment is postponed until the death of thl s.cond
spouse, at which time it will be fUlly taxable at th9 rllte(s) applicable \0 the remainder benefic:iary(ies). Ent.r lhe vIllNl "f thl trust on
Schedule J, Part II, in order to remove it from the calculation of the tax duo in this estate, Vou may wish ~~l fill Schedul. 0 In order to
makl tho election available under Section 9113, II the election is made, the trust or similar arrarllJlmtnt is tlXed in the IStlte af th.
first decod9nt SpOUse, Ih.. portion of the trust or similar arrangement which benofits the surviving SpCllIS' is taxed It the zero t.x rat..
and thft r~majnder is 'laxed at the rato(s} applicabl8 to the remainder benefic:iarylies), If you choon to make the election, you must
attach Schedul. 0 to a timely.filed tllX return, along with Schedule(5) K and/or M In Older to show th, apportionment of thfl trust or
similar arrangement b,tweon the surviving spouse and thl remainder bem,ficiary(iesl,
7W4Uo\2,QOO
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I ) P~yo J 01 '---
SAFE DEPOSIT BOX INVENTORY
INSTRlIctiO"~S ... u. ..
11) Co';h: ~"pOII 10)101 6"ly
(21 Stocks.; lis.1 in dulorl O'll1fY cornmon or pr'Jlorrou cortihw!o, 'Narronl or orhlJr rI~lhl'i found in box, Stuck,. orll
10 bfJ des.ignatod by nomu of company, certificate numbor, dOlO of cOrlifi(oto, nomo in which stock i, regislorod,
r.Hld number of shoree. C10d deu\ of ,tock
(3) Obligations 01 U, S, Gov.rnm.nt: Numb.r of iloml, doto of illUIl, loco voluo, nomoI in which rogill.red
and Iype of owne"hip, i.e" loinlly h.ld, poyoble on d,olh, ole.
(4) Bond" Oe.lgnole by nome, omounl, .er;ol number, or other do"gnolion IBeorer Bond'l
(5) Bank and Savings and Loan Pallbaak" Stole nom, of depo.llor, number of book, lo.t dote appearing In
book, nome of bonk and branch, and balance.
(6) Jew.lry, Coins, Stomps, Manuscrlph, etc: L1.t and d..crlb$ o. fully 01 pOlllbl.,
(7) D..ds, Martgag.s, Curr.nt Insuranc. Pollcl.. or oth.r .vld.nces ollrodebt.dn.II' li.t and de.~ribe a.
fully a. pOlllble.
(8) All oth.r cont.nh,
ITlM
NO.
ITEM DESCRIPTION
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I CERTlFy'UND;R'flTI!ALTY OF PERJURY THAT THE ABOVE RECORD IS
CORRECT A eMl'LITE TO THE BES MY KNOWlEDGE AND BELler,
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PERSON RECEIVING COPY OF
SAFE oOEPOSIT BOX INVENTORY,
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f.l\b.. II ______._ Oe'IOII Rtprl'lnla1ivt 0 Joint own.' of laf. d,polh bo/l,
NOTE: Attach addl'lonal 8111" )( 11" she.t (s)lf ""ceuory or use dupllc:atlS of .hls page 01 form.
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MUST8E COMPlETfO 8Y REPRESENTATIVE Of fiNANCIAL INSlIlUTION WHER~ SAH DEPOSIT 80X IS LOCATEO AND RI1URNED TO ASOVE ADDRESS
COUNn COOl fill NUMBIR SOCIAL SECURITY OR D~H CI.TlflCAII NUMI..
.:>SS' 36-S)ll7
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ADDRESS OP DICEDINT III ! f\ _ /" ICIT.y) IIII f) (STAll) II" COOII
~___}J_l~fl r UL. U.-{) __JiJL (/~ 170/'-
NAME AND ADDRISS OP PIR ON REQUISTING THE OPINING OP THI SAFEDiPOsiTaOX
jNAMfl
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NAME, ADDRUS AND ReLATION HIP IIF ANY) TO DECIDINT, OP PERSONIS) PRUlNT AT THI BOX OPINING
G. INAMEI.\. L II I' 1111 y&' f '1 IRe~7NIHI~
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SAFE DEPOSIT BOX
INVENTORY
IlTATEI
IllP COOII
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{STREET ADDRESS)
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NAME AND ADDRESS OF P1NANCIAlINSTlTUTION WHERI THE SAP! DEPOSIT BOX IS lOCATED
IN'M'~_al~ ______
1ST"" 'DO'ESSI II /7. I I J.I 'J. I\W~
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I -NAME OF P ON MAKING LAST ENTRY DAlE AND TlMI OF LAST ENTRY . --
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OAH OF CONTRACT TO RINT BOX ~ER OF BOX I' ---.mm~ UNO~R WHICH BOX).S R,IC;ISTUED
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NAM~ TiTLEOF EMPi:OvETAKlTHEiNiiiNTORY
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WAS A Will IN THE BOX? YEl If Y'" ft.
KECA-
Dole of willi ____
b. Name ond odd,... of p."oMal r.p,...ntatlve, If named in the will
INA.ME)
(STIlEEt ACOIlES!1
ICllYI
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IllP COO~I
c. Nom. and add,... o' Q"o,nev, If any
(N"MEI
ISlltUT ADDlU!SS)
((11V\
ISlATEI
flIP CODE)
Inv". ,cory 01 the real and personal eetate 0, .
Dads R. Mayfield
deoeased
L House, 2119 Wentworth Dr. Cl'ITlP Hill. Lot 33/ Highland Estatee, t.ower Allen
Township. Single story / 3 hedroaTl. Mortgage paid 5 Feb. 1990
2. Checking AceL !?NC Bank, P.O. Box 8874/ CCIllp Hill, pa 17001-8874
Acct. No. 51-4004-2272
3. Savings Acct. PNC Bank, P.O. Box 8874/ CCIllp Hill, Pa 17001-8874
Acct. No. 50-0080-3877
4. 1996 Saturn St.!, 4 Coor Sedano VIN 1G8ZH5285TZ270027
5. prepaid furla1 Plan, Rolling Green Cffi1etary, 1811 Carlisle Rd., CCIllp Hill,
Pa. 17011. (Plot 2100, Block N, Casket, MonlJ1l8nt, Installation, Grounds C
6. Money Market Acct., Government Mortgage Fund A, MFS Investment Management,
P.O. Box 2281/ Boston, Me. 02107-9906. Acct. No. 310110B184
7. IRA, The Hartford, P.O. Box 30197/ Hartford, Ct. 06150-0197
Acct. No. 130036447
8. Mutual Fund, Putnan Investor Sex:vices, P.O. Box 41203 Providence RI 02940-
1203. Acet.No. A25-1355305147B882
$84900 00
$ 2555 98
$10051 B9
$10500 00
$ 30B9 36
$ 6014 142
$30851 17
$35378 98
9. 10 $1000.00 EE Savi.ngs Bonds (SIN's M55186777, M55186778, M55186779, $17640 00
M55186780, M55186781, M55186782, M55186783, M55186784, M55l86785, M55186786
2 $10,000.00 EE Savings Bonds (SIN's X24l2802, X24l2803)
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COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
"1
.~-....-"-'" ..~..~-,.'-'"-"._--~.... -,.~. .-.. -.--..--. .~ ---.-;<..- ~---._~._-
beln9 dulV __.._~~..!ll._ ._., ,_ .eeordlnq to I.w, depou. .nd say. Ih.t h. KAith A. M"t:.rl'ip.ld
"EX8CULor,.--..".. "-~ 01 tho E.lel. 01 Cod; R. Mayfield
let. 01 ._,~119 .Wf!ntwor:t:h PL. Cl,lnp"UH1.....__....___, Cumberland County, 1'.., d.c....d end ih.I Ih.
within I. an Inv.ntorv m.d. bV ._....KElith.A.j\~eJ.d._ ,.__ ,_,__, th. .eld. EXecutor ___
01 th. .ntlr. "ht. .1 said d.c.d.nt, con.l.lln9 of .lIth. p...onal prop.rtv .nd real ..ht., exe.pl real oshte outsld.
the Commonw..lth 01 P.n",vlv.nl., .nd thet the 119urol OppOIIt. each lI.m 01 th. Inv.ntory ..pr...nt il'. lelr valu.
as 0' th. date 0' ::::::nt'l d..th. /{~,~ fII'7P
.. ..__.....____.._,......__... and lublerlbod b.lore mo,
KeithA. Mavfield
e..eufor . Aclml"ht,.fo,
I(rlal'a J. 1l.11npillR
._......_~._, .m___._.~.._...
1.'1', .IAue. USNR
I 0 lJ, S . G, 10/,4 (a) .
"-~{-OOJ=O(' ~
19 97
7088 Carpenter Park
PAnn<p.nt River. Mrl ?Ot;70
Addr."
J
o.t. of O..th .__.
15
~a.L.-_
Month
1997
Doy
Y..,
INSTRUCTIONS
I. An Inv.ntorv mUll b. /II.d within Ihree mont.hl a/ter eppolntmenl 01 p.rsonalrep,...ntatlve.
2. A luppl.m.nt Inventory mUlt b. Iiled within Ihirty daYI of dllcovery 01 .ddltlonal us....
3. AddItJonallh.." m.v b. attaeh.d as to personalty or ...IIV
4. S.. Artlela IV, Flduel..Jos Act 01 1949.
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LAST WILL AND TESTAMENT
-'-
OF
DORIS ROSALIE MAYFIELD
---
I, DORIS ROSALIE MAYFIELD, a resident of 2119 wentworth Drive,
Camp Hill, Cumberland County, Pennsylvania, being of sound mind and memory,
do make, publish and declare this to b~ my Last Will and Testament, hereby
revoking all Wills and Codicils heretofore made by me.
my funeral expenses including a suitable monument at my grave and the cost
of administration of my estate be paid as soon as practicable after my death.
I direct that my Executor payout of my estate, as a general charge thereon,
all inheritance, estate, succession and other taxes together with any inter-
p.st or penalty thereon assessed by reason of my death with regard to all
properties and assets subject to such taxes, whether or not such property
Il'El!~
I direct that all of my just debts,
and assets pass under this Will.
rest, residue and remainder of my property, real, personal or mixed, tangi-
ble and intangi.ble, of whatsoever nature and wheresoever located and all
property to which I may be entitled to or over which I may have any power of
disposition or appointment and whether acquired during or after my lifetime
to my five children, KEITH ALAN MAYFIELD, KYLE DEAN MAYFIELD, KEVIN RICHARD
HAYFIELD, KRISTIN LYNN MAYFIELD, and KAREN MICHELE MAYFIELD, in equal shares
ITEM II.
---
I give, devise and bequeath all the
per capita, absolutely and in fee simple provided that he or she survives
me by ninety (90) days.
I TEM I II .
I declare that it is my intention that:
the provisions of this instrument be applicable to my children now living,
and not as to my children hereafter born or adopted, if any. I declare it
my intention to make no further provisions for any child afterborn or adopted
and the provision made herein for KEITH ALAN MAYFIELD, KYLE DEAN MAYFIELD,
KE.VIN RICHARD HAYFIELD, KRISTIN LYNN MAYFIELD and KAREN MICHELE MAYFIELD
shall not be abated or otherwise affected by reason of the birth or adoption
of such child.
,.
.
CJ
ITEM IV~ In the event that KRISTIN LYNN MAY-
FIELD and KAREN MICHELE MAYFIELD are minors at the time of my d~ath, that
II to say, under the age of eighteen (18) years of age, then their respec-
tive shnres of my estate shall be held in trust by KEITI! ALAN MAYFIELD, my
oldes t son, 1'he sald KE ITI! ALAN MAYI1IELD shall have the power to inves t
IMid ohare of my estate and to utilize the income and principal for the
cnro, maintenance, education and support of either or both of said minor
(lhildt'en, it being my intention that KEITH ALAN MAYFIELD act as guardian of
said minor children until they reach the age of eighteen (18) years of age,
Upon the minor children reaching the age of eighteen (18) respectively,
then the balance of my estate held in trust as their share shall be paid in
full to the respective children, to be their sole property therewith,
ITEM V. For all purposes of this Will and the
disposition of my estate hereunder, adopted children of mine and their ~sue,
whether or not adopted and adopted children and their issue, whether or not
adopted of any descendant of mine shall be considered and treated in all re-
specta the same as children born of marriage and thier issue,
ITEM VI. I hereby nominate, constitute and ap~
point KEITH ALAN MAYFIELD as sole Executor of this my Last Will and Testament,
In the event the said KEITH ALAN MAYFIELD refuses or is unable to act for any
reason, I then hereby nominate, constitute and appoint KYLE DEAN MAYFIELD as
sole Executor of this my Last Will and Testament and I direct that no bond
be required of my Executor,
ITEM VII. I authorize and empower my Executor
and said Trustee to compromise, adjust, release and discharge in such manner
as my Executor may deem proper, all debts and claims owed by or to me or my
Estate; to sell, lease, or exchange, at public or private sale or in such
manner, at such prices, and upon such terms of credit or otherwise, as my
Executor or said Trustee may deem proper, all or any part of my property, real
or personal; to execute, acknowledge and deliver instruments of conveyance,
i,ncluding deeds in fee simple; to borrow money for the purpose of paying
estate, inheritance or other taxes which are required to be paid and to
secure any such loan by pledge or mortgage of all or any part of my property
- 2 -
and to execute the necessary instruments to carry out such powers; to dis-
tribute my estate in kind or partly in money or partly in kind, and to de-
termine the fair value at which any property so di.stri.buted in kind shall
be received by the distributeesi to conduct any business in which I have
an interest at the time of my decease, for such period as he may deem pro-
per, power to borrow money and pledge the assets of the business and the
power to do all other acts that I, in my lifetime could have done, to dele-
gate such power to any partner. manager, or employee without liability for
any loss occuring therein and to organize a corporation to carryon said
business by itself or jointly with others and to contribute all or part of the
said business as capital to such corporation and accept stock in the corpor&-
tion in lieu thereof and hold such srock for the uses of this my Will, and
to vote said stock or to sell the same as to him may seem best; to retain
all stocks, assets, bonds and investments owned by me without being confined
to what is known as legal investments; to execute any options to purchase,
to apply for stocks, bonds or other investments, to purchase or otherwise
acquire.real estate and to execute the same powers thereover as hereinbefore
provided; to retain indefinitely any part of my assets, real or personal,
which is or may become unproductive or to make sale thereof; to pay carrying
charges and expenses of the property out of other principal or income of my
estate. The powers herein conferred shall be to my named Executor and said
Trustee and all successors thereto, and shall. be in addition to and not in
limitation of other powers conferred on said fiduciaries.
IN WITNESS WHEREOF, I, DORIS ROSALIE MAYFIELD, have to thi.s my
Las t Will and Tes tament, typewri t ten on four (4) sheets of paper, numbered
consecutively, signed my name at the bottom of all pages hereto for the pur-
pose of identification and at
hand and seal this /9 day
the end hereof, on page three (3) have set my
of S€/JIPH hBI(.. ,1977,
,
ImR1f'tisAl:h~~Y~I~L~a#~
SIGNED, sealed, published and declared by DORIS ROSALIE MAYFIELD,
THE above named Testatrix, on the -Li.._ day of C';ffA>Hbl.3llt. , 1977, as and
~ 3 -
cnHHON....A1 01 or flfNNSYIVANU
~I~, II A,' I ~,~ ,II , Of III \If NIJE
I\URFAlJ or IHr>lvllllJAl IAll'[S
(Jt:riT. ,'111)601
HARRISBURG, I'l 111 ~a'Ohol
'i~~'~
r'?oJ.;l~tl)
'J.4~J~
INFORMATION NOTICE
AND
TAXPAYER RESPONSE
FILE
ACN
DATE
NO. ;> 1 .r II
'JlL\(d6(,
08-09-97
1/53
lIi.ll.III." !I.HI
-'
,_u\r.._.'-"'..".......,.._~."...,..,FI.._.......=-."""'...~_.-._...._...'-'U..~~~-.,,;O=-. ._--........,...."--~~."',,..
TYPE OF ACCOUNT
i..!J
EST, OF DORIS MAVFIELD
S,S, NO, 355-30-5147
DATE OF DEATH 05-15-97
COUNTY CUMBERLAND
SAVHWS
'X: CIlECKING
TRUST
CERTlf,
KYLE n MAVF.tELD
2119 WENTWORTH DR
CAMP HILL l.' PA 17011
REMIT PAVMENT AND fORMS TO,
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
PNC BANK \ t1fI~.prc;v~ded the Oepllrt~ent with the IMornetlor. 119tllcl bolow which hns hoen uud In calculntlng the
potgntllll tlll(' due. 'holr rocord. .In(:l1:Silto that at tho death of the nbove [lecedenl, 'IOU were it joint o...ner/bQrull'lclary of this <'lccount.
If yOU Isol this Information ill Incorrllot, plellse obtain wrltton corrdctlon from the financial Institution, attach II copy tn this for",
llnd return it to the nbolle nddress. This lI('oount I. ~axrtnlo In Ilcenrdance with the InhArltnnco T~)I Inw'l of the I;Ol'll'u')nW'IlIlth of Ptln'l!;'/lv1H,I~.
I::....t l",,~ ".... .... ..,,~...., otu UI ..ull.l"jjj (71.7l ;07 u:'Z;',
COMPLETE PART 1 BELOW
Aceount No. 5140042272
. .
. SEE REVERSE SIDE FOR
n.to 02-01-75
Establish.d
FILING AND PAVMENT INSTRUCTIONS
Account BRlance 2,520,24
Perc.nt Taxobl. X 50,000
Amount Subject to Tax 1,260 , 12
Tox R"t. X . 15
Pet.nUol Tox Du. 189,02
PART TAXPAYER RESPONSE
COI FAILURE TO RESPOND WILL RESULT IN AN OFFICIAL TAX ASSESSMENT BASED OM THIS NOTICE
A. n 'he abOll9 information and tllx cluo Is corroct.
'----.J 1. You M<lY choose to r91111t p<lY"lont to thl Rogistor of Irlills \.lIth tOlO coplos of this notice to obtllln
1I dlSCClunt tit. avoid Intorost, or YOU Play checl<. hox "A" <'Inti rohlrn this notlolil to tho ROl)I..tor 0'
I # Wltls and an offlci<ll ilSSe51n111nt will be Issuod hy thll PA UIilp6rtl'llnt 0' Rovenull.
:r~~: ~ . . ~ 'h. obo,. m.t ha, bo.n 0' will ,. ,opo,". .,n. t." p,l. with tho P.nn"I'M" Inh."I"n" ,.. "tum
L... ONLY. . to bill filed by the dQclldont's roprnsllntatlV6.
~.Q...u1JV).) c. J The abovw Inforlll8tion l~ncorroct /lnd/o~obts Md dAductlons were paid by you.
P '1'ou lIlust t.ollplet. PART, 2 I <lnd/or P,UlT I ~ belo....
.-- --
PART If YOu indicate a different tax rlt., ph... stlt. youI
~ relationship to doc.dentl__
_....J
TAX RETURN. COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS PAll
LINE I. D.to EstobUsh.d I 1
2, Account Bahnc. 2 2
3. Percent Taxabl. ! w: 3
4. Amount Subject to Tax 4_ 4
s, Debt, ~nd D.du~tionl 5 5
tJ, Amount hxabh 6 6
7, rax Rat.. 7 )( 7
8, rax Due 8 8
DEBTS AND DEDUCTIONS CLAIMED
To Insure proper crodlt to your /lecount, two
III coplas of this noUell nust <'Iccol'lparw your
piWl'lent to \ho RIIgIst9r of Wills. Hnko chock
pllYllble tOI "Register 0' Wills, Aglnt".
NOTE: (f tllx plly",ents t,ro mado within threo
(31 months of tho declIdant's Cl3t8 of dOllth,
you ",ay dClduet a 5% discount of thu tax due,
Any Inher I t'1nco tdX (lUG will boeome do I inq\lf~n t
nln. (9) /IIonths after tho data of doath.
OFFICIAL USE ONLY 0 AAF
PA DEPARTMENT OF REVENUE
PART
~
DATE
PAID
PAYEE
DESCRIPTION
AMOUNT PAID
TOTAL (Enter on Lin. S of Tlx Comput.tionl
facts I have reported above .r. true, correct .nd
~OME ()O) 22iL.Q ,)-'l.P:__ _ _
WORK (7/ 7.) 7 'I / '-/6.3 IQ~-;;.{;'\
TELEPH6NE NUMBrR ' ~
-
,
GENERAL INFORMAIIUN
1, fAII.URE TO RESPOND WILL RESULT IN AN OffICIAL TA)( ASSF;$SHF.NT wlttl 1lllpllcr'\ldq IHlfrut hlllflll \Ill Infm'l'Il'1UQIl
~uhMllt.d hy tll. IlIlflntllll In.tltuttOI1.
" In!lerltaf\fHt t$x 1111&011I115 dulltlf11l4llnt t,lnll "n!\lh~ Ilf\\1r' tllfI d4lt(HIt!nt'~ 11'lln of fl'"I\I\,
j, A Joint IIccoun\ I, tllJ(l\h!li lIvnn thnulIh IhM 11t1C'lIhUlt'~ fliHrll. WIIG Ilrl(!I1l1 ;19 ;1 1'\111 tor ul c:onvAlltonllll,
fl. Acc:tllm\!! {Iflllhnllf,ll thon "olel IHllwQon l1ulihllntl MId wlfol whlth 11111 clncmlnnt tllll 11\ jlllnt tlMlU wllllln {!flll ynnr f1rlflf to
dlll'ith Mil fullv In.<'IlIlo '" Irfl",.h,n,
11. AtHlOUtltl ..stl1bl!,hQd jolntl.,. ll.twaln hUillllnd tlnel \oIlf" MorD HIlIn uno yo"r fir lor III dOlltt, lire nul IRICIlhlll,
6. ftCf;iJunh 11AIlI hv II IlfteAd.fi\ "\" Irlllt for" Bnothlr or utlHlrs <lrU tn~tlhlo fUllv.
REPORTING INSTRUCTIONS
PART
1
TA~PAVER RESPONSE
IHoel( A . t' thll !llfo""'f1tlon find ClIlIIPutstll'Jn In tho 110tlcII ilro corn~ct llnll thlduc\ltlns tJro not hel"lI clnl!'lldj pl,lu:;, tm"I("
In blol.llo: "A" {)f P~tt 1 M th. "TflI(JHlv.r RQsponn" section, Sign two coplin Ilnd subllllt lhll", with <,lour chock for the l'Ift1Qunt of
tal< to tho ROIIlstGr of Wills of thl county lndlcntud. lhe fl411llPnrtllllnt or PllVllfliJo will tHUQ an official 1I1ieilm<<lnt
(f'orfll REV'lS4& E\(l upon receJpt of lhe rolurn (r()lIl th~ Rolllstor of Will!!,
Z, BlOC-K S . If tlul flint "hlclfled on thl~ nolttQ IIns been or OIllt bl roportad anti t!l~ Plllel with thl Pflnnsylvnnln intl.dtMet
Ti'll( Roturn ,llod by the dacCldont's I'oprountlltlvo. '1Inc. 1Jn "X" In hiDe'" "8" of Pnl"t I 0-1 Iho "Tal(payar RUPOfl'iIt" 5Iotlon, Sign "".
copy lIorl rlftur" to the P4 Oaparttrlllnt .~f RI1VlnUIl, Ruretlu of Individual TMU, Dtlpt 280601, tt.nrrlsburg, PA 11'126-06011" th.
onvetope p,ovldftd.
3. BlOCK C l' tho notice Information I! In{'urrllct "nd'or dedllctlnnl 11r'! b'llng 1\ 1 ,dllll\cI , r:t"~ck hlo~k "r:" ill'ld ct.>mpll'itll Parts i' and:5
according to .ml Instruction" belOW, Sign two cUPles nnl.i Iiullmlt thel'l\ wittl your chiCk fal' trllt IlRluunt at laIC ~llIYju,dw HI litw R"vi~l"r
of wills of thl qountv lndlGlIhd, Thll PA Depllrtllent of RllvenUII wIll Issue lln nfflchl! nSStlSlIlllnt (For", ReV-1548 EIU upon rltellpt
of the nJturn frolll the Roglltor of Wills,
TA~ RETURN - PART
2
TAX COMPUTATION
liNE
1. Entor
NOTEI
the date the nccount originallY was estllbl11hod or tltlQd In tho ~8nner olClstlng at date of death,
for PI d9cedent dying nftor IUIZ/tl21 Acco\UHs which tho docodont Pllt In JoInt nam8ll within one (11 YOM of doath arq
hlCllble fully all trnnsfers. tlowe"er, thero Is nn e)(cluslon not tC1 tllCelled $3,000 per transhlree rogardless of tho vatuiII of
the ocoount or the number of <'lecounts held.
If a doubh flsttrhk (MIl) llppears befor'l your first mllllQ In the nddross portion of thl, not1ce, th. $3,000 e)(ohlslo!'1
already has baCtn dllducten fl'olll the aCllount balilnco as reporhld by the financial lrutltutlon.
2. Enhr the total balance of the llec.\lUnt Including InterGSt aecr.lJlld to the date of death.
3. The p.rcent Qf tho account that 15 taxable for oach survivor Is detDl'mlned liS followil
A, The perc.nt tllx8blt for joInt assets uhbllshed "'oro than one Ylll!lr prior to tho decedent's death!
DHHDED BV TOTAt NUMBER OF OI\lIOEO BV
JOINT OWNERS
EIC8mplctl A joint IlSset roqistflrod in the nalll. of
TOTAL MUH8ER OF X 100 Pl:RCENT HXAIUE
SURVIVINO JOINT OWNERS
th'l d'lcedent nnd two other persons.
I OIVIOEO BV 3 (JOINT OWNERS> DIVIDED BV 'l (SURVIVORS> . .167 I( 100
16.1% (TAXARlE FOR EACtl SURVIVOR 1
B. Thn pareont hlCllble for aUllts erlllltod within onll yellr of the decadent's dOi'lth or Becount' o"lnod ~y the declldent but htlld
In trust for another lndl...iduaj(s) (trust benlflclariosl:
I DIVIDED BV TOTAL NUH8ER Of SURVIVINO JDINT
OWNE.RS OR TRUST !lEHEflCIARIES
I( 101) . flERCUH TAXABLE
ElCaMPlo: Joint account registered
the decedont.
I DIvIDED !IV 'l {SURYIVORS1 It ,!to
In the nllllle I)f tho deCIIUIf1t llM two other persoM and u\6bUshtd withIn on. year of d8llth by
100 ~o% {TAXA8lE fOR EACH SURVIVOR}
4. T"e uount subject to t/l1C Illne 4) Is deterllllned by lIlultlplylnG the /lecount balllMt (lio. j!1 by the perelnt tU,1fble (lln. 3),
CO, "~,hlr th" tnt,f\l of the debt~ 'tnd rj'"!:ldlon~ 11.,lnrl In Oart ~,
b. The i\lllClunt t/l_llble flln" b! Is oClturl'lined by subtracting the debts And deductions Illn. 5>) frail! the "Maunt subject tata>c {lint 41.
1, Enter the approprlllte tlllC r~te (lino II 115 d"terllllne(j tullow.
A. ror d~t8S of death OCC\lrrlng after b/30/'l4, the ti'l. l'i'ltllJ lor transfers to spouses "ro ilS follows:
1. Ollt(l'i 01 duth on or ~fter 11l/Q't nnd be for II l/l/<l!l tho ratll Is .5%,
l. Datu Of death nn or After llllq!l transllrs to lipmlUS will bo tlllCed lit 0% ~"IC rattl.
Nohl For d.!ltflS of de"th pr lor to 7/1/94 transfers to SPOlfSlIS are talCllble at 6%.
8. Transferll \0 lineal dliUcondants If\Chldlng IIIlher, ,..other, ~on, oltughter, !)rllndChlldren, son"ln-law,
dllughhr'ln'lllw, stllPchlld <tfld their lnue are tnlCoblD ilt sl~ pltre.nt {li%l.
C, Transfers to all othllrs Illcludlno brother, slshr, lInde, Aunt, n.phllw and rd.cllI arA talCable at fiftelln percent (l!i;.n,
D. If YOU change tne tal< rate, phase speelfy YO~lr rcdatlon!lhlp to the decedlilnt In the area provided,
a, The &lIlount of talC due (line 81 Is deterfldnlld by ,"wltlplylng the <lIlIount t"'lCnble {llnli 61 by the t.alC rate (lll1e 11.
CLAIMED DEDUCTIONS - PART
3
OEBTS AND DEOUCTIONS CLAIMED
Allowablll dtbts and doductlons Me (llt.rllllned <'IS lollows:
A, You l"I,l/illy are responsible lor pltYfII"nt, or th~ utatl SUbject \0 nt,lllllr,lstrntlon by II personal repreuntlltlv. It InluHlllllnt
to plly the deduetlhlll Itltllll,
8. \'ou actually paid th. debts llHlIr death of thlt d.c.donl Ifnd tun hlrnlsh proof of Plll/MenL
C, Debts b,ling clnllllerl fIIUlit blil Itulzod lully In I1I\I"t 3. If 11<I(lItlon81 \lp~Ce Is Illllldod, un plll~n paplr 8 112" IC 11". Proof 0'
paYllulnt ,..IlY he requ4lllted by the PA Dopartmont of Revenue.
TA~PAVER ASSISTANCE
IF YOU NEED FURTHER INFORMATION OR ASSISTANCE, CONTACT ANV
REGISTER OF WILLS. PA DEPARTMENT OF REVENUE DISTRICT OFFICE
OR CAI.L THE BUREAU OF INDIVIDUAL TAXES. TA~PAVER INQUIRV UtHT IN
HARRISBURG AT (17) 787-8327. TOOt (717) 772-2252 CfIEARING IMPAIRED ONLY)
I'
GENERAL INFORMATION
1, FAILURE TO RESPONP WIll RESUL T IN AN OFFICIAL TAX ASSESSMEN'f with 'lflldll1<ltllq InhlfD11 tllUiJd on ll\forllliltlul'l
~ul""lItltd by tilt! IIn"nchl lrutltutlon,
.. Intlflrltnnctf trlle IUt{)/JIIIUII dnllmlURnt nino flllflltlt Ilftnr ltHI dql.l'llllfll\t'~ drll.. of (lnll!!\,
.L ~. joint nct:ollnt Ii; l,lKllllla t!Vln though tllft dDcodlJnt'~ JWlIle WrlU t1lllhlll 'U '1 't;nUnr of convQnlonCQ,
4. fU1COllntw flncl\l(llnlj thou hold hatwnun hu~hl'nd nnrl \oIlffl) which 1110 IIflcndllflt put In Jlllnt t\llMiU within 1,111(1 '1flnf nflOf' to
duth <'IrO ful1'J (n)illtll. "II tran.fofl,
~. Atlcount. utabl!lIhtd Jointly lJ.tw..n 11u.bnnd ond wlft riOI'll ill"n ontl YIl,.r 111'101' to fhlllth Mil not llll(nbln,
6. Account. h.ld by II dlelHlent "In trust for" nnothar or nihil'" Ilfll \111(1lblo fully.
REPORTING INSTRUCTIONS - PART
1
TAXPAVER RESPONSE
1. 8l0C~ A . If tho In'forhlatlon /tnd CO/llputlltlon In tho notlclI IIrQ corrllci ilnd deductlonll ,lrll nnt helno clol,rJQd, riM' on ")("
In bloc~ "A" of pnrt 1 0; the "TlIKpnYllr Nupl)nlllrt ~Clctlon. 5\011 two coplu llnti lIubllllt the", with 'lour r.hlck for tlto ftllloynt of
tOI< to the RlIgllltllr of With of thfl countylndlenhd. Iho flA tJlljlilrtl'll'l(lt of Rovnnllll 01111 1I<"\le <In offlcl.,1 tluul"'en!
(f'orlll RE\o'~IS4f1 f.KI upon rGcIlpt of thll rllturn Irolrl tt\1l RltohtQr of Wills.
2. BLOCK B . H the nutt lIfl.tlnlld or, this notice has hOBn or will bt reported IInd lllw pnld ",Ith the r~lf1nsylvonl6 !nhClr'ihu,oe
Tnl< Return flhd by thll decedent'!! ropreuntlltlvQ, ,dnoe on "X" In block "1\" 01 Pnrt I Qf thCl "Tilwpnver Rlllpon~e" $ootlon. SIgn one
copy lInd return to the PA Dapnrt/llent ot Rltvnmle, Buroilu of Indlvldlllll TlIMU, Dopt 280601, Illlrrlohur", flA 17128-0&01 in the
onvelope provldld,
:So BLOCK C . If tt..1 notice Intorl'llltlon it Ineonool nmt/or dodue\:Jon, 1111I lltilno !.;\.lhrlld, tlW\1k hlock "C" tlnd c"nlplllte r,'rt!l :: <md .\
according to tht,lnstructJons below. SIQn two cop in nnd submit thlm wl~h your Chll(lk for the 1lI10Un~ of tall pay"!)!e to tho l('OlStllr
of Wills 0' the county indicated, Tho PA Oepartment of RovllmHI will Issue <'In official 1llSu.mtnt (for", R[V'I~48 El() uponrUllpt
of the return IroM the Reglstor of Wills.
TAX RETURN - PART
2
TAX COMPUTATION
LINE
1. Ent8r
NOTEI
the dah the llecount orlglmlllY)18S olltabllshed or titlod In the ~lann41r ol<J~tln9 llt dlttlt of thHlth.
For I'l dlcldont dyIng aftor 12llUa21 Acoount~ which tho docede"t put In Jolrlt nom9f\ within one (11 ~81lr of d.ath "ill
hKllble.fullii 81 transfers. However, there Is <In el<t'lluslon not to exocted ~j,OOO r~r trllns'eru rltllardleu of th" vllluo 0;
the IUlcount or th'e numbor of aC'.lollnh held,
If e double IIlt.rlSk {Mill appears before your first nomo In the addreu portJlln of this /lotloe, thfl ~:5,000 elColu!lJon
lIir.ady hns been deducted from tht account balanco liS r8j)orted by the financial InstItution.
Z. Enter ttlll tohl balonce of the account inclUding Interut aoeruod to ttle doto of dtllth.
3. Th8 PltrCllot of thll account that ls taxlIbh for El<'lch survivor Is dGttrlrllnad IlS ;0110'0111
A. The pllrc.nt tllllllble for joint ass.t, establlshtd more thon on8 ~ellr prior to the decedent's death:
DIVIDED BV TOTAL NUHBER OF
JOINT D~'NERS
EI<81l1pllll . joint asset registered
DIVIDED BV TJTAl NUI16E'R OF l( 100 PERCElfr TAXA!l€
SURVIVING JOINT OWNERS
In the na~e of the decedent and two other persons,
1 IHVIDED BV :5 (.JOINT OWNERS) OIVIDF.O BV 2 (SURVIVORS) . .16"' l( 100
16.7% (TAXABLE FOR EACH SURVIVOR)
I
,
IL Thll percent Ill)(''lbla for <Issets crei5t11d within one year of the clel1edent'.. duth or accounts owned bY thl dtoodlln\ but h.ld
In trust for "nother Indlvldu<I!(sl (trust btnllflclilrl'lSll
I DIVIDED BV TOTAL NUH8ER Of SURVIVING JOINT
OWNERS OR TRUST BENEFICIARIES
l( 100 ~ PERCENT TAKABLE
Ella.ph: Joint Ilccount rogl,;tored
tht dtc.dur,t.
1 DIVIDED BV 2 (SURVIVORS) r. .SO
In thll nil.. of tha daeed8nt Ilnd two o~hllr persons and ..tablilhed within ant ~.8r of alllth by
100 SO% (TAKABLE fOR EACH SURVIVOR)
,I
,
,
i.
r
..
s.
..
I.
Tha IlMOunt subjlct to tex Cline 4) Is deterr.lned by multIplying the account balancl (1In. l) by th. Pltre.nt hl<lIbl. (Iln. $1,
Enter t"'. total 01 the (j"t>'~ ~"d r!l)'l'_'ctl~n, IJ~...t1 I.. P"rt ,
lh. ""ount hlllahll tllne ll) Is detormll1l1d by subtrlltllng the debts IInd deductions (1In. Sl froll the ~lIIount SUbject to tllK (Iin. If).
Entor IIle appropriate tall rllte (tlntl 7) <'15 detDrlll\rHld helo...
A. fOf dates of I1tllth occurring <lflar 6/30/94, t~e tall ratu for ~r1msfllrs to SPOUSIS llrQ as 'ollo~$l
I O~h$ of dll.;UI on or 11ft., 711/'14 <lno hefor" 1/l/9S thl rIlt, Is 3%.
2. Date. of duth on or lifter lIl/9S translers to !'POUSttl will b. tl'llC8d Itt 0% tllW r"te.
Notel For datlls of death prior t~ 7/1/'14 tr<lnsfer5 to spouses art tlll<llblQ dt b%.
B. Transfers to Ilneol descend""ts Including father, molh.r. son, dllughter, gr~ndchltdren, son-In'low,
daughrer-!n-l:".. stllpcnlld and thuir lssuo lire tal<lIble lit 51\( Plrllent (6%),
C. Trllnsf.rs to 1\11 others Including braH,er, sister, lincle, aunt, r,,,plrew and nlllct II" tSlCable lit fifteen p.rllent <1SXI.
n. If you change tho tlllC rllh, ploase specify your r;lilltJonshlp to the decedent in Iht lIraa provided.
8. Tht Illlount of tall dU8 /ll"ell) is detllrMined hy multiplying the alllount h111llble (llml 61 by thtl tllW rllte (lIne 71,
CLAIMED DEDUCTIONS - PART
3
DEBTS AND DEDUCTIONS CLAIMED
AllDwabh debtl and deductions Ilrtl dehrmlned 115 followSl
A. Vou legallY are rlspo,,!Olblo for paYMent, or th8 05t9\& subj8cl to adllinistrlltlon by a parsonal repruentlltlve 15 Inlufflcl.nt
to poy the ltlductlble items,
n. Vou l'I(ltuall~ pllld the debts after oell1h of thQ decedent tlnd CIl" furnish pr'oof of plI~lII..nt.
C. D.bt, beIng claimed IIIUSt be Itllmlzed fuJly In flart.L If addltlonlll space Is nUllded, ~llll plain pl'lpllr " 112" lC 11", Proof of
plI~llIent IIIl!ty b. reqllolltlld by tho PA OepMtment of Revenue.
C- - -
TAXPAVER ASSISTANCE
IF YOU NEED FURTHER INFORMATION OR ASSISTANCE, CONTACT ANV
REGISTER OF WILLS. PA DEPARTMENT OF REVENUE DISTRICT OFFICE
OR CALL THE BUREAU OF INDIVIDUAL TAXES. TAXPAVER INQUIRV UNIT IN
tlARRISBURG AT (7171 787-8327, TDDt (717) 772-2252 (HEARING IMPAIRED ONI.V)
PAvtENTl
Dftlloh the top porUon of thil NOUoe Ind .~lt Nlth yOUr PIWNM\t ..,. p.~lbl. to the ...... end Iddr...
printed on the r"IVtt.. _Jde.
If RESIDEIlT IlECEllEHT _. _ .r _. ordor ......1. t., REGISTER OF MILLS, AGENT.
If tlo!t'RESIIlEHT DECIIlENT 1MIk. _ .r _. ......r ......1. t., COllItOIfWEALTH OF PE_VLVAMIA.
REflICD (tR)l A refund of . tlPl oredlt, Nhlch .... not r~.tld on the t.l( Rltum. MY be r.....tc.d by COIIpletlng ...
-AppU.-Uan for RtfwMt of PtnnIYIVJIf'Ii. InhtritM08 end Estet. TIIC" (REV~UI3). AppllotUon, ere IYIllltble It
tht OfflO1 of ~ Regl,t.r of Wills, any of t.,. 23 Revenue Dl.trict Offlc.s or fr~ the Dtpertllnt'l 24~hoUr
lO...rlng ..rvlce nu.btr. for fo~' ordArlngl In Pennlvlvanlft 1~aOO~362~2050, outside Ptnnsyluenl.
Ind within locIl ",rrlabUrg Ir.a {711} 1&1-8094, TOOl (717) ?12~22S2 (Hearing IMPaired only).
REPLY TOI
OUIIIUonS r..-,.dine errors contained on this notice thould be eddrtllHd tOI PA DlpartMnt of A.IIInUI, .....r..,
of Individual Tex8., ATTNI Po.t A......-nt R.vlew unit, Dtpt, 2&0601, Ktrrllburg, PA 11121~0601, phone
(17) 117-6505.
DtSCOllfT I
If tnY tal< due Is p.ld M!tMn thr.. (3) calendar IIOMth. aftar tho decedent'l aath, . five percent u:n dlscuunt
of the tax peld 1. ell~.
PENALTYI
Th8 15); tal< lIIM'ty non-partlolpatlon pctOalty is oottpUtlld on the totel of the tlx end Interest .....Rd. lInd not
paid before J8nutry 18, 1996, the first dly eft.r ttN .00 at the tax ~.ty period.
INTEREST I
Inter..t Ia charged beginning 'lflth flr.t day of dellnqlllflClY, or nine (9) aonthl tmd one (1) daY frOll the ate of
..th, to the datil of PIYltlf1t, TIK.. Nhlch blC18H delinquent before January I. 1982 beer Interttat It the rete of
.he (6X) percent Plr ~ calCl1lettct lit II d11lly rete of .000164. All taus Nhlch bee... cMllnquent on 8nd Ift.r
January 1, 1982 will bear lnter.~t .t a r.t. whioh will v.r~ ftOM oel.r~lr y.et to Cll.~r year wJth thlt rite
ennouncad by the PA o.p.rt.ent of Revenue. The appll~l' Intereat rat.. for 191Z through 1999 Ir.~
V..r Inttire.t Rat. DIlly Int.raat Factor V..r Int.rlSt Alte DlUy Int.re.1; Factor
1981 'OX ,00054& 19"~199l 11:li: .000301
1.... 16lC .000438 1'" OX .000247
1.... IU .000501 199~~1994 n .000192
1915 IllX .OO05Sb 1995-1998 OX .000241
1916 1O:C .000274 1999 r. .000192
1987 OX .000241
~~Int.re.t I. OIIloul.t~ .. follow'l
INTEREST . BALANCE OF TAX UNPAID X NUlIBER DF DAYS DELINQUENT X DAILY INTEREST FACTOR
~~Any Notlc. iSlued ,ft.r the tll~ bee~" delinquent will r.flaot In Int.r.lt oaloulatJon to fifteen (IS) dly.
lMyond the dab of the .....IIMInt. If paylttN1t Is .ada aft.r the Jnt.r,.t e~t.tion date s~ on the
Hotlot, eddltJonal Inter.tt .ust be ealculatDd.
//; Ii/- ,F
~
BUR~AU OF INDIVIDUAL TAXES
INUERITANCl TAli DIVISION
DE"'. ?f1060!
tlARR I SWRG , P#.. 1112'8-0601
COMMONWEALTH O~ PENNSYLVANIA
DEPARTMENT OF REVENUE
(....
NOTICE OF INIIERHANCE TAX
A~PRAISE"ENT, ALLONANCE ON OISALl.DWAN(:E
Of DEDUCTIONS AND ASSf.SS"f.NT OF TAX
11"16-1998
MAYFIELD
05-15-1997
21 97-0453
CUMBERLAND
101
E~~=,~~~~~::~d - -l
MAKE CHECK PAYABLE AND REMIT PAYMENT TOl
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
CUT ALONO THIS LINE ~ RETAIN LOWER PORYION FOR YOUR RECORDS ~
REv: iS4"7-E'if"AFP- ioF97Y - NOTi cE- -OF-YNHER iT ANC"irTAX -'iiPPR'A-isEH€N'f; -A L.i"oWANCE-iiri-- - - ------- - - - - --
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
DORIS R FILE NO. 21 97-0(.53 ACN 101
DATE
ESTATE OF
DATE OF DEATtt
FILl! NUMBER
CWHTY
ACN
KEITH A MAYFIELD
708 B CARPENTER PK
PATUXENT RIVER ND 20670
('!
"
CLli
ESTATE OF MAYFIELD
TAX RETURN WAS: (X) ACCEPTED AS FILED
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1, Ro.l Est.t. lSchedule A)
2. Stocks and B(mds (Sch.dula 8)
3, ClolI&ly Held stock/Partnership lnt.r-est (Sched\lb C)
4, UortgaQfls/Notes ReclIII.\vable (Schedule OJ
5, C.sh/Bank Deposits/Hisc. Personal Property (Schedule EJ
6, Jointly Owned Property (Schedule F)
7, Transfar$ ISr.hedule G)
8, Total Assats
APPROVED DEDUCTIONS AND EXEMPTIONS:
9, Fun_reI Exp.ns.s/Ad~. Costs/Hisc. Exp.ns.. (Schedule H)
10. Debts/Hortgeg. Liabilities/Liens (Schadula Xl
11, Total Deductions
12, Nat Valu. of Tax R.turn
13, Char1tobla/Gov.rnllental Beque.ts; Non-alecbd 9113 Trusts
14. N~t Value of E$t.t. Subj.et to Tax
NOTEI If an assessment was issued previOUSly, lines
re'i'lec't figures that include the total of ALL
ASSESS"ENT OF TAX:
15, AMount of Lille 14 at Spousal rat. US>
16. AMount of Line 14 tax.bl. at lin..l/Cla.s A rata (16)
17. A.aunt of Line 14 taxable at Collateral/Class B r~t. (17)
18. Principal Tox bu.
TAX CREDITS:
PAYHENT
DATE
07-21-1997
09-10-1998
RECEIPT
NUHBER
AA211556
AA296639
DISCOUNT l+ I
INTEREST/PEN PAID (-I
473.68
54.06-
. IF PAID AfTER DATE INDICATED, SEE REVERSE
FOR CALCULATION Of ADDITIONAL INTEREST.
I ) CHANGED
(1)
(2)
(3)
(41
(5)
(6)
(7)
84.900.00
17 .6~"p""'!u!"
.00
.00
99.984.J!..Q..
.00
.00
(8)
*'
UV-1l41 U ,,, IIt-tll
DORIS
R
(9)
(10)
26,770.CO
242.00
(11)
(12)
(13)
(141
DATE 11-16-1998
NOTE I To ln$ur~ proper
oredit to your account,
.ubwit tha upper portion
of this forI! with your
tax pay...nt.
202.524.00
;>7 .01:> QO
175,512.00
.00
175,512.00
14, 15 and/or 16, 17 and 18 will
returns assessed to date.
.00
10,531. 00
.00
10,531.00
10'556'6~~
25.62CR
.00
25.62CR I
---'
, IF TOTAL DUE IS LESS TIIAN n. NO PAVMENT 1S REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR). YOU HAY BE DUE
A REFUND. SEE REVERSE SIDE OF THIS FOR" FOR INSTRUCTIOHS.)
(Sohedule J)
.00 X' OOc
175,512.00 X.06c
.00X.15c
(18)
ANOUNT PAID
9.000.00'
1,137.00
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST AND PEN.
TOTAL DUE
RESER'IATlONI Eltat.. of de~tI dying on or before Dtoltlber 12, 1932 -- If any futura inhr..t in the "t.te 11 trtnlf.rrld
In po.....iOfl or enJoYHnt tn Ct... 8 (oollateral) beneflolarl.. of thtl deo.dalllt aU.r the .l(Ptretlon of tny ..tat. fOf'
IH. or for Yttr., the COlItIOnWealth hereby .Kpr...ly reserve. the right .to apprals. and a..... transhr InherttltM<!& TIK"
Ilt th. lawful CI... 8 (coUat..r.l) rat" on any Nuoh futuro Jnterest.
""""'"'Of
NOTlCf.l To fulf111 the requlre..nts of Seotlon 2140 of Hie Xnhtrltlmoe and Estetlt YaK Aot, Aot 21 of 1995, 02 P,S.
Sltltlon 9140).
PAYHENTI Detllch tho top portion of this NoHcl! and sub.1t with YOUl' plly_nt to the R"SJstor tlf WJ1h prJntsd on the r.""erslIr Ilde.
uHake ctmek or .omay order payable tot REGISTER Of MILLS, AGENT
REfUND (CR): A rtllt'und of 8 tux crodlt, which WitS not reque~ted on tho T8x Roturll, ..ay be f9queflted by co.plettng IIIn "Application
for Refund of PQrnulylvMI6 Inh...rJt8ncD I!md Estate T6X" IREV"1313J, Applloations Ilre avalhblo ot tt.e Office
of the Reuhbr of WUh, Ilny of the 23 Re...onuo D!strlct Off1eDs, 01' by cfl111ng the spaolal 24..hour
ftftsw-rlng i'lervice nlMber); for for.s ordor.lng: In Pennsylv".!Jn l~tI00~362-2050, outside PennsylvanIa and
wUhJn lool'll Harr hhurg area (717) 787-8094, lDDi! (717) 772-ZZS2 Wel!lr ing bp8Jrlld OnlY).
OBJECTIONS: Any party in Jntarust not sut!sflud with the 8ppraisa.ant, allowenco or dlSl'Illowance of deductions, or en.....nt
of tax (includlug discount or interest) 8S shown on thh Notioe .ust objoct wJthJn sixty (60) days of rt(leJpt of
this Notice by:
--written prohst to the PA Depart.tnt of RevenUll, 80elrd of Appoals, Dopt, 281021, Harrisburg, PA 17128-1021, OR
~~oleut1on to havo tho lI!1tt8r d8t()roined ot Dudit of thu IlCflount of thl) p8rsonal rapr..",ntatlvlI, OR
nappeal to tile O"ph&ns' Cour t.
ADttIN
ISTRATlVE
CORRECTIONS I
Factual errors disCOVIlf'6CI on this I!lSsfUlu1ent should be tlcldresssrJ in "f'UlnR to: flA DlIpartlllilnt of RevenulI,
Bur.eu of Individual TeXQs, An": Post hSQuII"nt Revlow Unit, D9pt. 280601, tltlrdsburg, f'A 17128~0601
Phone (717) 787~6S05. SlIe pago S of the booklet "In!ltruotJons for InheritftO(l{\ Tal( Return for a Rssldent
heedant" (REV~lS0l) for 00 <fxphtnotJon of ftd.lnJstrotivs}y eOI'reetable error!!,
DISCOIMTI
If DnY tax due is pahl within thrall CH oalendur lIooths 8fter thQ doeedent's dalth, II fhie porr,t"1t (5;() discount of
ttM. tal< pl!lld is elllowed.
PENAL TV ,
The 151:: taK unuty non-pl!Irtlclpl'ltlon ponei ty Is co.puhcl on tho totltl of th8 hx ftnd lntorut l!I11unod/ IInd not
paid before January 16, 1996, th0 first d8Y nftQlf th" and of tho tAl( aonosh' perJod, Thh non-partlolplIUon
panllty is appoalable in tho so.e lIonngr and in the tile !WlIl'l t hi8 period a~ YOU would appaal thr.l tax and Inter..t
that hl!ls boan IU6Issed 85 imHcl'lh.d on thls notlen,
INTEREST:
Inter..' is chargo(1 boglnning with first dfty of delinquency, or nkno (9) .0ntl1s and ooe (11 d8Y froll the datil of
duth, to tll" d8te of pay.ent. Ttl)(IHi whlch bl'ICl&lUI dQlinqullnt bofore JllfluOry 1, 1982 buar Intlllrillllt at the r.t. of
ilK (6;'0 perolllnt per .mOll" calclJ18ted at It dAlly rete of ,000164. All hKQS which bece.a delinquent on and IIft.r
JMU8ry 1, 1982 wlll tKlar intanut I'It 8 rate which will vary frOll cslond"r yeaf to calondar Yll!Ir with that rata
1lOO0000ead by the PA Dapart..nt of RIIVIIIllllO. rllll appl icable Jntllrast rates tor 1982 thrc.uyh 1998 are:
:!!!r Intlrlist Rate DIIUy Interest f/'lCtClr Y!!r Interest Rfth, Dally IntQrlilSt Faotor
19&Z ZOr. .000548 1987 9% ,000247
198) 16% .000418 1988-1991 11% .000301
19M 11% .000301 19lJZ ., ,000247
1985 13% ,OOO3S6 1993-1994 7Y. ,000192
1986 10% .000274 1995-11)98 9% .000247
--Interest is cnlculehd .. 'follows:
INTEREST = BALANCE or TAX UNPAID X NUNBER or DAYS DELINQUENT X DAILY INTEREST FACTOR
--Any Notico lUlled after the tex beeo.llS ctelinquont will reflect an inturut efllcu,\atlon to flfte.n (15) days
boyond the data of the aJ;sess.4tnt. If PlJ~.Clllt 1:; ..adCl lIfttr tho int..rest cClJlputa'llon date Ihown on thll
NoUc., additional Interest .ust b~ colcull'lted.
eOMMONWIALTl4 OF PINNSYLVANIA
COUNTY OF CUM'ERLAND
UI
Hworn , according to I.,W, dopo,., .nd 'ey" thet h~ ,_.~Keith.)h,",~field
executor 0' tho E.hteo' -....[)grill R. -May.fieJ.d....-----..-~-
lato 0' _ 2119 Wentworth Dr. Canp Hill .., _, Cumberland County, Pa., decea.ed end that the
within I. an Inventory mad. by.. _ Keith A .lo1ayfield:.____ _ ,..___, the laIL-Elleoutor.__.._ .__P_
0' the entlr. e.tete 0' uld decedent, conllltlng 0' ell the p.rlonal prop.rty and reel ..tet., e.cept reel uht. cuhlde
tho Commonwealth 0' Pennlylven'a, end thet the flguro. oppollle oech Item ., the Inventory reprellnt It'. fair ..Iue
U 0' the d.te of :::::ont', do.th. ~ J flt.;-P
______ and .ub,cribed bofor. mo,
.__K~ith AL!!~t:iel!!_______.. ________
executor . Aclmlnhtrltor
b.lng duly
KriRta J. Dellopina
LT. JAGC, USNR
10 U.S.C. 1044(0).
-ll1 \Q.Q1.Ly ~
19~2-
_7.QBI>.~_f.!rn~.Qt~J'...l'F1r~__~_.__~__
___.P.atuxenLRillp.r. MJ) 'Q6.1.O.......____
Add""
Date of Death __ ___ ____
15
____MBL-___
Month
1997
DIY
v..,
INSTRUCTIONS
I. An inventory must be filed within throe month I a'ter appointment of perlon.1 repr...nletlve.
2. A .upplement Inventory mUlt be flied within thirty day. of dllcovery of .ddltlcn.1 e"eh,
3. Addltlonel Ihteh may b. etteched u to perlonalty or realty
4. See Article IV, Flduclerle. Act of 1949,
~ w -g
l'l ~ ffi!;< ~
1/1 "
C!; ~ ~ u ..
"
g Q I ~
9 w E
:I: : ~
..... Z .... Ll. ~ 0
~ ~ 0 I 0.. ~
.... UJ ~ " ~ {
>
Z o 0 D
- VI Z ~ tl
0 ffi <( ...
Z 0.. -g
, ~
I ... "t;
0 "
I ..<l "'II ...
.. e g
... u ..
~ it
-' III
Inventory of the reel end personel estate of
Cbris R. Mayfield
u_.,...___._ deceased
_7,"'."~_'__'___.'_ .....___~.___..~_.__
.,..-.--.--..--..--.-.---- --- ---
1. Houee, 2119 Wentworth Or. Csnp Hill.
Township. Single story, 3 bedroan.
Lot 33, Highland Estates, LeMar Allen
Mortgage paid 5 Feb. 1990
2. Checking Acct. PNC Bank, P.O. !lox 8874, C/J'llp HU1, Pa 17001"8874
Acct. No. 51-4004-2272
3. Savings Acet. pr.x:: Bank, P.O. Box 8874, C/ITlp lUll, Pa 17001-8874
Aeet. No. 50-0080-3877
4. 1996 Saturn SLI, 4 COOT.' Sedan, VIN 1G8ZH5285TZ270027
5. Prepaid furial Plan, Rolling Green Cemetary, 1811 Carlisle Rd., Cenp Hill,
Par 17011. (Plot 210D, Block N, Casket, Momrnent, Installation, Grounds Ca
6. Money Market Aceto, Government Mortgage FUnd A, MF'S Investment Managenent,
P.O. Box 2261, Boston, Ma. 02107-9906. Acct. No. 3101108184
7. IRA, Too Iiartford, P.O. Box 30197, Hartford, Ct. 06150-0197
Acet. No. 130036447
8. Mutual FUnd, Putn/lTl Investor Services, P.O. Box 41203 Providence RI 02940-
1203. Acct.No. A25-1355305147BBB2
9. 10 $1000.00 EE Savings Bonds (SIN's M55186777, M55186778, M55186779,
M55186780, M55186781, M55186782, M55186783, M55186784, M55186785, M55186786
2 $10,000.00 EE Savings Bonds (SIN's X2412802, X2412803)
gp
~ -
t.(}
'.1
ill
t~J .
~
U1
..
,'--\
\' -,~l
L,J
$84900 00
$ 2555 98
$10051 89
$10500 00
$ 3089 36
$ 6014 142
$30851 17
$35378 98
$17640 00
,
'TI
I!{;