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HomeMy WebLinkAbout97-00517 _r_,_ t""' l(;" 'C::> I t- o- cr- - I N ~ ~ ..1 :;i; UJ ! w- o . o ",Z CI) a ... tit '\W , '" ' ,-;"r'-\"i' 'r, ,-~ ," ~ E <0:': o <:: ..,. " - 'i~ ,l1 'Jil =-=-'> ." I,:W{I/(' ql .13t.I/faI,:'I!F ClI,~.o know" liS PETITION .'OI( I"ROIIATE I1l1d (.RANT ()Ii I.ETTERS ;(. biTs/II'! N". 2./-/qqrl..051'] I,,: . /)('('('lISI.t/, Scw/al S"<'III'Oy No, ja'f' - 3;:: '~"Ii:;-I Ilegiste. "I' Wills I'm till' COUIlIV of C'(t'!~~(t1("Q_, ill tho Cmlllliollwealth or I'ellnsylvallia The pelilioll "I' Ihe Illlllcrsiglll'd respl'elfllllv rrl'rl'selll" thai: Your pClitillllcr(sl. who h,/arl' l~ ~'l'ar\ or age m older an the 1,';\CCHl.af~ in Ihr lasl will of Ihl' ahovr den'delll. dall'd ..,l)'1/VtI/ltfY_ and l'(Hlidl(s) daled _ _,,____~ nllmed _I,;?,___ ...______.192.5:__ l~latl' rt'll'\-Ullt l'irl'llIl1,tlllll'l", c,~_, Il'tllllll'ialinn, dl'lIth (lli.'\l'l.'lIIOT, etc.) Derendelll was dOlllidlcd al dl'alh ill n' C.'&lo11e(1,"(r.!I'(!::'l ______ Coullly. Pennsylvania. wilh h~_~".. last family or prinl'ipall'l.'sidl'Ill:l' at _.__3 ~...- C(i_r<A~;t/ u~._~.{?P_-;__~/p'c t.. ~. .. ~ ~___n___" n _(-<,J"';y/'u:.,<;.'!J./.;,H(\.<:"i.;----!L~ /lif.3-_ (11',( \11'i.'l'l, Ilumber ilnd llllllhip,lliIY) D,wndenl, 111I'n _ -9'0 _ years of agr, died .jt/f'lf:~..Jl./.______. 19$-2-_, al _ J3t. LIe;- '[.:j{'f.(t:-'/I&IIEt'i t'<Jt3:.s'T'. . ..--------------------------, F\;I:Cpl a\ 1\,110\\\, dei.'l'Jclll did lIot marry, was IHlI ~Iivorl'cd and did not have a child born or adopted oflcl' C\l'l'lIlinn or tll(' will offered for probate; was not the vktim of a killing and was never adjudicated inl..'OllIPf,,'IL'III: _ ._~___,___.__,.._ .~____.m____.._________.._ DI..'i,,'l'IHk'1l1 al dcath ll\\'IICd properlY wilh t~slil11atcd values as rollo\\'~: (If domiciled ill l'a,1 All pl'rsollal properly (If not domiciled in Pa,) Personal properly in Pcnnsyl\'aniH (111101 domiciied mPa_, Persollal p.operlY in ('ounly Valth.' nf l'l'all..'o.;tillL' ill Pl'nno.;yl\'ania siluatrd (I... fnllow...: $_,._3QQ,.t-QO<>'_ o~ $---- $ $ u_._.._n_.~____~____'" _ ...-..~_~__.__..~____~_.__'_ \\IILKU-UKF. pelilioller(s) respeell'ully reqllest(s) Ihe probale 01' the Inst will and eodiell(s) prescnled herewilh and Ihe gralll of Iellrrs.____.Z_L"::r:Tl9~}lZ?J.Lff_/--------- , (ll'''lall1~'l1tary; adllllnhlralioll (',t.u,; adminislration d,b,n,c,t,a,) I hl'lllll , ..., -;--;-) our.;V ~jJX1itr- L( ''J)A:dl -r .('4;,S/1?1 ~ t ./1 ?l1<-~,),--<<__~i;5;; ,-(,s/fE€.': -g~.f..;" /TZOF/Y" 2"L./ 7"'Y.~_ ;"I';: ~~ ~l, '7: ,-.. ------------------------..---,....-.--."..---------.....--.-.-- --- _n_________ _ _ _______~ ..... .. ______~___.... _ ._m.. ,._.___ OATH 010' I"ERSONAL REPRESENTATIVE COMMONWEAtTtI Oil PENNSYLVANIA I "" COl Nn' mCv,tY'lt.lC1~(1\'N/;.u ._______ J " TIll.' pClil;olll'r(-'l ilhm'l"II:lIllL'd '\\'l'urh) or affirm(q Ihat tl1(' qalClIll'llh ill the foregoing petition cue 'trill' ',\lid L'll!'rl.'L'! 10 till' hl'~1 01 I Ill' ~Ilowkd!!l' and Iwlid of pctitinncrb) and thut as personal rcprcsen. 11I11\'l'(\llllllil' ahovl' d l'l'f,,'d 1.'11 I pl'litiullc-l'b) will wf..'il alld truly adminisler tl1(.' estate ul:l:ording to law. .-.---_ , ' , ? y' .(-r-'".L,;l ---' S\\i\lll III 01 ,tllllllH'd dlld o.;Uho.;L'11l11'd~_:;J~'-- ',-J<~"",4e.~? ;;t;q.{:<L~"'::~ Vl hchlll' 111ii1\' Illh /.:( tJ... dllJ' {l __u . ------ ~' -", ~. . ~ ~(17 ~ -n u}\ t ,'/J,.:Lc.i'paftrVr;i..u If ~-=---.=-_=- ~ M RY C. I,EWIS Ij<"~/lI('1 ------------ ~ ''''' ..-.... - ..-- ,.,...... PA n., ~rland ".,K) =-=..- -' llO'"!;k~~"mr.-"- "WMWOADON.~.~""lIp~ 85 Greenwood Circle Wormle .NI/Ile" !MY. WoIlTlleysbuE2.... Ps 1704 3 .........0 .-- 1.997 ..""- 01l654-L , ............ .... _, dlM IIllt pANt..... ................................... Oa............." 1..-...--...... __ICMIII,1'lIII _.00l\I1IiGn ....."...- ..,. ....., /fl7 .....fMlIlI..,.,."....INcIIOf"""...... ",,0 ..0 .,.,......................... ... 1'lI'II-.............................".,..,1 I ...",,,,,",,, -]...."'........ 'j'''''''' """.." ..""-""'......,,,,,,,_.. (t,b\f\,0ltj,_1 o o ... 0 ..0 O -.. c..rdlllll"~ ~Of.,.,..'t.A&IlorN,_."'''',~" lOCAfKlN"'_.~,"" ~..~I ...... II. .... ., _,,........ . __mu",,,.TflI. .CIMTW'tItI~",,,,,,,,,,,,,,_llIclMt1""*'~~iItI""IIlOfORlld~.vwJ~.......-.s_"nl tvf....,.,...a L 1""-7'\ -?1JI,,,,L,I1- -, "........,~,.....................-.(......~-.......""'..,...,.....,.."..,...""""""..""""., ~o llCl-"~-OS'O;'_'L1 L~~~~' ,pP'!l1Al? orne ~ ~AHOCMt"""""""'~"jlf~~Il'cl~IrI,**oldINIIl C1 ., ltt.._JI1.1 t 1 f ................................................, .......... ..... ........1--.......""".,.,."'.""."" MA'" AHOAOONIIOl'"~ 'MtOCOWU'IIOCAUII Of OllAr" (~ln'"".ftInI \: C/oi':: MfOfCfIAlA~OlAINClOf) ....~9.r.~...."""" ,&:^9J;. F~ill re!. ow AU rlJI Of'): -- \::::'.= """'1 ..... " -"""'., o<UUT1DH"'...... "'........ - - \jl' o o - -'- ...0 ..Ill - -...-...-" 0lIl.....................1IIIfJ........., III .............. ~.........., .'e,.,...,-..., eM""" 1M MY"'.,.... .................",..,........,.".""";,."...."",..,.,,.,..."""""".",.,."""",..,.".,"",.," .... /) -- - ~- - ---'- ~~.-LLJ " ~ eJe.. IV--b ... , . ITE.M IV: If I prcdeccase my hushand, GEORGE S, LATSIIA. I givc, dcvisc and hequeath all the rcst, residuc al\llrl~mahl(kr of my estatc, not disposcd of in thc prcceding portions of this Will, to my hushand, GEORGE S, LATSIIA, and my son, DAVID T, LATSHA. as Trustecs (hercinaftcr collectively rderred to as "Trustec"), IN TRUST NEVERTHELESS. to hc further divided into two parts, l'ach or which shall he h(lld in trust and constitute a scparate Trust Fund to hc known as "Trust A" and "Trust B", "Tnlst A": There shall he placed in "Trust A" lhat rraction of my residuary cstate of which thc numcrator shall he a sum cqualto thc largcsl amount that can pass rrcc or Fcderall~slatc tax undcr my Will hy rcason or thc unificd crcdit and the statc dealh lax crcdit (provided thalthc usc of this credit docs notrequirc an illcl...~ase in statc death taxes) allowahlc to my cstate hut no other credit and after taking account of dispositions undcr olhcr items of this Will and properly passing outside of this Will which do nut llualify for thc marital 01' charitahle deduction and aftcr taking acwunt of chargcs to principal that arc nul allowed as deductions in computing my Federal cslatc tax and or which the denominator shall he thc valuc of my residuary estate, Fm purposcs of estahlishing such fraction. thc values finally fixed in the Federal cst ate tax proceeding relating tu my estate slHlllhe used, (rccognize that thc numcrator of such fraction may he zern (0), in which casc IlU pl'llJ1erty shall pass ullller "Trust A" and that said numera((lr may he affcctcd hy the al,tion of the Exeeulllr in cxcrcising certain tax elcctions, "TIUSI B": Thc halance of my residuary estatc nut placcd in "Tnlst A" shall \1e ph\c\~d into "Trust B" III he held. administcred and distrihuted in accordance with ITEM Viol' this Will, Page 2 D j /,,'--1- 1,) v~' t. ~: , '. ,\ II ""I" 1\\ "'\'I'llsI 1\"', 'r\\e 1\\lllIWI\\'ll 1\llI"Il\llI\\S l\IIII \I,.," ' ., "" ,,,,,,., ",." ,,,' ,'" "''' ,,,,,,,,,, .,.,,,, ,,,,,, ,'" ",,,,,,, ,,' ( " , ,\\1 .."""",,,,,, "", ,,,. ,,,,,,,,,,,,, """ ",,,,,I" '" "" Ihll\ '\'1\\l\1 III ClI\\"cnIC . ' ,,' , GI' S \ t\'rs"l\. dllll\\'ll hll\ IllclI\\W, hIll\"\I\\d. OEOR ) > .' ' , ' \ Ih' 'tl\ISICC ,,\1\111 \1\1" 10 o ' ,I\IC \I(CIII"C \\( I\I~ l\\lI\\ hIlS\)I\\\~' ~, (" ",,'" ." \ ,'" ,.,,,,,1'" ,,\ "". "" '" n I I"" S'lill h\ISI"I\\d sO 1\1111: \1 (\1 1\11 \hc \)C\\C I \\ " , . , . I''''. ,\", \1\hC\' \h\l\\ 1\1 ~ hIIS\)\ln\I), , I" \' dISCICII\1\\ \11 \W ,illS ~I; \ ",., .""",""" '" , " "". ," .." ,'II' ,,\ "" "," .",."", ". ,.' """"",~"" "'.,,,,,,,,'" "", III' ,. ' " I' ".,~ ",' ,'" .,,,,,," "..II ,., .11 ",,,," ,) \.l1'0\\ \hC Ilel\I" 0 n" " ." . ' (, . _ . " "',''''" I." "",,,'ri"'~ '" ,.' ,.." ,,' "" 1\\COnlc and \1\\ \nC\1n1" \11:1:11 , \.1 h' \\\en ICI\\\llnln'll 1\llnei,,\I\ In 1'11Il\\ . p' ...11 ,"'".,,,' M" , , ''"'''" .., ",' . . . . -\ "," '" ." ,'" .. """"",.~.., , ,0' \,\0 't, \..1\ 'tSHI\ lhClcln\II\CI II; C ' . 1\\1 nl~ son, " , , 1I l\1 (01 \hC "c\\dl\ 01 \he 'fhe 1'1"\IS\CC shall 1lll\lllCM ",l~ \ ' '\ Ilnei"'\\ 01 said 'fl\\l\1 \IS, 1\\ .. ." ,II "II'''''''''''' -", .' ".", "II" , . . \\C\\CI\CI\lI~ I" \'" "(1)"CI SIII'''I'I\. , " \I" "C \\Cccssal~ 0\ "1;,, ,. ,hC dll\ct~.'I\1\\ 01 \h~ 1'IIIS\Cc, \\' , " ' , .' \\,1 ",cdIC\l1 CIIIC nl l\lIch \\cncl\Clal~' "'\lI1\\C\\\I\\I:C \I " U \I, "", ", ,.' ",~,\ld." ,'" """" ",,, ""''''' "" ,., ld' ~'" I ",0' I,"'"' IV'" . . "" "~,, " "" ,,,,,,,''''' ", . . ' O"CI all 01 \hC lC",allll 6 .' . "co G ' 1\ 'tSHI\ In CI\\II\I Sh\lICS, C\\R\S1'OP~"'" ,.... . . . "10' LI'''"'' \I ", (:,\<,,,,01'"'" Q. I.'''"' ,. "'. II ,.." 0 ,. . ' ." ,"'" \ II \)' 1'\lld 10 his Ihcn \1,,1\\'ll ISl\Uc. "CI S\ t"C$, ,hcn \1"ln\\. ,hIS shalc l\ \\1 I; PII'IlC 3 i,J I ;\_..p j'1fl;J.-' Indlrcclly affcClCd l1y the ~,I~cllon, Only property which Is fully eligihle I'lli' thc mllrilal dcductionunder FedCl'1l1 eslate tax law shall hc assigncd to this Trust. Notwithstanding anYlhing to the contrary conlained in lhis Will, the Truste,' , lhis Trusl shallnol rctain hl~yond a reasonahk time any properly which may at any time he 01' hecnme unpwduclivc. IHlr shall Trustee invest in unpwduclivc property, Notwithstanding the pwvisions of suhparagraph (h) of Ihls lIem, the Trustee shall pay to Ihe Executor of my hushand's estate, out of lhe principal of this Trust upon thl~ dealh of my hushalHl, an anHlunt equal 10 the estale. Inheritance, tl'llnsfer, succession and other lkalh taxes ("death laxes"), Pederal, state and olher, Ilayahlc hy reason of the inclusion of lh~ value of Trusl pwperty In my hushand's eslate, Such paym~nl shall he equal to the amount hy which (I) the lOtal of such death taxes paid hy my hushalHl's estate exceeds (2) the total of such death taxes which would have heen payahle if the value of the Trust property had nol h~en includcd in his eS'laie, Thc detcrmination hy my hushand's Exccutor of the amount payahle hcrcundcr shall he fiml!. I direclthe Trustcc 10 pay such amounl promplly upon wriw;l1 reqUllsl of my hushand's ExeculOL Thc final detenninution of thc amounl due hercunder shall hc hased upon the value as finally delerm;ncd for Federal csliltc lax purposcs in my hushand's r.statc, Afler paymcntof the amounl finally dclennincd 10 hc duc hercundm, thc Trustee shall hc discharged I'wm any furthcr liahility with rcspect to such payment My hushand may waive his estalc's rightlo paymenl under this suhparagraph hy Will. excculcd aner my dcalh. in which he specifically refers 10 the right 10 payment hereunder given 10 his estate ITEM Vl1: If I survive my hushand, GEORGE S, LATSHA. I give and devise all the rcst, residue and remailHlcr of my estate. nol disposed of in the preceding (lOltions of this Will, lO my son. DAVID T, LA TSI-IA. as Trustee (hereinaftcr referred 10 as J3;J)Io Page S -'" . ~~ ~, ~~ ~;... ~. ~ ~ ~ ~ "1-~ '~ :(-, l"} ~ ~ C~ '~ (j q, q, ~ ~:/' ""1-- ~i, ~i, ~ ~ '0 ~ ~ ~. (~ /> ~...~, ~"~. ' 1j,~" ~ .(...,. ~~, -i /~ -I' t"' VI ~. ~J h. 'l ~ '"", ~' ..., "of, "1./, Q"~ .. -'/ .~. '~ ~-' 0"" ;.."t. ~ '/._ , ". ~ ;.;j, r, I- <> " '/ ~. '~, ~; ~ ~/, ~ '? /.' 1'" ~ -i "I- /f. ~I t"' ~ ~ '? n. (I> ~ .. '^ ..~. ;j. %. '1:, V "1.< "1' ". ~ f, (') .~. ~.. ., ~ ~, ~, '<(' ~{', '/~,^ ":~, ....,,;-, ".., ~. ~ .~ ~.~ ~}. ~ C}. ~ . , . ~, IJ"...._ ~, ~, '^ "'" ~ ~ t;I/, "'0 ~, r ~ '? 1, "el .. "? I)..... ,.~ (, -~ ,........ ". ';f. ,..~ ("~ - "':,;.. '1-. '6 ....r ...~. .." r:. ~ ~ ." ~ ,. '/ ;{"... 1';1/- -...,. '?J' ~ /. "e, l:' '* * ~ ~ 1;, ~ ~. ~ ~z. ~ ?f-- '1.. " c;: <<;:... ~. ~ .z 'J.- 0/ ~....: '~ '~. .1;;, ~'. ...~, ~J' ~ (I .... '~' '(j ~-'- "7j.; 1':;:, ~ '~ ':.)4 ~/ /. q '/ c' - ~ '7';, re. 'J! ~ ~ ~ , V ~ 4 "& ~ ~ V / ,~ o ~, ,7 </' r.; 1-. .(..., -? 'Q , h />... ~J> ,;, '1;, "',< , ~ ,;, C~ ~ ~ 'f.',:, ~. r. ~ V <> ~ ~, 1--' ,~ '~ '~ ~ Vc>() ~ %' ~ 'ih ''0 , /: ("0 "-2 r, , J Z, r, A ~J' 7J_ ?,. '(-. , ? ''lo, V"", .,. 9',c ~ k ~,. C} ~; (:I ~ ''0 0 ..., c7. ' ~ . 4%"'f;~ o,..! 0..;. f') .~ n, 0' '"t, .,... c' !J... .. .A '^ ,I', V '9. '~ ~9-~ ~ "0 -;I~. ~ .;, '?/' q.., 'i<& ~ %" % ~'^ '~ A , . ~ ,c '?~ ,'if I' ~ ~ ('}, ~ ~ ~~ <1: V, IC' ?t- ~I" ~ ~ ~, -i -:< 't" V ~! ~, ("1; ~ 1,. () . ~. ~. ~/, ~,c ...~ c, J -?: 0 '''f7 <,}', 'i/. :'.t. 'J> ~ '{-. r ~ "'" ~J :'). ~. '''0 ..t~ ~, ';0" r,. . 'C., ~ ~ ' ./. '?J' , 9'/ i"..L C'. V ''''0 c'. ''0 "-2 ""1- ':j-, r~(., ~. C;;, ~ (I...... ,I: ~ 'V ~. c~ ~ /; ,I' O/.;. V. . ~~ ~~ ~v 0...... 'lb ~, ~ 'to /.' ~ oJ;e, ~ <<, 4 o.t-. "if,. ~ ~/' '~ %r ~ %>/. :t- oO ~ ~;- .()" ~ ~ ~: '~ '~ ~, '~ ~~ ~ " n. /.;. ~ \, '/~ '0 c~ ~ % ~, ~ 'Q ~ ~~ (I...... <:j-~ he r, ~. ~ ~ ~, c.. ~, h. ~. 9'/ ~ 0...... , ~, ~, ~ ~J 'v 9.j, ~ v ~" -f. . /. ~ ,1' ~ ,;. ,c, "'~ /~, '~ ,I' C::, ~ '~, -..., 4:., ~ 1n 'I, C',/ ~/' ~ ~ /J fc~ 'l ~ ~ J... '~ ~ e, ~ .....-:1 ~, ~ V' ';-" ~. ~~ he.., .~ ~, 4. ~. ~r. ~ '( ~ o~ J~ J ~i ri. ~ ., ,. ,I',. .....1 ehhe\' hy, Instrument filed wilh the Trustee dur111g the Beneficlary's Ilfelimc. exercising this Power of Appointment. 01' hy the Beneflclary's Last WlIland TesUlmenl. (d) If this Power of Appolnunent is 1'01' any reason not validly exercised hy the Beneficiary, in whole or in part during the Beneficiary's \il'etime, 01' in the Beneficiary's Lilst Will and Testament. then upon the death of Beneficiary, the remaining assets shall he addelllo the assels to he lIistrihlllellunder pal'Ugl'llph (h) of ITEM VIII. ITEM.x: (n the selllcment or my eslale and during the continuance of the foregoing Trusts, the Executor and the Trustee shall possess, alTlong others, the following powers:, (a) To relain any investments I may have at my death, including specifically those consisting of stock of any hank even if I have named such bank as the Executor or Trustee hercin. so long as the Executor 01' Trustee may deem it advisa.hlc to my estate so to do, (h) To vary inveslments. when lIeemed lIesirahle by the Executor or Trustee, and to invest in such honlls. stocks, notes, real estale mortgages 01' other securities 01' in such other properly. real or personal, as they shall deem wise. without heing restrictell to so-callell "legal inveslmenls". and without heing limited hy any stalute or rule of law regarding investments hy fiduciaries, . (c) In order to elTecta division of the principal of a Trust or 1'01' any other purpose, including any final distribulion of a Trust, the Executll\' or Trustee Page RJdltI iN uulhori~,ed lo make said divisions llI' distrihUllons of the pcrsonallY and rcalLy, flurlly 01' wholly in kihd, alllllO allocale spednc asscls among hcncndarics and Trusls crcaled hc\'Cundcr so long as the Iolal markel valuc of any sharc is nol affcclcd hy such division, dislrihulion or allocation in kind, Should it appcar dcsil'l\hll~ lo parlition any real estatc. thc Exccutor or Truslcc is authorizcd lo make. join in and consummalc partilions of lands, voluntarily or involuntarily, including giving of mUlual dccds, rccogni/,anccs llI' othcr ohligalions, with as widc powers as an individualowncr in fcc simple, (d) To sell eilhcr at puhlic llI' privale sale and upon such tcrms and condilions as the Execulor 01' Trustec may decm advanl.ageous to the cstatc ll\' TrUSl. any 01' all rcal or pcrsor.J\ cslatc or inlcrest thercin owncd hy the cslatc 01' Trusl scvcrally 01' in conJunclion with other pcrsons llI' '''lIuircd aftcr my dcath hy !hc Exccutlll' llI' Truslce. and lo consummalc said salc 01' salcs hy sufncicnt deeds llI' other inslrumcnts lo the purchascr or purchascrs, convcying a fee simplc title, frec and clcar of alllrust and without ohligation or liahility of thc p\lrchascr 01' purchascrs to sec to the application of thc purchase money 01' to make inquiry into the validity of said salc 01' sales; also, to make, cxccutc, acknowlcdge and deli vcr any and all decds. assignments, options or othcr writings which may hc ncccssary 01' desiruhlc in carrying out any of thc powers confclTcd upon lhc Exccutor 01' Tl'llstcl' in this paragruph 01' clscwhcrc in my Will, (c) To mortgagc rcal cstatc. and to makc Icascs of rcal cstatc, (I) To hOlTow moncy from any parly, including the Exccutor or TruslCC, lo pay indchlcdncss of minc 01' of my cstatc, cxpcnscs of adminislralion 01' Pagc 9 l3/J~'-/! . ~~O ~ '(. ~e ~ ~ c}. ~ h 7.i"" -(. " ~?, ....~ ~ <f'. -0 ,,;. :f. '/~ "'/ ~ ,:~ o ~" 0:' ~ ---'- 9'~ '/ -I' i';.o ~ "h..,~~,,- 0,.. ?t. ~. ,h, , ~ 10'; ", ~ ~; ~ ~ ~ ~ ' ~ h '.I. ~, C~ ~~ '0 i ~ './. ~ ~. ~~J! 0/_ ~ ~, r-t, ~ (//' I),~ of; ~~ ~ O,..?, '~ 'f.< ...... (> ''2 4, 1-~ 0"" .~ (}O ~, h. ~O '*~ /., ~" ?k /. ~ z.. -- '?O O~ C~/ ~, . c}. ?/, ...... L IJ, 0", "'~ 'I', '1. " ..../ V -0 l:}, ~ ~ 0;1, ~ '/'. 0 1, .f "'~ ~ /! 4 IJ/., ~ "c, ".~ C} 1:, I)~ ....0 ;JZ b. ~ o ,1([_ cb ~ .qJ. 0.... ~ '.~ ~ ..~ ~ V. '0 (!:~ ~ '" 9: ~..." (' '+ (' VJ.. O~ t'/ -~ IJ/, .,~ ~ 1;, (;';" ~ ~ ...~, 1:. "<'" () ('I {~, '^ 7'".,. /.,' , ' '0 ..... _ IJL' """, ~ ,..'" 't, e 1),,""0 v ~, /;......~ ',~ %' "*J;: "6-6 <?9 ~(>~ /-4- ~ '-' 'I;) ..... ,I'. ~ . !t- 'I.? -'-0 'j .~. h", /; 0..... ~_ fJ ~ 'T;,. ~ ~/' ~ <?9 '( V Ij "'9: ~ J.. ~. '" ......,-; 1C, ~~ 1.1. ch 1, '<'I' ~ ~ ~ 'i< ... ~ /~ ~b~ '*~ ~~ ~ ....,.. ,.. '~ ~. I--: ~ ~~ ~, ~ V (~ 1f, ,.. c. ~ C.},/~ (/ ~. 0;' "J- ;~. tj..... ~ ~. ~. 'J}.' IJ...... ~~ 0,.... ~ % 0...1 ~, '" q., ~ ~ 'f~ ~~ "4 ~ v~ c,. 1;: ~. ~ ~ ~. ~ ;Sf. "'/ 0- ~ ~, ~ ...... IJ.... C IJ", ?L' V~ 9'~ ,.. 0/, 'f~ C~ 1:. ~ V/." 1-.. ~ ~, % 1:.~ '0 l:h .. "',.. ....it "...... 9- '" '/~ ex C~ "'~, 6. tc:. v '?(> IJ/, ~ '/~ C1;, ~" ~. .,06. , " q,. "001":" 1',- ~~ ..~ ~O ~ Y.i(> '?e Ov ~ ./;: 'f~ "O~ .,~ '0 i; ,.. ~ ~ ~! (~. O-f: ~, '?0:' %> ,f'. ~ 'l' - /.' 0,.. ~ V6. ~ 0/." ...,.. 0,/, ,$-. "'/- V 1:. ~ (>/." ,,<,. ~ ~ ?, ~ ?j, h Q~ (J. '~. ~ ~ r ~ 7.i/, ~ ~ ~ %' ,.- ~~ ~ "l ',~ ~ "9 4:., '~ 4, '/b 1-" e ~ '/ ~ 0. c", (>~ ~ "c:z 'Cc,. c:,. ".. /- ~~ '~ ~. r> -Oe v ~ ~ '1, ~ '" 11- ~ ~ "0 ,f: ~, c" ~ ~ ~, 0,.,.., ~ v .f: ~ "", ~ o ~ cllnnot be established hy pl'lllJf. my hushand shall he deemed to havc predeceased me, Any pcrson (other than mysell) who shall havc dlcd atthc SIlI1lC timc as IIny thcn reclpicntof income or in a common disaster with such hencficiary. or under such circumstanccs that th(' ordcr of deaths cllnnot hc cstahlishcd hy proof, shall hc dccmelltn have predcceasell such bencficiary, ITEM XIII: I hereby nominate, constitute and appoint my hushanll. GEORGE S, LATSHA, 10 he the Exccutor, In the event of his death or his inability or refusal to serve. I nominate. constitute anllappoint my son, DAVID T, LATSl-IA, to be the Executor. In the event of his lIeath or his inahilily or refusal to serve. the successor Executor anll Trustee shall be such person or corporation as my son shall have lIesignated. either In his, Last Will and Testament or In writing, delivered to the successor Executor and Trustee, In the event no such lIesignation is mulle by my son, the successor Executor anll Trustee shall be ELYSE E, ROGERS anll JAMES 8, ULSH of the law finn of METrE. EVANS & WOODSIDE, The EI\Ccutor anll Trustee arc specifically relieved from the lIuty or ohllgation of filing any bonll or other security, IN WITNESS WHEREOF, I have set my hand and seal to this, my Last Will and Testament. consisting of this anllthepreceding cleven (II) pages. at the cnd of each ,~ag;t of which I bave also set my inillals for greater security and helieI' identification this / z day of ~\i'v\_LC(I"cr' ~ .19(ltr~' .' ...." , , ,!'''. ' . f/ /,u") I i / ..... " Y "I .,"\' 'i i~:~~~~i~:~:t~1r;)i/6;G(T-"(SEAL) We. the undersigned, hewby certify that the foregoing Will was signell. sealcd. puhlished and declared hy the ahove-named Testatrix as and for her Last WilllInll Testament, in the presence of us, who, at her request llnd In her preSenCl) and in the presence of each /- ,', .' IttI , GEORGE S, LATSHA 85 GREENWOOD CIRCLE WORMLEYSBURG, PA 17043 JUNE 1.0, 1.997 ESTATE OF BLANCHE H, LATSHA DUE TO HEALTH, AGE AND OTHER REASONS I DO NOT WISH TO SERVE AS EXECUTOR OF THE ESTATE OF BLANCHE H, LATSHA AS DESIGNATED UNDER THE WILL OF BLANCI'IE H, LATSHA, /', /} r ,) -li/ '. _/~(.t?J-- / lA (1'16?'( \: DAlE SWORN AND SUBSCRIBED TO THIS K.!- DAY OF JUNE 1997, ) /),no-/I /\.. il,il NOI~I Notarial So.1 Peggy S: Nye, Notary Publlo susquohanna Twp" Dauill1ln CounlY _ My Commission e'piros Fob, 1, 19119 t'!'<l!, f'em9'IMlria,l\eeodallonol~ <,.,~;" "\,'\'" ,Y-" ,0,\ " ~'}.0 \.' Co' ,~ ~\~ ","' ,\", ",'" .._'-~t" " " \ " " " " " " ~' ~ NOTiCE Of UENEflCIAL IN'I'EI\ES'l' 1N ES'fA1'E ._.~_.__.___.~__.___.._.___.,. __.....~_..____.________n-~--- ---.-- " BBFORB TIIB 11 FoG 15'I'EI\ or W II.I,S, colltl'I'Y orC.f{tt1~AN/), I'ENNSYLVI\NIA In re Bstate of _'13t.JflI'LCII~}!:uL.-lJrfl/,4- -' deceased, No. /'I'Il .01 (JO..5L'l, p~, No, 21?7-()$'17 "0 1,__.u._.CtigJ~]3?PIi~g~Ci:.~Mr:,1.1tA _ (bene f ic isry) ~~jLKI9..!:-.P!"I!LI1J'; AYe;. (lIddre88) ;y~w Cql'11~E!f.~I'1IYD '[.),4. /7<17(;) I'lealle take lIotice o( the denlh of decedEllll. IlIId lhe 9rllnl. of letterll to t.he per!lOnal repJ:i>!lentntlve(!I) nllmed below, You may have a beneficial interest in lhe eslale all followSl _._~__Sff~_/llIflCIle-D WILl- (1 f aclclITlon8rlipiice-rol,eeaea;--use backOl pllge) NaMe of decedent.--"13-bJ!Y'l.CIlt: JI. Lt9rs,l//9 LII8L knowlI address rS t;/?5!!NWiJo,D Cllectli" of. decedellt_..'.__.__ tA!~c.!!.j!J!:-~~~t.ltefi- p~ /7tJ:f,3 ".-- iJii.teOrae8Tii~-~-:::...,jrJ.llE-:i4~:1.9.fl!Z=~~~-.- I'lace of deilthJll..'f.t: 7r../P~~ III1y"E/IJ lAJ~r- E!I$'r?SfNsiJd!llJ "riNJ! County of grallt of orlgillf.1 letler9_Ct.lntB~IeLl4lt[) Decedent died X tA!llnl" IlItestale, .-.-_.__.-. _.,--~- A copy of the wi.l I _6.... l!l :n :.11:' IItt.BcI,ed. "ame(ll), lId<lre!ls(e!l) I\n<l telephone nllinber(!l) of 1111 personlll representative!! Bppolnted Addresll Telephone 7/7~ 7.1 '775'77 Name David T Lalsha 1141 Columbus Ave, Lemo)'ne,l'^ 17043 -.-----.---...-----.----- .---.-..........--..--..--...--.. --~._~~---- RECElVEDUi-fl tJ!~ ~4/&' .. 'I01~OF ~~~~rICIAL INTEREST IN ESTATE eKronE "IIE REI; I STEil or W 11,\,(1, coUNTY or (lJA1>>..ER.lAN/), In re Estale of ';BI..I4NClllt 71. L"'rull~ , _~M__""""'__'__"~"'_~"""~~~~""-'~---~'-"-'-"--'.-.--- No. 1"'17~.- of eO~rl, PIl, Ne. 2/97-()$'17 "01 ,.__G:~()]fLf.r:t:.., _$:,~'1rS'l//.l .u._ 5'.~Ji:.~~!:!y'.fA)~J.L.QMtr:. t~!?---'3111~c~<f/i'1'..~q. ?11 !7~.J " PEHNSYLIJMHA decealled, \ bene flc1ary) _ (lIddre8ll) Please take I\otice of Lhe ue/lth of uecelhmt fll\d lhe grant of letters to t he pI-'! I: Aon/) I rl'l'reRf'nt/lll.ve (A) nnmed below. You mny hflve a benefl.cial. interest 1n thl:! e!lt/)le liS (olloWSI ..._'_ ..~E_.I!l,!I!!L~JI e:!? ~ I!::.f -------_..~---~_._--_.._--_.-_.._---------- (If add It lOllliT'- iipiice-Tii-j',eeil,,-a ;u-,iiii--i>ackQfpnge,--' Nnme of decedellt.__73.b11lY..CILE."" II. Ll9rs.JI,tt; Lnst. knowlI 8drlreA!l.._.rSn!iB-~_~/lj",!()0I:2-_'lreC~6' . of decedellt__.H_______~~!!:I!1/..o.f3t.-':I;eq. PA /7dj/J lJa teoIdeair.~=~-:.~~~lf'l.l1E~3~J.9'l'7 rlace of dealh~l{~ 'H!P'ff 118..VFN tAJ~r-E;lS'rJ7S(lIsiJ~ tlAl?? County of ~,rallt. of orl.gillf.l letterll Ctln1B~;eLI4h'D lJecedent dled ./S._____ telll"I" A copy of the will ~_ is illleetllle. ;:r /I :,. rr at lacl,ed , Name(lQ, IId.Jre!lll(eA) /Inri telephone number(!l) of all personal representlltivell III'Pointed Name Address Telephone 7/7'" 7J,/7SU David T, Lalsha 1141 Columbus Ave, Lemoyne,I'A 17043 ------- RECEIVED #' 6~~~;f~JW~ ,~ lIonCE or DEllEflCl1\L llfl'ERES'l' t tl ES'l'A'l'E ,-"-'---'" --_.__..--_._---_._._,~------_. " BErORETlIE I\IW\STEII or WlI,\,r" COllll'I'Y orCgnt>>.E.P..tA@, rEtlNSYLVAN1^ 111, re Estate o[ .?Jt..II/'{~!!!!.}f.:.i:.-I'JLfJl!!..--~.---' deceued. No, /1'17_--. of oe.SI7 p~, Nc. ~/97-()tj/7 '1'0 ,__---.-.....:l2l1 &II 'tL7Sj,.,1l,7S,,1t1L U""----.- (bene (ie lary I .__~It?.-3-_7i~!d.4f.~& S5._..tIV~ _- (addre811) ,__ fll9~fi 1.~(i~€.'f:--__.-'P'&} ____L2lL?,.:- ~.3M rlealle tllk~ Ilutice o( the ..lenth of decedent. 811d the grant of letterll to Lhe personnl rf'presenl.l\tlvl"(S) lIamed below, You mllY have II beneUclal Intl"r:est. In Lhe estate as folloW1I1 ___... __.5% Ii' ._;q". 7L,('[.C ~ Wi L f- - ----.---- (I ( IIddltlOI'8T-iipiiceTiiIiCede(j~"i80-biiCkOrpa99)-' l1ame o( decedelll..._.73./..Jl-!LCIl.~ lI.ll9 rslll9 LUI: known Ild'Irf!!lf!...~9:.-.ti:B-~/Il?!!aop C/fect6' o ( dec ede I' L._..__._-':!!..9 re. .tJ1f.~.~ li tllt.cr P Il /7 tJ~.3 -- oa~(deiliJ,--------:;v122 v--o:Jrzz:J77r?----- ".._.___LUllL.JJ-1l- 7J..-L- rlace o( denlh]lI"lJE :B/p~.!!,ql!.E/tI /A)~r-EA$"rpB(!/S7J~ -rIP!! County o( qrallL of odqilll I leLtlHlI. C l/nt{js-;eI..I9/YD oecedent died )S...._. LellI..1\" ^ copy o( the witl ;).___ If! illlelltnle, ~ I .. r!: 8 ttllcJ.ed , Nllllle("). address(I'l!'!) 1\1\,1 telepholle Illlmber(s) of all personal represent.atlvell al'l'ulllled Addrellll Telephone Name 7/7'" 7; 775"'77 Dftvld T, Lftuhft U~o~~~~~~u'~04ej .___..__.,.._d______ -- -,.---'--- . ---. --~._._-~...-"..__._-_. .---.- ~ RECEIVED '2 u 'j) .\).,.,I.j~IC , '",..."'.....",.,.........'. _.,c !iQ'!:ICE OF--1l,E:!!E:.Lt~J.N! IN'l'ERES'1' -11LEs'r^'r~L ' .' BEFORE TilE REUl s'rEIl OF WlI,L,!;, CoUH'I'Y orC!J1tlIJ.E~~dN12, l'ENNSYLVANIA In re Estate 01 '23t.I4Nf!.I/E 71. Ll4rulll? , deceased _~L.__.~~._.__~_'___.. --~-,.....,._-_.._--_.----.~..-.---- ' No. /1'1Z-,- 01 Q.9.-SI7 PIl. No. /Z.197-()$'17 1'01 __;J)lL<LL'l)~.-"[;.-~-1r~ItIl------,--------- (beneficiary) .-llJ!l__ C ~':.tl.l!i!~_t.t.~~ (lIddrelll) .L~CJf"N~_'2tJ /7~K~ l'lealle lllke lIotice of the denlh of decedallt llnd the grant of letters to the pel.'!'Ionnl rf!prenellllltlvl'!(!!I nllmed below, You may hllve II beneficial illterest 1.11 the estate liS (ollOWlIl __ ~€__r1 ]rfl.~ II e-D WI it. TI:TadaltTOii'ii --iipltceiii--iieedii-a;-.usebackol pllg9) Nllme of decedellt__73.LI'iNC!i~ t!._i..I97.:S,l/~ LllIIt known IIddren!!_E.S._r;E~It.5POO/:) ClIect6"" of decedent__.p_____~~!!_:Mf:.-~~~4';eq. PA /7tJ~ Ua te 0 fdeatil~~:=~~1l1l1E:.Jl;:7.!l7J~ l'lace of dellth:R{l(E' "H./P~ III/yEN lAI~r-EII6'rpS'(l/s7Je?It!LJ tIN?? County of grallt of Orlgillll letter:9___c. tltr/EiTJeLAItJ) uecedent dIed X tenl..,l" intestllte, ........-- ._'''~-_.- ^ copy of the will ~,_ in .;..au ""ur attactted. Nllme(!!), llddrons(ell) 11111\ telephone number(ll) of all personal reprellelltllt.J. ves IlppO lllled Nllme Add(ess Telephone 7/7~ 7.1 ~7S7...7 Dsvid T, Lslshs 1141 Columbus Ave. Lemoyne, PA 17043 .,.---.-------,,---- .__~___. .__..__~4_.,_....'_.n____...__ ~_.. ItECE'iVED /(i& " -r-:~ .t: p-L ~ ( co II) -Ti ""L I} , O~ , \ ,~ p~ 'I (;0 N r:) L!::! nr; (.-~ , \:f; ~. (" III u: DB 0:: i' I " tJ I, , THE SUNDAY PATRIOT NEWS Proof of Publication Undor Act No, 587, ADllIovod Ma~ 16._JiZL Couoow..HII ot '.00.yl...01., Couoty ot D.upIl10/ .. Mlch,e/Morrow being duly sworn according to law, deposes and says: That ha I. thaAlslstant Controller 01 THE PATRIOT.NEWS CO" a corporatiun organized and exlsllng under tho low9 01 tho Commonweollh of Pennsylvania, wllh lis prlnolpsl olllco and plaoe of business at 812 to 818 Markel StlGol, In tha City 01 Harrisburg, County of Dauphin, Stalo 01 Pennsylvania, owner and publloher of THE PATRIOT. NEWS and THE SUNDAY PATRIOT.NEWS newspapars 01 ganeral clroulatlon, printed end published sl812 to 818 Markot Slroet, In the City, Counly and Slale aforeSAid; thai THE PATRIOT. NEWS and THE SUNDAY PATRIOT-NEWS were eatablished Maroh 41h, 1854, and September 181h, 1949, rospectlvely, and all heve been oontlnuously published ever since; That the printed notice or publication which is securely atloched hereto la exaolly 81 printed and pUblished In their regular and/or Sunday and Metro odltlons/issues which appaarod on tha 24th and 310t dsy(a) of July and the 11h doy(a) of Auguat 1991, That nellher he nor said Company Is Inlareslod in Iho subjeol moiler of said prlntad notice or advertising, ond that oli 01 tho allegatlona 01 this statement ~s to tha time, placa and oheracler 01 publication are true; and That he hu personal knowledge ot the lacts aforassid and la virtue and pursuant to a raoolutlcn unonlmoualy paaaed end adoptlld severally by the stockholders and board ot dllGotora 01 the said Company and subsequanlly duly racorded In the 011 Ice tor the I~ecordlng 01 Deeds In and lor aid County of Dauphin In Mlscellaneouo Book 'M", Voluma 14, Page 311, COpy OF PUBLICA liON Sworl F '. .. E*" Notices , "_;slo.~~:~.fVzaD:fZ~~'fw.hO ...." .. H, ~"wOllMLavllu'<l . 'OR un , . Urnbtrtanct, Ptnn.vlva. ",., .""ttdtotntllftdtr. . . III M' IMine ndlbtH t. takf R.~ .""""ttcftofMIl:I .mmtdlot. ~""""t"aU ~1:~c~~~t"'Nnt ttttm for ..t. fn~r~'Tu\ATJrli1JI ' . LlMov'iltJA1All : I MMCJIf, DAVID T, LATSHA 114100LUMBUSAVENUE LEMOYNE, PA, 11043 5taternent Or Advertising (ollL To THE PATRIOT.NEWS CO.. Dr, For publishing the notice or publication allached herelo on the above stated dates, $116,28 Probating sarne $ 1,00 Tolal $117,28 Publisher's receipt for Advortising Cost: THE PATRIOT-NeWS CO" publisher 01 THE PATRIOT-NEWS and THE SUNDAY PATRIOT.NEWS, newspapllro of general olrculation, hereby aoknolVledga receipt 01 the aloresald notice and publication costs and certifies thaI Ihe same hsvo been dUly paid, THE PATRIOT. NEWS 00, By,,,'(l.:~t:.,,,,~',-f..~1.,?!:,,,,~g,,,,,,~;f7 /-11 ~"rL.t.. \(.'.1 , .-I.,'.j i'J cu ... ~'UillATION OF _l!Q1.1CE UNDER Rill&. 5.6 (" l Name of Decedent I :J3Lf.lA/OII; II, L fJr.sllfl Date of D~ath:_ II1Af' .31-;_.L111 Will No.jf'17::- a(~SI7____J\dmln, No, ,2/ rJ7-0$"/ 7 I certify that notice of beneficial interest required by flute 5,6(a) of the Orphans' Court Rules was served on or mailed to the fc)llowing benef.iciaries of the above-captioned estate on /~ ' 711s/9'1G-:~(JIE'<;E S. I. nrSl/fJ gs C;-fel:~;UA)q,{JD CR. W(J!<ff7L.t:/'5.6'q,eG~ 'PIJ, 1701(3 7;isll77J~VID r: /.. ~r::/I;q1T 6/~3 13L.tlt:GRIfS.s I/VE.II/1~RlslSqIX,-, PI/ IlIIZ-2.32.1 7 f'l/97CIlIfIS'1"C''P11lif( _t;, 1.Ar.s/l11 201I1AtJ)E1:mlJ;./Il~c. /lEtv C<1If/B&:Ll9t11J>fJl/707tJ '0f/'11 "])AI/ ID r: L~r.sHf1 //'11 Cvi<1ff/!it{.5 /ll/F. Lvrl.:Jll;j!e, ~'FJ, 17tJIG .. To the Register: Ad~ Notice has now been given to all persons entitled thereto under Rule 5,6(a) except ---- Date: r / JJ.. 6/1 I -r=<-') , // (/"'~ /;J~ .,_~_~~< ,/, ~,1, . . ( Signature Name :.I)/tl/li) /.'" /tTJ'11fi }l.11dress 1/.y/t.'}J/"i(;r?I9/IS ,1t/F ~I.:/I1cJPAlr PIl /70f.5' --- LL" Telephone1Zlll 7.377.5'77 capacitYI~ Personal Representative .~-, i" (-j r'i~ \;.1 .--"'j counsel for personal representative j,.j," \,.-_\ J ~- f,~jC: - ." '," ," ~ .'\ LAT SAA , BLANCHE H, ~---~---_._-_._.._._-~._._._-'_._--_.._'--_._- SOCIAl. SECURITY NUMOEII OAn Of OEA1H o.\1E 01 OlRlIl 188_32:4EL___92j~LjXJ----~___2.~_h_OI:L_- . --- II' mUeA"" SURVIVINO SPOUSE'S NAM' ,"'51. ",,1. AND MIDDLE INI1"" SOCiAl SECUIIITY HUMIIEn THIS "TUIIN MUST .. ,,"0 IN DUPLlCAli WITH "" LATSHA, GE:ORGE S. 194 . 28 . 8616 REGISTER OF WILLS , ITJ, ....;;:;; -~.--~ [J ; .......,.. .~;,- .------ -- - r=j,~;'.~~, .'"" ... , ~"'. " ; ;.; di [J.. ,.... .... CJ ..."". ~.. ..~.- ,." ."". ,,,"" ['-J "..""'",,. ,...." ,..... 5 ~m [~J... o".d,"' o,.d 1,,1.1' lA'''''' "" 01 W.III C;ll o".dool M.lnt"ot" .li,lou 111'" I""'" ""I 01 "",,1_0 '.101.1 N""b" 015.1. 0'1'0" 60'" $ [.1 S.l'~"~O ,,,,,,,,, ""'Nod L J '0. S,o,!,,1 ,,,.Il' C"", ,.,,,,. ..,,"..~.~ 111I'"''H''''' L. II LEI""oo 10 '" un"" s". 91 13\A\ 1,,,.~\<l>O1 THIS SECTION MUST aE COMPLErED, ALL CORRESPONDENCE ANOCONFIDENTIAL TAX INFORMAi1ciN SHOULD BE DIRECTeD TO: __" coMPLETE MAIUNO ADDRESS ~------- ffi ~ o ~ffi 8l DAVID T, LATSH!'., EXECUTOR RMNAME 11n;p,;ilC.bltl - c/o Howell C, Mette, Esq, El 'HONE NuMBEII 1"/1"1 \ 232005000 _....:-- Mette, Evans & Woodside 3401 North front street p,O, !loX 5950 ~risbur9,_~1."I~0950 OffICIAL USf. ONl~ --.--- 2. Stock$ and 8ond~ (Schtldulo Ol 111 121 743 749 ,. Real btate (SchedUlll Al 3. Clo$ely Held COfpolltloTl, Partne!$hlp or Solo<Proprielorship I'J) z o ~ E 5 '" a: 4. Mongage$ & Notes Receivable (Schedule D) 141 6. CI$h. Bank OepO$its & MisceUallllouS PelSonal PlOpefW ISch.dul. EI 1&1 6. Jointlv Owned Plopal'" (Schedulo n (6) 1. InterNivos Translsr$ & MiscellaneoUS Non-Probate Property (Schedule Gar 1.1 (11 181 1 141 397 448 - , 197 8. Totlll Oroll Asut& (total Lines 1-7l 46 811 9. Funeral bpoMes & Admlni;;trallve Cosls (Schodule HI {9l 46 (J94 811 386 , ~ 10, DeblS 01 00C9(tel'll, MortgAge liabihho$, & Uens (Schedulo n (101 1\11 1 1121 11. Total Deductions Ilolal Unes 9 & 10) '2. Net Velu. of Eatete IUne 8 minus Une 111 13. Chilil.bl. end 0"0,""001.1 8'Q"0"'/S" 9113 T'''''' fOf which en .I"tion 101" hos 1'01 heon made (Schedllle Jl 1131 (141 1 -=.'~ 094 386. ~ \ ~ 14. N.t VIlu. SubJ.ct '1:0 Tel( (Uno 12 fllinus Uno 131 1&. AmountOrrrntT41lxablo -.------------ II ,he spousal tax ,ate ' 161 See iMtfucll(ms on fevflfse ~idll fOl ullplic(,b\o pOlcentage '0. Amount 01 hne 14 1a:iable 1\ 6'4 lale 932 17. Anlount of line 14 ,a_able at '6114 laUI 55 ...----_.. 641 D 1161 55 965 "/45 .06 1191 1111 1181 ,18 965 18. Tlx Out 19, [X) cHECK HERE 15 you ARE REQUESTING A REFUND OF AN OVERPAYMENT ---..'IIOBE SUR'E TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND RECHECK MATH ~..-- _ _~.,=.=rr"",,,,fii1iiiOllll, 1""'" liW1iI<1ii1i1 "'O,,,pTnil,," 1<h""i1OilfiO.,.I.nl,,'I., .iiilTol1iO buol 0' "" jllOw,.;,T.. end b""" .. I,"" ooil"" . .,._ t~ h~...,l nl\ 11Iln!otlllilltlOIl 01 whiQh pl.plrll hu .nv knowledU" --...--'.- --- !lATE 0\ /.. ~-- = ~ ... .. --. ._._._--'-'-----.~~- - . ------- ~'!t--=:1zlr PA. J.70~___ Decedent's complete Address: ll1lrrntlMUS ----------- 85 GREENW09-~IRCLE -"- WORMLEYSBURG __><-.-------.---- TalC Payments end Cradlts: 1, Ta, DUI (Plgl 1 L1nl 18) 2, C"dll,/Paymlnl' A, Spounl Po,lIly Cr.dil 8, Prior Plym.nl, C. Discount (1) ,-- 55,965 ..2),000 3,316 Tol.1 C"dll' (A + 9 + C) (21 66,316 3, Inllllll/Plnllty If Ippllc.bla D,lnll"" E, pln.11y Tol.1 Inle",I/Penoltv (0 + EI 13) 4, If IInl 2 I, g"atll lhln IInl 1 + lint 3, Inler thl dlHerencI, This Is the OVERPAYMENT, Chick bo, on rlgl 111nl 1 S 10 ,oquosl I ,ofund 14) 10,351 5, It Ilnl 1 + Ilnl 3 I, grll'" thin line 2, Inter tho dltfe"nc.. This Is Ih. TAX DUE, (51__ (PA) A, Enter the interest on the tax due. 8, Enter Ih. 10t.1 ot Une 5 + SA, Thl, I. Ih. BALANCE DUE, (59) Make Check Payable 10: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS 8Y PLACING AN ")(" IN THE APPROPRIATE BLOCKS 1. Old dlc.denl make a lran.f" and: YII No a, ,,'lln lhl un or Incom. of Ih. propllly transferred; """""""" ,0 CKJ b, "taln Ih. rlghl 10 dlllgnale who sh.1I use lh. properly Iran,terred or its Income: , . . ,0 CKJ c, IOtaln a 1O""lon.ry Inler..': or """""".".,"""'" ' , ,,0 CKJ d, IOcII" tho proml.. fo' lif. ot ellher payments, b.netit' or carej ".'".., ' ,,0 CKJ 2, If death occurred on or before December 12, 1982. did decedent within two years prlclding de.th IlOn,fer prop.rly wlthoul IOc.I,lng adequate con ,I deraIl on) II death occurlOd after Oecember 12, 1982. did decedent 'ransfar property within one year 01 death wilhout IOc.I,lng .dequatl conslderallon? """""""",.,"',.," ,[!] 0 3, Did decedent own an 'In trust fOl' or payable upon death bank account or security II hi, or her death? , , . , , , , , , . . . , , , , . , . , , , , , . , . . , , , . , , , ,.0 [!] 4, Old dlc.d.nl own .n Indi,ldu.1 IItillmenl account, .nnuity, or olher non'probal' property? ..00 0 IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN 1 6 (a) ( .1) (I) provl .d fo, Ihl r.ducllon of Ih. t.. ral' ImpolOd on Ih. n,' v.lu. of Iran' I." 10 or tor thl un 0 'POUII hom 6% \03% for d.,es of death on or .ftor July 1, 1994 and b.loro January 1, 1996, 72 P,S, ~9118 lal (1,11 (iil p,ovld.d tor tho IIduction of th, ra" Imposed on thl net valu. ot lran.for, to or lor Ihl use of thl ,urvlvlng 'pou.. trom 3% to 0% for dalll of death on or .fter January 1, 1995, Th. ,'atut. do.. not ...mpl a lran.ter 10 I ,urvlVlng 'POUII from loa, Ind Ihl ,'atutory IIqulllm.n" for dl,clo.u,. of ....t. and filing' toa r.iuIn '" ,till .pplicabl. IVln if the ,urvlvlng 'pouse I. Ihl only blnlficlary, FOR DATES OF DEATH ON OR AFTER JANUARY 1, 1995, Plea.. .n,wor tho following qu,,'ion by pl.clng .n ',' In Ih. approprllte spice. Old Ihe dlcldonl c,o.l. .Irusl or .Imit.. "'onoomonl which Is sololy for tho survlvlno .pOUSO'1 b.nolil fo, hie or h.. entl,. Ilflllml1 Vos [jJ No 0 It you an.world yes 10 thl .boVl qu,,'ion, th. I.. on lh. tru,' or .imllar ."ang.ment i, po,tpon.d unlll tho dlllh of Iho second .pouse, II which Uml It will b. luity t..abla ., thl "t.(.1 .pplic.bl. to Ih. remalndor b.n.liclary(iesl. Entor Ih. volul of Ihl tru,t on Schldull .I, ParI II, In ordor 10 IImoVl 11 hom thl calcul.tlon of thl I.. dUI In Ihl, ..t.,a, Vou may wl,h to fill Sch.dull 0 In ordor to makl Ihl Illcllon "allabll und.r Section 9113, it tho II,cllon I, mad., Ih. Iru.1 or ,Imllar a"ang.m.nl I, t...d In Ihl ",all of Iha firs' dlcldlnl ,po use, lha porllon of Ihl trust or ,Imitar arrang.m.nt which b.n.fit' tho survl,lng 'poUlO I, la..d allhl "'0 'IX ratl, and lhl "malndor is 1..ld allhl IIt.(,) IPplic.bll 10 Ihl IImalndor b.n.ficlory(I..I, If you choose 10 makl Ihl II.ctlon, you mu,l attach Schldul. 0 10 a llm.ly,tilld t.. IIturn, al..,g with Schldul.(.) K and/or M In ordor 10 ,how thl apportlonm.nl of lhl 'ru,' or ,,1",11., 1"lng.m.n1 b,twl8n the surviving spouse Ind the remainder benellc~arv(ies), ~., ,,_. " . '" L SCHEDULE H ~ COMMONWEALTH OF FINNSVlVANIA FUNERAL EXPENSES & INHIRITANCE TAK RITURN ADMINISTRATIVE COSTS ._ RESIOENT DICEDENT -- 'r.STii'fE OF -- - . ~~- =''''~- - FILE NUMBER B1~CllE.~~_-.._------------------'--'-- 21-1997-0517 .. ",1'/,1'" U'II,'" _~~btl of ~..cedent mUlt b. ~!"port!~~~~!!!~~---..;....------- ITEM NUMbER A, AMOUNT DESCRIPTION 1. FUNE'AALfXPENSES: .-.....,----------.-. MYERS HARNER FUNERAL llOME, CAMP ll1LL, PA CEMETRY LOT, OPENING AND CLOSING cos'rs, HF.AD 750 2,821 1,740 STONE, BURIAL VAULTS 2 FOOD, REFRESHMENTS AND MISCELL/l.NEOUS EXPF,NSES DURING FUNERAL PERIOD 3 B, ADMINISTRATIVE COSTS: 1. P",onal R.plInntatlvat, Commlulons 20,000 Nama 01 pallO,al A'P""""lvo(.) DAVI D T, LATSllA Social Securlty Numberta) I E1N Number 01 Pllsonal f\eplullnt.tlve(al Su.a' Add"u 1141 CO~S AVE City 1&'i9YNE S'a" PA Zip 17043 -- -- v..".) Commlulon Paid: 1998 10,000 2, A110rnev F.., 3. Familv exemption: III decedent', addresa Is not the urn. lIS claimant'.. .1tach eKplanl1ion) 3,500 Claimant _George s. Latsha Street Addle" 85 Greenwood :1 r.ole Zip 17043 State Fa 8,000 6, BOLES, GROVE AND METZGER, PC, hxR'h.un Pr.p'''''. Fe.. 7, 3 TOTAL (Al,o ,nlll on lin, 9. R,upitul,tion) l~ mOll 'pac:t It ,,"d.d. Insert .ddlllonat .h..'t ot urn. ,ill) $ 46,811 FILII'JOMBIR 21-1997-0517 RELATIONSHIP TO DECf,OEN AMOUNT OR SHARE Do Not L1.t T,u"..I.1 OF ESTATE ~ RIV,ISa IK'II,tll SCHEDULE J BENEFICIARIES COMMONWEAlTH OF PINNSVlVANIA INHIRITANCE TAX RIlURN RIIIOINT OltlDINT ESTATE Or-- BLANCHE H, 1J\TStlA -- =--.:-. NUMSER NAME AND ADDRESS OF PERSDNtSI RECEIViNO PROPERTY I. TAXABLE DISTRIBUTIONS 11"lud. oUlflghl ,pouIII dl."ibullonoJ I, SEE ATTACHED SCHEDULES ~ I' I ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON liNES 16 THROUOH 17, AS APPROPRIATE, ON REV 1600 COVER SHEET II, NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL OISTRIBUTIONS UNDER SECTION B113 FOR WHICH AN ELECTION TO TAX IS NOT BEINO MADE 1, B,CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS " TOTAL Of PANT II. ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV 1600 COVER SHEET S (tf 11\0" lP'CI II nlltd.d, In..rt Idditlon.1 ,h"" of 11m. IIz'1 ... . , ' "'-'-'--"~-~'---_.~~-"~-~._-.~'--'-----'-''''--'''_. ITEM., IV; If I predecease my husband, GEORGE S, LATSHA, I glvc, devise and bequeath all the resl, residue and remainder of my estate, not disposed of In the preceding portions of this Will, to my husband, GEORGE S, LA TSHA, and my son, DAVID T, LATSHA, as Trustees (hereinafter collectively rderred to as "Tnlstee"), IN TRUST NEVERTHELESS, to be further divided into two parls, each of which shall be held In trust and constitute a separate Trust Fund to be known as "Trust A" and "Trust B", --. -' "Trust A"; There shall be, placed in "Trust A" that fraction of my--- residuartEilate of which the numerator shall be a sum equ~to the larillL , amount that can pass free of Federal estate tax under my Will by. reason of the ~ ____________~.'.._4.'_. .._____. ________ ..\!Dilled ~rediU!.!.1!Lthe st~.\.9...Q.~.A!.!J_!~2~g.~QlL(pr.ovi~esUhatthe use of thls.cr.edlt_ does not require an increase in stale death taxes) allowable to my estate but no ------ -- other credit and after taking account of dispositions under other items of this Will and property passing outside of this Will which do not qualify for the marital or charitable deduction and after .taking account of chargcs to principal that are not allowcd as deductions in computing my Federal estate tax and of which the denominator shall be the value of my residuary estate, For purposes of establishing such fraclion, the v.alues finally lixed in the Federal estate tax Droceedin2 relating to my estate shall be used, I recognize that the numerator of such fraction may he zero (0), in which case no p'rollWY. shall Dass under "Trust A" and that said numerator may be affected bY.Jhe action o(,\M._ Executor in exercising certain tax elections, " ~. "Trust B"; The balance of my residuary estate not placed in "Tru~L A" shall be placed into "Trust B" to be held, adminislered and distributed in accordance with ITEM VI of this Will. Page 2 13!U . ~".,_....,.,.,..,.-'...'_r_,,,,,,,,_-,,,,,,,,,,,,,,,,,--,,,,,,-,,,,,,,,","r""""""'-""''''',-.' ' .,.. ,....,"'-"",~ ..,......,.=-"'.........",.. IIEM'y': The following provisions shall apply to "Trust A": (a) The Tnlst~e shall pay the net income arising from the principal of this 'frllstln convenient Installments not lesS frequently than annually to my husband, GEORGE S. LATSHA, during his Hfetlme, (b) During the Iifetline of mY said husband, ~le Trustee shall pay to or for the benenl of my said husband so much of lhe principal of this Trust as may be necessary, in the sole discretion of the Trustee (other than my husband), for the proper support, maintenance and medical care of mY .!laid hUW.lli!., (c) Upon the death of my husband,Jhe Trustee shall pay all accrued income and all income accumulated but undistributed to the estate of my deceased husband and shallthe~fter ho\9 the then re,maining principal in Trust for m son, DAVID T, LATSHA (hereinafter referred to as the "Beneficla!t1, The Trustee shall quarterly pay to or for the henem of the Beneficiary all of the income and so milch of the principal of said Trust as, In the discretion of th~ Trllsl.~eJ may be necessary for the p.!QP~r suppo!1._ maintenance and medical care of s~ Beneticial}'."._ (4) "Upon the death of t~~iarj', the Trustee shall con~y and p~ over all of th~.!~!:!'_~~!1.I.!!g.~~~\Q..!1)v;randsqnS..l-PA VI2-r, LA TSHA,Jl,J!Dd CHRISTOPHER G, LATSHA, in equal shares, --. -- If either DAVID T, LATSHA, 11 or CHRISTOPHER G. LATSHA Is not then \I~lng, this share shall be, paid to his then living Issue, per stirpes, If there I1IiiI Page 3 / ., , ' Is no such thcn living Issuc, his share shall bc paid to the survivor of them, or the then living issue of the survivor of thcm, per sllrpes, if nellher of them are then living, ITEM VI: The following provisions shall apply 10 "Trust B": (n) Trustee shull have, hold, manage, invest and reinvest the assets of this Trust, colleclthe Income and beg!!ll~i.ng.l!t..!11y_!!ea.!lLp"~~.Q.Y.\lr the net income in convcniem installments not less fr~.quently than anlllUlllY-lG..ID.Y--- h\!~!1t1[l.~., GEORGE S, LATSHA, during_his lifetime, The Trust~e shalll!!so, from time to time, pay to my husband such amounts of principal of this Trust as .the Trustec (other than my husband>-dsen~~.!!rY...!Qr the.J!rop-er.MlpPJltl... maintenance and medical care of my husband, (b) Upon the death of my husband, the Tnlstee shall pay all accrued income and all income accumulated but undistributed to the estate of my deceased husband andshallthereafler transfer the then remainine princil1.ill..QL this Trust to "Trust A" to be held, adm.!.nisterecl and distributed In accordance with theQLovlslons of ITEM V of this Will, (c) The E".E~ shall be authorized In the Execulor's sole, exclusive and _un~~i$~!.'lliE!etion to determine whether to elect (under Section ..~056(b)(7) of th~rnal Revenue Code of 1986 as amended, or any corresponding provision of the Federal cstale law), to qualify all, none or a fraction of "Trust B" for the Federal estate tax marital deduction, The decision ,of the Executor with respect to the exercise of the election shall be linal and ..__.~ - conclusive upon all p:~s w~~se interests in my estate are directly or Page 4 ~, . , ' , " ." '""..... _., 1'. ,. ~'" Indirectly affected by the elecllon, Gnly property which Is fully ellylblc for the marilal deduction \lI1dllr Pederal estate tax law shall be assigned to this Trust. Notwithstanding anything to the contrl1l'Y contained in this Will, the Trustee of this Tl'lIst shall not retain beyond a reasonable time any property which may at any time be or become unproductive, nor shall Trustee invest in unproductive property, NQI.IYllll~lll.lli1iDg the lliovislons of subparagraph (b) of this Item, the Trustee shall pay to the ExeClj~r of my h~sband~~_~~~;:~ut_l?LthU)ri~s.!~ of . this T!:!!.~pon th~.~E~~!.._OL!!~}::J!usbanA~~,.?II.\.~~~~~'!'!..n.U.'?l!!~..e.~~~L. inheritance, transfer, successi~'Land oth.~r deut_~JlI~~.c.d~1!h. ta~$.:'),..E'ederal, state an~ other, ()!yable.bU<.l..a~Q~_~I~th~.J,l1c!~l.si.ol1. C!.f~l.~...\:l1!!le.Q.f T~\I~t.proP\l!1Y ilU)1y. husballil.:s.~.!.!l.\Q. Such payment shall be equal to the amount by which (1) the total of such death taxes paid by my husband's estate exceeds (2) the total of such death taxes which would have been payable If the value of the Trust property had not been included in his estate, The determination by my husband's Executor of the amount payable hereunder shall be final. I direct the Trustee to pay such amount promptly upon written request of my husband's Executor. The final determination of the amount dlle hereunder shall be based upon the value as finally determined for Federal estate tax purposes in my husband's estate, After payment of the amount finally determined to be due hereunder, the Trustee shall be discharged from any further liability with respect to such payment, My husband may waive his estate's right to payment under this subparagraph by Will, executed after my death, in which he sr.eclfically' IllillJ.9....lh~ght to P..~Y..ment hereunder given to his estate..:. N{ r ITEM VI!: If I survive my husband, GEORGE S, LA TSHA, I give and devise all the rest, residue and remainder of my estate, not disposed of in tre preceding portions of this Will, to my son, DAVID T, LA TSHA, as Trustee (hereinafter referred to as JJJ1:' Page 5 " " --- .. '..' '" ....--_P~.....,.---.......~~ ,............,'" . -', ,..,_......."....l,..,.'..'rl.;tj,j,J~......,I#iI., .... --"".;- (b) Upon the death of the Beneficiary, the Trustee shall convey and PRY over all of the remaining assets to my grandsons, DAVID T, LATSHA, Il,and CHRISTOPHER G, LATSHA, in equal shares, If eithcr DAVID T, LATSHA, II 01' CHRISTOPHER G, LATSHA is not then living, his share shall be paid to his then living issue, per stirpes, If there is no such thcn living issuc, his share shall bc paid to the sUl'vivor of thcm, 01' the thell living issue of the sl\L'vlvor or them, per stirpes, if neither of them arc then llving, ITEM IX: The following provisions shall apply to "Trust 0": (a) Trustee shall have, hold, manage, invest and relnvestlhe assets of this Trust, and shall quarterly pay to or for the benefit of my son, DAVID T, LA TSBA (hereinafter referred to as the "Beneficlaly") all of the income and so much of the principal of said Trust as may be necessary in the discretion of the Trustee for the proper suppol'l, maintenance and medical care of such Beneficiary, (b) Trustee shall pay such amount of principal of this Trust as the Beneficiary shall from tlmc to tlmc rcquest In writing, " (c) If the Beneficiary survives BLANCl-lE 1-1, LATSI-IA, then upon the death oC the Beneticlary, the Trustee shall convey and pay ovo,r all of the remaining assets to such person or persons, or corporation or corporations, or to the estate of the Beneficiary, in such amounts or proportions, and in such lawCul interest or estates, whether absolutely or in tnlst, as the Beneficiary shall direct, 1lIE Page 7 --.--. , . ..." ,",'/ . ... ".' .. ~ r.'~' ,,~r...M\#A '....1.110 ..~, _..........,..~ ,-. either by Instrument filed wllh the Trustee during the Dencflcll\l'Y'S IIfetlme, exercising this power of Appointment, 01' by the Beneficiary's Last Wlllllnd , Testament. . (d) H this power of Appointment is for any reason not validly exercised by the Beneficiary, in whole or In palt during the Beneficiary's lifetime, or In the Beneficiary's Last Willnnd Testament, then upon the dealh of Beneficiary, the remaining assets shull be added to the assets to be distributed under paragraph (b) of ITEM VI11, ITEM X: In the settlement of my estate and during the continuance of tllC foregoing Trusts, thc Executor and the Trustec shall possess, among others, the following powers: (a) To l\~tain uny investments I may have at my dcath, Including specilically those consisting of stock of uny bank evcn if I have named such bank as the Executor or Trustee herein, so long as the Executor or Trustee may deem it advisable to my estate so to do, (b) To vary investments, when deemed desirable by thc Executor or Trustee, and to Invest in such bonds, stocks, notes, rcal estate mortgages or other securities or in such other property, real or personal, as they shall deem wise, without being restricted to so-called "legal investments", and without being limited by any statute or rule of law regarding investments by fiduciaries, " r I , (c) In order to effect a division of the principal of a Trust or for anY other purpose, including any final distribution of a Trust, thc Executor or Trustee ~ Page 8 . """""~"""""'~~:r.llill<:;;;""~=.7:mj;\;:;;:.....ua;J:l'l.lmi:l~::;""~i,,,.i41.'tF.:il'/j~'lIJIllJI/)!I-': \J::'.,I'.~.< . . cannOl be estabUshed by proof, my husband shull be deemed to hal'e predeceased me, Any porton (other than mysell) who shall have died 8tlhc same lime as any then recipient of income or in a common disaster wllh such beneficiary, or under sllch clrcllmstances that the order of deaths cannot be establlshed by proof, shall be dcemed to hal'c predeccased such beneficiary, ITEM XIII: I hereby nominate, consl!tute and appoint my husband, GEORGE S, LATSHA; to be the Executor. In the event of his death or his inability or refusal to serve, I nominate, constitute and appoint my son, DAVID T, LATSHA, to be the Executor. In the event of his death or hislnability or refusal to serve, the successor Executor and Trustee shall be such person or corporalion as my son shall have designated, either in his Last Will and Testament or in writing, delivered to the successor Executor and Trustee, In the event no such designation is made by my son, the successor Executor and Trustee shall be ELYSE E, ROGERS and JAMES B, ULSH of the law finn of METTE, EVANS & WOODSIDE, The Executor and Trustee are specifically relieved from the duty or obligation of filing any bond or other security, IN WITNESS WHEREOF, I have set my hand and seal to this, my Last Will and Testament, consisting of this and the preceding eleven (11) pages, at the end of each pagu.. of which I have also set my initials for greater security and belleI' identification this ---1.1:- d., or r'-'""cr ,19 '16 Tr :.. (':'.. ,':;~~l!;A.d"c;/ L) , BLANCHE H, LA S A We, the undersigned, hereby certify that the foregoing Will was signed, sealed, publlshed and declared by the above-named Testatrix as and for her Last Will and Testament, in the presence of us, \vho, at her request and in her presence and in'the presence of each f ' ~ I. I \ Pam 706 United Stltel Eltlte (end Generlllon-Sklpplng Tranller) Till Rlturn (ROY, April ''''I E.blle 01. clllzen or rnldent ollhe Untied StaIn (Me MP..telnlltucllonl), Tn be o...n, No. ",,-,"" Olplrlmllll of 'hi "",urv flied lor decedenll dying .n., Oc:tobef I, ltto, for "eplfwork Reducllon Act Nollce, Inl.rn.\ Alv,nu. S.rylC. tee page' 0' the Inatructlanl, ~~;~~. l~' ~.m. on' mlllu" 1011111 '''," ''''do,,;;;m., ilinyj--- .----,.~~~~:~.~~ili..,n;~i--~..---~.-j~ :-;'_";; ~~I~ ,;n;ltv no, 3II---OO~~';:lh(COu~i:".nd-.w;, Of Io;;;g;~.(;oo;;tr-v)"---- '3b--V'-'~.;IO~lIcilt.'~I.-f~l~ed'-[-'Oii;~jblfth--- -, o.i. 01 dulh ~ ,____~_ ~_'____ ._",___19Q~-,--- ~.lI 019.i. _?_l.l!.L.97 --- N.m.ol.)Ctoulor(u.ln,'ruoIIOn'j - - eu f:l(lIOlltOl"llddreU(nUmhIH .mlWltt tnQludlngaPMlmllnl or lull. no, orfur.1 rOIlI.: o!\'(, lown, or po,' 011100; I'al.: and ZIPeodt) Ie El('CU\or"'OOI"I'ClKltvnumb.r("'ln"ru~iiIOnl)-.-.~_.'r ---~_.- "..----. 11.41 COL,UMBUS AVENUE 194-28-9384 LEMOYNE, Ph 17043 . ~OCIIIOI\ 01 oOllrl where wll;';i"-;;bjj.~-;iit, ~dl'1;11119Im~i"""-~--~.'" .----... ~~-.-.-.----.~----_._'----~6CI" number CUMBERLAND COUNTY L_~~GI e_I.ER ,gl'__I:I_IIJI,S.L_~!,l;I~~~!?A ______________E.! - 199'7 ~ 0 51 7 1 It decedent died testala, check h~...~,Jll anE. altac!'u~_"~tlfle_d.,""I'I...~L'ha wll~::::I!:!!.f<lIt11..~766Is alteched, check heee ~ 0 10 It Schedule R-Ils a,lteched, check he.. ~ 0 _uu_______________~__ , Tolal grossestate (~om Perl 5, Recapitulation, page 3, IlemlO) , , , , , , , , , , , , , , , , , , , , , , ' , , , , , , , , , , , , , , , , 2 Tolal .1I0w.ble deductlon~ (~om Pa,t 5, Rec.pltulatlon, page 3, Item 20) , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , . 3 Tax.ble ISlate (sub~.ct line Bom line I) , , , .. . .. , .. , , , , , .. .. .. , , .. , , , , , , , , , .. , , , , , .. , .. , , .. .. .. , 4 Adjusted taxable gifts (total tax.ble gilts (within the m.anlng 01 section 2503) made by Ihe decedent alter December 31, 1975, other than gifts thai are Includible In decadenl', gross estate (section 200I(b)), , " " , '" " 1 Add llnos 3 .nd 4.. ' .. , , .. .. , .. ' .. .. .. , .. , , .. , , , , , .. , .. .. .. , .. , , .. .. , , .. .. .. , , , , , , , .. , , , , .. , 1 Tentative tax on the .mount on line 5 ~om Table A In the Ins~uctlons , , , , , , , , , , , , , ' , , , , , , , , , , , , , , , , , , , , , 7e II line 5 exceeds $10,000,000, enter the lesser 01 line 5 or $21,040,000, It line 5 Is $10,000,000 or less, skip lines 7e and 7b and ente; -0- on line 7c"" , " " ~1_ b Sub~.ot$IO,ooo,ooo ~om line 7a .., , , .. .. , .. .. .. , , , , , , .. .... .. , , , " 7b I c En"" 5% (,05) olllne 7b.. , .. , , .. .. , .. , , .. .. .. .. , , , , , .. .. .. .. , , , , .. , , , , .. .. .. .. .. , , , , , , .. .. , , , 1 Totaltenbltlve tax (add lines 6 and 70), , .. .. , .. .. .. , , , , .. .. .. .. , .. , , .. .. , , .. .. , , .. .. , , .. , , , .. .. " . Total gilt tax paV.b1e wllh respect to gifts made by Ihe decedent alter December 31, 1976, Include gilt taxes by the decedent's spouse lor such spouse's share 01 spill gifts (secllon 2513) only It the decedenl was the donor 01 these gifts .nd they are Includible In the decedent's gross estate (seelns~uctlons), , , , , , , , , , , , , , , , , , '0 Gross estate tax (sub~ect line g ~om line 6), .. , " , , , , , , " , .. " " , , " , , , , , , , , " , , , , , , , , , " .. , , .. " , '1 Maximum unified Cledlt egalnst estate tax, , , , , , , , , , , , , , , , , , , , " , , , , , , " \ 11 \ 19 ~~q.2..c. 12 Adjustment to unified credit. (This adJuslment may not axceed $5,000, See page 7 olthe Ins~uctlons,) , , " " , , " , " " .. , , , .. .. , , .. , .. , , , , , ,12 ----- 13 Allow.ble unified credit (sub~.ct line 12 ~om line 1 I) , , , , , .. . , .. " , , , , , , , , , , , .. " , , , , , , , , , .. , , , " , " 14 Sub~.ct line 13 ~om line 10 (but do not enler lesslhen zero), , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , 1& eredlt lor state death taxes, Dc not enler more than line 14, Compute the credit by using the amount on line 3 less $60,000, See Table B In the Ins~ucllons end attach credit evidence (s.. Ins~uctlons). , , , , , , , , , , '1 Sub~act line 15 ~om line 14, , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , 17 Credit lor Fed....1 gilt taxes on pre-1977 gilts (section 2012) (alt computation) , lli=7 '1 Credit lor lorelgn death taxes (~om Schedule(s) P), (Attach Form(s) 706CE) , " ~_ 18 ,. Cradlllor tax on prior ~ansl...s (~om Schedule Q), , , , , , , , , , . , , , , , , , , , , " L 1. 20 Total (.dd lines 17, lS, end 19) , , , , , , , , , , , , , , , , , , , , , , , , , , , , , ' , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , 21 Net estate tax (sub~aclllne 20 ~om IIna 16)" , " , , , , , , , , " .. .. , , " , , .. , , , , " " , , " .. , , .. , .. , , , " " 22 Ganeretlon-sklpplng ~ansl... taxas (~om Schedule R, Part 2, line 10) , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , 23 Section 4960A Increased e,tale tax (~om Schedule S, Part I, line 17) (see Ins~uctlons) , , , , , , , , , , , , , , , , , , , , , 24 Total ~ansl... taxes (add lines 21, 22, end 23) , " , , , , , , .. " " " , , .. , , , , , , , " " , , , , .. , , " , .. , , , " " , 26 Prior payments, Explain In an attached statement. , , , , , , , , , , , , , , , , , , , , , " L~.L_. 28 United Slates Treasury bonds redeemed In payment 01 eslate lax , , , , , , , , , " Lll 27 Tolal (add lines 25 and 26), , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , 27 21 Balance dun orove< ament sub~actllna27~omllne24),,,...,,,..,,,,,.',,,,,,,'"'''''''''''''''' 21 146,316. Under panaltles 01 p.../ury, I declare thltl have examlnad this return, Including accompanying schadulas and slatements, Ind to the best 01 my knowladge .nd bel~I,-" Is~ue,correct, and comPlet":.p'eclaratlOn oY'repare~ other than the ~~eculor Is based on alllnlormetlon 01 which preparer hes eny knowledge, ~..~-,-z..._ ,;:',2-",-,,-&/ y , '-t:-Q~" .^'S(C. .'::j/...!.!r'l slgnIM'('lol 'IClcuIOf('1 t7 ) . Oil' ' I ~ P A R T . T A " C o .. p U T A T I o N --~, ?-;:1/:I'2:. !.)' /,)~//r- WILLIAM B, BOLES Signa"., 01 Pf',partr olhlr lhan Ilrleculor KFA BOLES GROVE & METZGER, P,C, 3601 N, FRONT STREET HARRISBURG, PA 17110 ,6,ddreu (and ZIP code) (,;'11 1 2 3 4 6 8 7C 8 . 10 13 14 1,979,123, 904,218, 1,074,905, 1,074, 905~. 376,511, 376,5-11, 376,511, 192,800. 183,711, 16 18 37,395, 146,316, 20 21 22 23 24 146,316,. 146,316, ;/')>, ./ -,\ Dale FOIm 70e (Rev, 4-07) 188.32-41.31 Eltlte 01: BLANCHE H, ~!:lA Plrt 3, _ Election' by the Executor VII No X X ~..; "::;,;:,:'.?~:)\~:i';:::; -=n: --- ---- ~.. check IIIe "VII" or "No" boX 101 leeh qUIIlIon, (SII !!'.!J!!!.~lIona beQlnn,I'!i2.!U'aoe 3,) -- I Do you _lIlternall valuaUon?...... ......,.... , , , , , , ........ .. , .. ,.. , , , ' , , , , .." , , , , .." .. ' , .. ,.... .. , , , , , , , ...... 2 OOyoue;Ctip;;iilUtlvaluatiOn?", ,:=-:~~"'" """"""""'" ,,:-:=~,~"""'" "~=:-:," "", It "VII,' you mUlt Qomplltl and attao~ Schadule ,10.-' ~ ' -- 3 Do you aleetlo pay the taxllln Inltallment..I d.scrlbed In I",lIon 611$6? ' , , , , , , , , , , , , , , , ' , , , , , ' , , , , , , ' , , , , ' , , , , , , , ' , , , , , .. , , " "VII,' you mUll attaoh the addltionallnlOlmallon dllOllbed on plge 5 01 lhe Inl~uctlonl, - ..- ---- ,I ;\ i ~~ou .leOllo pOllpon. thl plrt 01 lhe """ alb'lbulable 10 a r.verslonary 01 rem.lndm:~~Icrlbed In locllon 6163? , , , , , , " , , , X Pert 4 _ Generallnlormetlon (Nole: Pie... 11IIIch the nec.Slary lupplemontal documents, Vou mUII.tllch Ihe dealh cerllflClte,) , (SlHllns~uctlons beginning on pare 6,) ---- - AuthOllzation to rocalve confidential laX InlOlmltion undar Regulatlonl lectlon 60' ,604(b)(2)(I), to act as the estate's reprel8ntatlve belore Ihe Inl<<nal Revenue Ser\iCe, Ind 10 make Wllllen or OIal pres.ntatlons on b.hell 01 Ih. .slel.1l return pr.par.d by an allOlney, accountant, or .nrolled Ig.ntlor tho exeoutOl, F I n. 3401 N, FRONT ST; P,O, BOX 5950 HOWELL~METTE, ESOI PA HARRISBURG, PA 17110-0950 ------ I deollll.lhlt I am thl Il!I allOln.yl 0 certlfl.d public eccountanV 0 enrolled egent (you must check Ihe .ppllcabla box) lor the eX8cutOllnd prlparld !hIs IIturn tOl the exeoutOl,lam nol und.r luapanslon 01 dlsbarmant ~om practlc. b.IOIa the Inl<<nal Ravanue SllIvlce and am quallfl.d to actk:.ln the ltall hown abo,,!, 1;57 f)1l A. ----' Signa"" "eliY'. /LJJt-IJP t^Fnumbor 1 Outh c flcata numb<< and l$Sulng authOlltY (Ittach a oopy 01 tha death certlfloato to thll relurn), 4276219 2 08Clldenfa bUlln..s or ocoupatlon, 11 retired, ch.ck here ~ Il!I and stale deC6deni'I 100mer bUllnelS 01 occupallon, RETIRED 3 Marllal llatUS of the deCedent at time 01 death: Il!I Married o Widow 01 widower - Name, SSN, and dlle 01 d.ath of d.c.as.d spousa ~ Nlm. 01 rtpr...nIIUVt (ptlnl or type) -- o Single o Legally sapar.ted o OlvOlced. Oala dlvOlce docree became IInal ~ 4e ....,"Ing .pou.." n.m. 111) 900"1 ,",u'''' num'" 40 ^mou~."" pg, · ollnll,) GEORGE S, LATSHA U94-2B-B616 ~0,426. & Individuals (olher then Ihe surViving spouse), ~usls, or other ..lal.. who rec.lv. ben.flts ~om the eslat~ (do nollnclud. charltabl. b.n.IIQlarles Ihown In Schedule 0) (see Inl~uotlon.), FOI Privacy Acl Notlc. (.ppllcable to Individual b.neflola"e~S.. th.'ns~uctlonslor FOIm 1040, Nlme 01 Indlv1dual, ~u.l, 01 e9tat~lvI $5,000 or mOl. Id.nll n number Relatlonshl to d.c.d.nt Amount (s..lns~uollonl) DAVID T, LATSHA, A-TRUSTEE BLANCHE H, LATSHA TRUST 11 DAVID T, LATSHA DAVID T, LATSHA, a-TRUSTEE BLANCHE H. LATSHA TRUST B TRUSTEE OF TRST 194-28-9384 SON 67,994. 374,948. TRUSTEE OF TRST 62B,944. I All unasolllalnable b,n,nolarlellnd thOle who rocelvll..slh,n $5,000, , , , , ' , , , , , ' , , , , ' , , , , , , . , , , , , . , ' .. , .. , , , " ~ ", I Totll ...,..,.,.,.,...."",..,..."",.,..,..,',.,""',...".,.. t'.". """," I.'."'.",.",....., 1. 071 8B6. p... . (Continu.d on nexl pagl) Foem 706 (Rev, ~..91) BLANCHE H, ~A Part 4, _ GenerallnlormaUon (continued) P:'''D::~~;::~~:e::~: ':~~~~no:~;::;~:~g:o::li;:p.rty ~~.III1~:;~::~;;.-i~lor~:~~;~~~~~;a;;~~om -;:~;I~~Ht~.S~~) .-=-~=- VI-- No __.J!" PIQ!.6 01 th.lry~_~~ctlons)? , , , , , , , , , , ,_":.=-,-,-,-cc:-,-,-,-,-,-,-,-,-,-,.~,_,_:,:..,-,,.:.:.."--'--'c.c=-,-,-,.c'--'--'-'-'-c,-,--,.,--,--~-'-=c=~ - .~ 7_ Heve F.derll gift ta~ r.lurnsev.r b..n fiI.d? , , , .. , .. , .. .. , .. .. , , , , , , , .. , , , , , , , , , .. , , , , , ' .. , .. , , , , , , , , , .. .. , , , , .. , , .. , X .. -=-- II "'(IS: pl.... 1"lch copl.s Ol]lhO r.lurn., Ulv.llabl!L,.nd I~nlsh .t,t>o follo~l~g~f1f~m.~~.___.... .' ______ -""T'/'1 70 p.rIOCl(I)CO'i.rtd 7c InltrnalRh'enUHlllct(llWhlfl 11I,e1 ,-, , , ';-i:: .. _.~-_.-...-----~_...--~.__..._-------_.---~~----~----- ___II you _nawer "Y.." to ~ 01 qu.stions 8-1S,.you musl ."ach ad~itlonBI ~!<>rmall...n os d.~."rlb.d I~!h. hl~-"ctlon,!: II WI' there Iny Insuranc. on Ih. d.c.d.nt'~ iii. Ihatls nollnclud.d on Ih. r.'u"!'..~s part of th. gr~I.?-,-=.~~: ' , , , , , , , , , , , , , , , , bOld Ihe d.c.dent own any Insur~nc~_tho III. olano~h.r Ihatls not ~nclud.d 1~_9ro.. ..~t.,,-l=.:-,-,~., ' , , , , , , , , , , , , , , , ',' , t Old the dec.dent.t the time of d.alh own any prop.rty a. a jolnllenant with right 01 .urvlvOlshlp In which (a) on. 01 mOl. 01 Iho o',.r Jolnllenants wa. .om.one olher than tha d.c.dan!'. .pouse, and (b) less Ihan the lull valu. 01 the prop.rty I. Included on Ihe r.lu I . as perl 01 the gros~ ..tat.?II"Y.s: you must co~pl.t. a-"-'!.!l.~~Sch.d.~~lL_:-,--,-,-,-,-,-,."_'-'-'-'-c~c:-'-'--'--'--'--c' , , , , , , , , , , , , , , , 10 Old Ihe decedent, al th.tlme 01 dealh, own any Inl.r.slln. partn.rshlp 01 unlncOlpOl.,.d bu.ln." 01 any stock In an In.cllv. 01 closely h.ld COlpOl.tlon?, , , ' , , , , , , , , , , " , , , , , , , , " , , , , , , , . , , , , , , , , , , , , '.' , , , , , , , , , , 'c.' , ',' , , , , , , , , , , c:-'-'--'-'-'-'-'-'-'-' ' , , 11 Old th. d.cedenl make Iny ~ansl.r d.scrlbad In s.ctlon 2035, 2038, 2037, 01 2038 (s.. Ih. Instructions 101 Sch.dul. G bOll'nnlng on page 11 01 th...paral. Ins~uctlons)?1t "Y.s{ you must compl.l. .nd a".ch Sch.dul. G, , , , , , , , , '.' , , , , , , , , , , , , , , , , , 12 WOIe th.,. In exl.t.nc. at the tlm. Ihe d.c.d.nt's d.alh: e Any ~usls creat.d by the dec.d.nt during his or her lif.llm.?, , , , , , , , , , , , , , , , , , , , , , , , , , . , , , , , , ' , , , , , , , , , , , , , , , , , , , , , , , , , , , ~y ~uslli not cr.lt.d by Ih. d"."~nder which th. d.c.d.nl po......d .!!'l'.E.ow." b.n.ficl,llnter.st, 01 ~lJsl...!.!!!f>l '" , , , , , , , , , .!!-~e decedent ever po....s, .xerclse, 01 rei.". eny general pow.r of .ppOlntment? II "Y..: you must compl.te and attach Sch.dule H 14 Was the martial deducllon computed under th. ~enslllonal rule 01 Public Law 97-34, s.cllon 403(.)(3) (Economlo Recovery Tax Acl 01 1981?) "", """, ,,' "" " , , " , , , ,"" " , , " ,,' , , , "" , , , , , , ,'" ","" , '" " , , " , , II "Ye.: ettach a separ.'. computation of Ih. marllal deducllon, ent.r Ih. amount on lI.m 18 of th. Recapllulallon, .nd not. on II.m 18 'cOf11putallon ettached," 188-32-44.l!- X X x x x 15 Was the d.cedent, Immedlal.,y b.fOle d.ath, rec.lvlng an annuity d.scrlb.d In Ihe "G.n.ral" peragraph 01 thelns~ucllons 101 Schedule I?II "Yes: you f11US~ compl.te and attach Schedule I "" , , , , , , , , , ' , , , , , , , , , , , ' , , , , , , , , , , , , , ':.' , , , , , , , , , , , , , , , " X 1. Old the decedent have a total-.,cess rellrementaccumulatlon" (.s d.fln.d In s.ction 4980A(d)) In quallli.d .mployer plans and Individual relllemenl plans? II "Y..: you mllsl compl.te and_!ttach Schedul. S, , , , , , , , , , , , , , , , , , , ':.: ' , , , , , , , , , , , , , , , , , , , , , , , , X Part 5, - Recapitulation II... ..... GlOSS e.tate Alternate value Value al date 01 death . ' 1 Sch.dule A - Re.1 Estat. , , , , .. .. .. .. , , .. , .. , , .. , , , , , , , .. , , , , .. .. .. , , , , , .. , , , 2 Schedule B - Stock. and Bonds, ..' ,..,.."..,......"""""....,"",..," 3 Sch.dul. C - Mortgag.s, Not.., and Cash, , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , ' , , , , , , , 4 Schedule D -Insurence on the Deced.nt's Ule (.ttac~' FOIm(s) 712), , , , ' " " , , , , ," , , , 5 Schedul. E - Jolnlly Owned Property (ettach FOIm(s) 712 101 1I1eInsuranc.) , " , , , , ,'" , , . Schedule F _ Olher Mlscellen.ous Prop.rty (attach FOIm(') 712 101 lileInsur.nce): , , "" , , 7 Schedule G _ Transf.rs Dudng D.c.dent's Lile (.ttach Form(s) 712 fOlIlI.lnsuranc.), " , , , . Schedul. H - Pow.rs 01 Appolnlm.nt. , , , , ' , , , , , , , , , , T ' , , , , , , , , , , , , , , , , , , , , , , , , , t Schedul. L - Annuitl.s, , .. , .. , .. .. , , .. .. .. , , ":c' .. , .. , , , , , .. , .. , .. , , , , .. .. , , O. 743,749. 0, 50,000, 860,426. O. 0, O. 324,948, _10 Total II... ....... ross estet. (add lI.ms lthrollgh 9), Enler he,e and on II.n. I 01 Ih. T.~ Computetlon, [Ieducllons 1 97~_L123 , Amount - .- - 11 Sch.dule J _ Fune'al Expens.s and E.p.nses Incurr.d In Admlnlsl.rlng Property SubJecllo Claim. " , , , , , , , , , , , , , , 12 Schedule K - D.bls olth. D.ced.nl.. .. .. .. , .. , .. , , .. .. , , .. , , .. .. , , .. , , , .. .. , , , .. , , , .. , .. , .. .. .. .. .. , 13 Schedule K - MOItgag.. and LI.ns .. , , .. , .. , , , .. .. , , .. , , , .. , , .. , , , , .. , , , , .. .. , , .. , , .. .. , , , ' , , , .. , .. .. 14 Total ofltam. 11 throllgh 13 , , .. .. .. .. .. .. , , , .. .. .. .. , .. .. , , , .. , , , .. , , , .. .. , , , , .. ' , , , , , .. .. .. .. , .. .. 11 Allowable amount 01 d.ductlons ~om lI.m 14 (se.'helns~uctions 1001I.m 11; ollhe Recapllulaflon), , , , , , , , ' , , " , , , , 11 Schedul. L - N.t Loss.s During Admlnls~allon, , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , " , , , , , , , 17 Schedlll. L _ E~panses Incurred In Administering Property Not Subject 10 Claims, , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , 1. Schedule M - Bequ.sts, elc" to SurViving Spou.e , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , .. , , , , 1t Schedule 0 - Charlteble, Publlo, and Similar C3~ }:!.qu.sts , , , , , ' , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , .. , , , , 43,792. O. O. 43,7~ 43 792, o . o , 860,~ o . ,20 Totallllowable deducllons add lIem. 15Ihrou~, Enl.. hera Ind on line 2 01 the Ta~ Computellon", " "",', " Pege 3 904~:. FOIm 708 (R.v. 4-97) ~I' BLANCHE H. LATSHA Contlnuetlon of SCHEDULE B - Stocks end Bonds 188-32-4431 Iltn, OtlOrlpUon Includlnoflc. amount 01 bond. or numb., of 'h.rtl.nd par no, vakil whir. "ud,d lor fd,nllUcallon, OlvI '~dlgll OUSIP numb." AII.rMl~' \of,lv,llondal, AII,rnlllv,lut V.IU..t dill 01 death UnllVlIUt 16,63 362,425. 8 ACCRUED DIVIDEND PAYABLE ON 21,800 SHARES OF NUVEEN PENN INVESTMENT QUALITY MUNI TRST CUSPID 670972 10 8 ACCRUED DIVIDEND PAYABLE 6/02/97 $1,831,20 1,831. TOTAl" orward 10 main sohedull ....."....,... ~......,......,...,..,...... 364 256. ", 10: F"," 712 llill...., NOV'ITlb.r '.'t) o.ll~I'l\'1'\1 olll'lf TF.....~ 1111"".. "'''''''Ii' J"""ce FEB 27'98 10:03 No,006 P,02 Life Ineuranee Statement OMB No IU"~OU e.pll" t \ ,')0."" Decedlnl-Inl~ed (To Be F,lld With United Slllos estltl x Relurn, Form 706 0_ ~~'d.nl" 11.., n.m. .nd middll 'n"ltl \~'d.nl" 'lit n.m. S olcldenl', ,ocl,1 ..curllV numb"-I~ Oil. 0' de..n \a.('\c.he _k ill ~.___ _ . "',me .ncllclclr..s 01 In,u/lnc. comp.nv Phil d 1 hi Lif a e p a e Insw:ance Company Post Office Box 1917 Carmel IN 46032~4917 . TypI 01 policy 'i , . Own.,', namt, II cllo,Olnt I, no pit.., ,IIICh copy of .ppllcstion, " 7 10 A"'gnOC", nlml. Pies" Ittach copy Qf ...Ignmenl. 11 Dale ulIgnld 14 N.mo 01 blneflclar,.. [Q\lid \, Lo.-TGho.. s ff),('Y"'i), m s s :=T.) 308, 'lQ $ . 15 UI 17 I' 18 20 21 22 23 24 25 211 Face amount 01 pOlicy, Ind.mnity benollts , Addltlonlllnsuranc. '\ ' -k. '.e:....">+ ' Other benefit., ' ('\ \....( , , , Prlnclpel 01 any Indebtedness to thl comp"ny thltl. d.ducllble In detem,lnlng net proceeds, Interest on Indebtedne.. (111m' 91 .ccrued to dlte 01 dlath Amount of accumulatad cllvldends , A,.. ,unl of post.monem dividendo, , Amount of rl,urnlcl premium , , , Amount of procUdo il plyaola in one sum , Vllue 01 procleds II of date of death (" not plylble In one suml Policy provisions concerning daferred paymlntl or inslallmenll, Nole: If oth~r thiln lump"um setl/ement Is ,uthOrilld for. survlvlnQ spouse, plaa.. attilch . copy of the in$UflnCe policy, s s s ~511 -aoe-:QO s . - - - .......".........................""..",......".......,,,......,......."......,........,......"" ....".""....,....,,,,,,,,,,.....,,.,, ~1 Wu Ihl insured Ihe annultanl or beneliclary of any annuity contract luued by Ihl company?, , , , 0"," ISl. No 32 Namtl of tOmplnles wilh Vlnlcn clteedenl carri.d othar pohclll Ind amovnt 01 lucn policlnlf Ihl. inlormalion II clisclolCcI by your r.cords, 12 Valul of tht pollcV It In. 11m. o1.luignmln\ ~ 3 \ c;?O(~, DC) .........,..........".."",...."....",......................................."......,..........."....."I"t,. ..............,.......""".....,.."...,"',..........."...,...".........,......."............,........"0..."...,...."..""....,..."" 27 28 ....."""".""".,."""........"""',.,,........,...,..,.....,..,."...,.,........,.,.....""",..."""." ,,,,,...,,,,,,,.....,,,.....,...,..,.......,,.,..,.......,.....,,..,,,..,""'"................"............,.................,,,.....,,,,",. S' 1\11\01" Instructlo s Plp.rwor~ A,duQtlon Act No1lcI.-Wo '51( lor tho information on thit 'orm 10 Clrry aul 'he Int'/rI.If~.....nue law' of Ihe Unite if SlaIn, You Ire rOQullld to givI UI the InfQrmalion, W. ne.O It 10 .nsur. Ihat Vou .re complY'''Q WiH'I l!'ln. lawS an~ 10 ahow ul 10 hgurl .no coli let the right amount of 'a.., The lIml Modld to complete aNI1tle 'hi,folm wllllJ,ry dtp.nding on indl....ldu.l clrCumslanc.s, 'Tht estimated aVirag. tlm. Is: Por", Alcordkltplno ""rarlng thl form 112 , a hr., ~S mil'" , 8 min. If you I'll\l' c:omm.nll cor.etfnil'l9 the IICCl.ltle~' allllUO lime Ullma'ft Of 11.I;;1S110n. lot mlll,ing lhil larm mort Ilrnpl', WI 'I'/o",ld be "11'1))' '0 h..r 'rom yOI,l, Yo~ can ,\'ltlle \0 bolh the 1~9 arid ell, No AmOunt or Inotallmonts ' . , , , ' , , , Oate 01 birth, $8',. ~ name 01 any person the durallon 01 whose life m.y m"lure'hl number of paymenls, ",......"".",.."...,.."........"",......,,......"...."..........,.......".....".....".,.",...,",.,.., 28 ........"........""",..."",........""...,...........",...............".....,........,,,..,,,...,,.,..,,.,, Amollnt applied by the Insur~nce company IS I lingle premium representing tha purchase of inst~lImlnl blnefits, , , , , , , , , , , , , ' , Basil ImDnalily lable and ral' 01 intalOst) used by Insurer in vllulng Inllallment benefits, T"I 'II.O'''19~'O ollie.. QI ,,-.. lDO'.","II"".d >.""u'lne. ,ompsl'ly "".ov elMIII ItllllI'II' III,.m.nl .." Ion" Viii I,.,i GOH,~\ lnfC)/:T\IIIOt''I, 3D T,"O . V __ ~ick41t Po" 01 C.nil'''',on · a .,;:;;)-, ~8" the OHlc. of Mlnagement end Budget 1111'1. JddtlhC! U,'od in Ihe Intl,uellont of 'h. ta. relu'" wl't'I whlc~ Ihls lerm II Wtd. l),l NOT und 'he II( ferm to IiI he, 01 th... offices, Inillld, fllutn i' 10 the IKIc:utor 0' '.p'....ntatl"'. who r,qullted It, St,tlm,nt of In.urtf,-Thll 11.'lmlnt mUlt bf mad., on be hall of l"e tnluranC' complnv t~lt InUCld lr'lt policy. by In o!'flcO( of lr'lt complnv hiving ICCUI to ,1'1, record, of the company. Fur purpo&ll of Ihll Itltlment. . f'~llmll. I.gn.lur, may be u$td In lI.u of a manual .1;nltu'l and II ultd, .",11 b, binding as I manual slgnetutl. Sap.ra.. SlIt'm.ntt,-A sePllrll1 slalemlnl ",u~1 bl liltd for nch polley. Llnl 13,-~.PO" on Un, 13 'h. .nr.uII p'.mlum, nOllhG e~mull,jv. pflmh"m to dAle of d.(lIth, II de.th occurre" Ilt.' lhe end 01 tl'l. p,.mium period, re~o" Ihe lltt ./"Inull prtmllolm, 10\7011 ,o~ 712 IR.",. \1.91) Filtm 70& (RIV, 4-V7) Elllleol: BI..ANCHE H, LATSHA Continuation of SCHEDULE E - Jointly Owned Property 188-32-4431 , ,. PART 1, - OUlllnld ~Inllnllrlltl -lnl","11 Held b thl Deeldlnt end HII or Her S UN IIlhe Onl Jolnl Tlnlnll Slellon,2040(b)(2)) Allernlle Vllultlon dlle Vllue I' dl'e of dlllh 111m DelCrlpUon no, For .IOUtltl.., give CUSIP number, llavIUable, 4 PNC BANK JOINT INTEREST CHECKING ACCOUNT NUMBER 5000641468 TOTAL VALUE AT DATE OF DEATH $3,885,58; 50% INTEREST $1,942,79 5 PNC BANK JOINT MONEY MARKET ACCOUNT ACCOUNT NUMBER 5000820079 TOTAL VALUE $79,489,52 50% VALUE $39,744,76 6 59 SHARES OF VAN KAMPEN MERRITT PA CUSPID 920934 10 6 NAV 5/30/97 $17,40 NAV 6/02/97 TOTAL VALUE $ 1,026.60; 50% INTEREST $513,30 7 26,406 SHARES OF FRANKLYN PENN TAX FREE FUND; CUSPID 354723801; NAV 5/30/97 $10,35 NAV 6/02/97 TOTAL VALUE $273,302 50% OF TOTAL VALUE $136,651 8 '1,015 SHARES OF FRANKLYN PENN TAX FREE FUND; CUSPID 354723801; NAV 5/30/97 $10.35 NAV 6/02/97 TOTAL VALUE $72,605 50% OF TOTAL VALUE $36,303 9 9,010 SHARES OF FRANKLYN TAX FREE TRUST; CUSPID 354723702; NAV 5/30/97 $ 11,16 NAV 6/02/97 TOTAL VALUE $100,551,60 50% OF TOTAL VALUE $50,275,8 10 9,125 SHARES OF FRANKLYN TAX FREE TRUST; CUSPID 354723702; NAV 5/30/97 $ 11.16 NAV 6/02/97 TOTAL VALUE $101,835,00 50% OF TOTAL VALUE $50,917,50 11 6,200 SHARES OF NUVEEN INV QLTY MtrnI FD CUSPID 67062E 10 3 NAV 5 30 97 15,25 TolIlI (CInylOfWlld 10 main IChedull), , , , , .. .. , , , , , .. , , , , .. , .. , , , , .. .. .. .. , , , , , , , Allernate value 3,886. 79,490. 1,026. 273,302. 72,605. 100,552, 101,835. 632 696. Form 706 (ReV, ~-D7) Eat,t, 01: BI.J>.NCHE H. LA'rSHA SCHEDULE I - Annuities 1.88-32-4431 Nottl Oenerllly, no ..elu,lon II ellowed tor tho nlll" ot decedents dying Inor OecembOl 31, 19941!!! pege13 of Iheln,~uctlon'l, A ke you ..eluding ~om the dICedenl', groll nlllle the vllue of I lump-Ium dls~lbu'lon described In secllon 2039(n(2)7 , , , , , , , , , , , , , . , .-!! "I",. you must lt1ach thelntormellon ttq~y the Ins~ucllcns, Item Onorlpllon no, Show the entlte vllue 01 the ennulty before eny exclusions, 1 LUTHERAN BROTHERHOOD ANNUITY Alternsle vlluetlon dlte Includible IlIornl'o Vlluo l', Includible vllue It dlte 01 dealh 324,948. TolIl ~om ccnllnuallon IOhedu\e' or addlllcnal sheet I at1ached to this IChedule, , . . , . , TOTAL, (A110 anlll on Pili 6, RlClIpllullllcn, plge 3, et lIem 9,) , , , , . ,~"'" ., . , , , (II mOle epace" needed, at1ach the ccnllnulllon IChedu'e ~cm the end of thl, peckage or Iddlllcnallheets 01 the ..me ,'ze,) _ (Theln.~ucllun' 10 Schedule' tlO In tho "plletalnl~\lCIIOns,l 324,948. fOlm 706 (R.v, ~-97) ~.tlte ol:B~9HE H. LATSHA SCHEDUl.E M _ Bequests, etc" to surviving Spouse Eleellon To Deduel Quelllled Termlneble Interlll Property Und.r Seellon 2056(b)(7), - II a trust (01 olhe< prope<ty) m..l!i the requlromenl. 01 quellfled termlneblelnlerlll propO/ty unde< IIcllon 2056(b)(7), Ind I. The tru.1 01 olhe< prope<ty I. lI.ted on Schedule M, Ind b, The value 01 the tru.1 (01 o\her propO/ty) I. ent.red In whole or In p.rt o. u d.ducllon on Sch.dule M, Ihon unle.. the execulOl .peclficllly Idenllll..lhe tru.t (.11 or a tactlonol portion or perc.ntage) or othe< prop.rty 10 b. .,clud.d tom Ih. .I.ctlon the executor .hall bo daomad to hlv. mlde an el.ctlon 10 have suoh tru.t (or othO/ prop.rty) troat.d a. qualill.d larmlnable Inl.r..t property undor aICtion 2056(b)(7), lilt.. Ihan Ihe enllre vllue of Iho tru.1 (or olhOl proporty) thet Iho ..acutor has Includ.d In th. gro.. e.tat. I. ontor.d a. a deduction on Schedule M, Ihe "ocutor .hell b. con.ld.r.d to hlv. modo In .I.ctlon only o. to 0 toctlon 01 Ihatrusl (or othe< prope<ty), The numerltOl of Ihll hctlon I. equll to tho Imoun\ ollhe tru.t (or oth.r prop.rty) daducl.d on Schedule M, Tho d.nolnlnatOl I. .qual to Ih.lolal volu. 01 Ihetrusl (01 olher prop.rty), Eleollon To Deducl QUllllled Oomllllc Trull Prop.rly Under S.cllon 2056A, - II 0 tru.t m..ts th. requlr.m.nt. 011 quallfl.d dome.tlo tru.t undOl ..cllon 20S6A(I) Ind Ihl. r.lurn I. 1II.d no late< than 1 y.lr .1I.r th. time pr..crlb.d by luw (Including e,tonslon.) lor filing the r.turn, and ., Tha enllre valuo 01 I tru.t 01 trust prop.rty 1.lIst.d on Sch.dulo M, Ind b. Th. .nllre value olth.trusl or trusl propO/ty I. enle<.d 0.. d.ductlon on Sch.dul. M, Ihen unlelllhe .xecutor .peclflcllly Id.ntlfi.s Ih. tru.t 10 b. .,clud.d tom the .I.ctlon, Ih. e,.cuIOl .hall b. d.. mad to have mad. an .I.ctlon 10 hive the .nllte trusltr.at.d IS qUlllfiad dome.llo tru.t prop.rty, 1BB-32-4431 --.------ Old Iny properly po.. to thosurvlvlng spou.eo. ....ull ola qUlllfi.d dl.clulmOl? , , , , , , , , , , , , , , , , , " " " , , , , , " "",.'"", II "'f.... .ttach I copy ollh. wrlllen dlscl.lmOl r.qulred by .ectlon 2516(b), 2 a In whal country was thesurvlvlng .pou.e born? UNITED STATES b What Is the .urvlvlng spou.e's dale 01 birth? B / 1 9 / 04 " -- e Illhesurvlvlng spou.eo U,S, citizen?, , , , , " , , , , , " , , , , , , , , , , , , , , , , , , ' , , , , , " ' , , ' , , , , , , , , " " " , , , , , , , , , , , , , , , , , , , , d Illhe surviving spou..ls I nllurallz.d citizen, when did Ih. .urvlvlng .pou.. acqulr. clllz.n.hlp? e IIlhe lurvlvlng spou..I. nol aU,S, clllz.n, of what country I. Ihe aurvlvlng spou.. a clllz.n? - 3 Elecllon oul 01 QTIP Trlllm.nl 01 Annul1lll, - Do you elect undO/ s.ctlon 20S6(b)(7)(C)(II) nollo tr.at II quallfi.d lermlnable InlO/e.t propO/ty any Joint and .urvlvOl .nnultie. thallr. Includ.d In the grolS ..tal. and would othO/wl.e b. tr.ll.d I' ullined to/mlnoblelnler..1 propO/!i.'!~~2056(b)(7)(C)? (s..ln.trucllon.) , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , . , , , , , , , , ':' ' D..crlptlon 01 prope<ty Intere.t. pa..lng 10 .utvlvlng .pous. Amount Vel No X Item no, 1 RESIDENCE AT B5 GREENWOOD CIRCLE WORMLEYSBURG, PA 17043 ESTIMATED VALUE $300,000 (SCH E, PART 1, ITEM 1) 150,000, '; , I I i \ ! 3 1990 LINCOLN TOWN CAR FAIR MARKET VALUE $5,4251 50% OF VALUE $$2,713 VALUE ESTABLISHED BY NADA BOOK (SCH E, PARr 1, ITEM 2) 19B7 CHEVF.OLET VAN i VALUE OF VEHICLE $1,550 FROM NADA BOOK, 50% INTEREST IS $775. (SCH E, PART 1, ITEM 3) 2,713, 2 775. Tolal tom continu*tion .chedule(.) (OIlddlllon.l.h..'!(.)) .tlaE~.d to Ihls schedule, , , , , , , , , , , . , " " ,', , ' , , , , , , , 4 Tolallmounl 01 propO/ty InlO/e.ts lI.ted on Schedule M " , , , , . , , , , , , ' , , , , , , , " , , , , , , , , . , , , , " " ' , , " , 4 6 e Federal eslale tax.s (Including s.ctlon 4980A tax..) payebl. out 01 pi operty Inl.r..ts 1IIIed on Schedule M , , , , , , , , , , , , , , , , , , , , , , , , , , .. , , , , . , , , , , , , , , , , , , , , , " tiJa bOther de.lh tax.. payable out cl prope<ty Into/.'Is IIst.d on Sch.dul. M , , , , , , , , , , , 5b e Federellnd .lele GST lI><e. peyable oul 01 propO/ty Inlere.1s 1I.led on Scr,edule M , , , 5e , d Add Item.., b, Ind c , .. , , , , , .. , , , .. , , , , , , , , , " , " .. , , , . , , , , , , , , , , , , , , , , , , , , , , , , , , . " " , , , , , , , 6d . Nelamounl of property Inleresls 1I.led on Sch.dule M (.ubtract 5d Irom 4), AI.o .nlel on PlrtS, Recepltulatlon, pege 3, It Item 18, , , , , , , , , , , .. , .. , , , , , , , , ," , ,.. , , , , , , , , , , , , , , , , , , " , , , , , , , , , , , , , , , , , " , , , " , · (It mOle specets ne.d.d, Ittach the continua lion schedule ~om Ih. end of Ihl. psckeg. or Iddltion.1 sh.els ollh. .am. .Iz.,) (Set Ihe Ins~ucllonl on Ihe revO/s. side,) B60,42~ Schedule M - Plge 27 'Olm lot IR..., ...1) SCHEDULE R-GoneraUon-Sklpplng Trt\nsfer Tax Nol.t To .vold .pp/lc.tion of fh. d..med ./Ioc.tlon rul.s, fo,m 706 .nd Sch.dul. R should b. flI.d fO ./Ioc.l.lh. GST ex.mpllon 10 Irusls fh.l m.y III" h.v. f.x.bl. f"mln'llons or dlstrlbUllons under seer/on 2612 .v.n If Ih. form Is nOI required 10 b. flied fa report esf.f. or GST f.x, Th. GST f.x Is Impos.d on r.x.bl. It.nsf.rs of Inter.sts In prop'rty loe.red oursld. Ih. Unil.d St.l.. U 1'1.11 IS prOpMy /oe.r.d Insld. fh. Unlt.d St.tu Se. Inslructlons b.g/nnlng on p.g. 17, Part 1.-GST Exemption Reconciliation (Section 2631) and Section 2652(a)(3) (Special QTIP) Election You no longer need 10 check a bOK to make a sactlon 26S2(aIl3) (special QTIP) election, II you liS! qu.llfylng property In Pert 1 , line 9, below, you 1'1111 b. considered to heve made this election, See p.g. 19 of the seperele Instructions for details, 1 Mexlmum .1I0weble GS,. exemption Z TOlel GST .xemptlon allocated by the decedant agolnst decedent's lifetime transfer. 3 Total GST exemption allocaled by Ihe executor, using Form 709, egalnsl decedenl's Ilfatlme Iransf,c., , , , , , , , , , ' , , , , , ' 4 OST eKemptlon allocated on line 6 of Schedule R, Part 2 5 OST eKemptlon elloceted on line 6 of Scnedula R, Pert 3 8 Total OST exemptloo allocated on IIna 4 of Schedule(s) R.' , 7 TOlal OST exemption allocated 10 Inlervlvos transfers and dlrecl skips (add line. 2-6) , 8 OST eKemptlon eve liable 10 allocate 10 tru.IS and section 2032A Interests (subtracllln, 7 from line 1), , , , , , , , , , ' , , , , , , , , , , , , , , , , , , , , 8 Allocation of OST exemption to tNSt. (as danned for OST tax purposes): A s C GS T tltemptlon ,Uocated on lines 2..S, .00.... (Set Instru(;~onsl D MdlOOnll G.T uempuon IlloClled 1,.1 InlVUt1iOns) NlmI oftrusl TNst'l EIN (if ..ny) 1. Trust A, Credit Trust U/W Blanche U, l.stsh None $ 67.994* 2. Trust B, Residue Trust U/W Blanche 8. Lstsbs None 932.006* *See attacled Schedule f r formula for allocatio of GST exemp ion " 90 Total. May not exceed line 8, above , , ' , ' , , , , 90 $1,000,000 10 OST exempllon available to allocale 10 !acllon 2032A Inleresls received by Individual benenclarles _ (sublract line 90 from line 8), You must attach special use allocallon schedule (see Instructions) (The In'.vucUon. to Schedule R are In the separale Inslructlons,) Publllh.d by Tu Manag.m.ntlnc" . Subsidiary 01 The Buraau of National Analrl, Ine, ~l,OOO,OOO 2 None 3 None 4 None 5 None 8 None 7 None $1.000,000 E TNSI" k1cluslon ,.1.10 (OplJoN~I" "'IVOCO...) Zero , Zero 10 Schedule R- Page 33 ,_.,1>\'\'-' J'-' . ' This i, 10 certify that the information here given i. correctl)' COplel\ frol\,' ;In origin;!1 ce,niflc.ue of death duly, fIled with me os . Local Registrar. The original cenif"ate will be forwarded to the Slate VII,!! Records Glflce for permanent filing, WARNING: It Is Illegal to duplicate this copy by photostat or photograph, Fcc for th'lS certificate, S2,00 "",rr;";li"-;;", /~~.~. QL.Pl~'.:,j;'" '/i(~ ~,:~~;~.~ ~" .. \~ l,..I' ltt 5: . . ...."'....1 * , ~~%~/ ~~! "...'f-,," ." MEN1 ~~"". ""''''11I111''-''.''' av7uI(J~fL- _._____~C- 0 l.o"" R'gi"',\( JJH 0 2 m7 , 4276218 D,II' No, COMMONWEALTH OF PENNSYLVANIA' DEPAR1MEHT OF HEALTH' VllAL REOOROS CERTIFICATE OF DEATH 10' '.~ ' _WI ,...1MMIl ac.. s,oew....C\If\IT'fHUW..A I, F""",le ., lBB - 32 4431 j)Rt0l1lf'lTrl ~lCf1"'" ~OI~itNC"~QI'4"'-""'-'''"'''''' \loIoI....,Oe<(-I. ....1Il,C'l..qn~." t<l'W'lw.: - ....__ (J 11'A'f"-- 0 June 10 06 ,.' TO'<IE!r Ci P .lWf'0I/'0U01'M ~N.u4(llrd~'~""'vd""""'" ,~"""",,,,,,\II'Nl._"" ,-, ,. White SiJilN'NlHQSKlIJY--- 1Il....,....~.......1 0410f1ou:r..~,0iI~'...,1 .MaY 31, 1991 9C ".........UoIt ~IO ...- ~~.~ ........"....~ -- , . Married , GeOrge 5, Latan. ,~ . &IS t Pennaooro .. \,r::;r'1 17..0.__"-" Of,CIOlHTI ..,"".. ".......,. ...- ,,"...1oOI1 ... - ..., ~rland ,"..."..7 17..~ =~- W0111'f1,~~\r,...'1~-~"""""" , Minnle ",/\ HOiWAHT"~'DOMP~~"" ,.C4lIt . B5 Green'tKlOd circle Worml~abur . pa 11043 iV.ct ~~,""""'Ifc.Nl""'e...-.. ~ClCJ'OOH.~Ilal..z.CO<M .."....... ".. sa-.-Pa- Wormleyaburg \,...~ lIN--::"''7... 2 1991 v:tI'lM",-,1IIVl 011654-L ,.MIl~....t_.o.,""'pUOI"'llId. '10 ... ...0 ..0 ... __ .................., H DNl~.O ~,Dw.~ _..._-' , D" !l1f1~AI /tjq7 ",...,. .._...._.-----...... ........._.... ...:k""'.....""'..,..._.M....... L.III......_&IlMtl\...u....... pun III 0fl0Il' ..,..,... .................. "'". w 1IOI........1l""'~....r-Il,.....,l =-=- \-...- I ...e.DIATlGAoUtI~Nj -.- ......n......- CH~ OutlOIOf'MolCCNSlOV<<HCI"'~ ~O p'\) OUIlO~"'lCOHSlOUl,a()f) Qp ",,..L r='1'",'11 r"'~ ClIAlO~"'ACCf4lQlJIHClOf): 11'" 01 lIV.Ifrf ~YII'l\QNtl lllleNMt<MIHJUflVoceulU'f,O. . \-..- , ,,,,,,1M*lI.~~1~ ......,lI'Mll.*D&lU- CA....~.,rtI"1 ,............... !~II....IL.A.I' L-- ... 0..0 llRIC'lFlHJlJI\" 1..........,0.",.,,\ l<!' _ 0 o ,~l"''''~'1l1Oo'l 0 " ... D..'ill ... 0 ... OJ ..- 0 ""'........... 0 """",,,,,,,,,,,--"--"*' ~ -" ~..~ CUl'ff'lAlltO'C*f/f'ff.-t ,c&M'"..'""t.lQ.....""l"C*'~CM*Gl...._".."..!t'po:*'f\MII(jI'O.f'Ull'*"_(lfI"C1I'loo3I1<<ftT.lI ...............llIf.".......,...IfI.....,...........~.I.,..-'...W""'.,..""...,.."..".""..'''."...''..,...",...,', 'fNo 0 ~ nMIJcuniI"(WQMlIlCW4""tI"fII'_,.lJ'CUU'i'*"tr4~l"'4lOc.MotGl-"I' ,...............,.,..-..........IfI_..................,....,.,..fIM4,.,..........,...-.(.\.,..~.. ..i4oL, .." ,.,.", ",."..."., iiiWHfI 01 OUO'K ...... y N_ ~~...J~rl ~r.-ColU" - .-. " ~ e..1e.. fv-J) .M.CMCALDAMUil~'" ...=:.:..::':.~.::~',~,~~:':~~~I~I~:~::':',~,~:~::~~:~~,~:I,?':',~"~,'~:~~~~: ~,-:,' :~~ ~::'~~',l,~ 0 .... "'-. A-' 'd" ~,J ,II .4l" ' 7 " __L- -'"' -~ ... -- / /I~. /i'(S / IURWAU Of IHOIVIOUAL TAKfl ,...."'" U,NrI lAM fllYlilON 111'111, ,.out l( IIAft"'U'IMO, .'_I",.'O"a COMMONwaALTH OF PENNSVLVANIA DaPARTMaHT OF RaVaNUa *' HOTlCf OF IHUUITAHCE TAM A~~RAISEHfHT, ALLOWANCE DR DISALLOWANCE OF DEDUCTIONS AND ASSESSHE"T Of TAK U~.I'H.. m c...." 05-18-98 LATSHA 05-31-97 21 97-0517 CUMBERLAND 101 r- 'A.ount Ro.1 tt~~~~J MAKE CHECK PAVABLE AHD REMIT PAVMENT TOI REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINa .. RETAIN LOWER PORTION FOR VOUR RECORDS ..... nv: Ui;'j- ix -AF' - i 09 :,,-i -iioT"i ci" -op-INliEii if Aiici - 'fAir APPRA'i sEiiEiir; -,U.i.-OWAN-ci- 'Olin - - - - ...- n -... -- DISALLOWANCa OF DaDUCTIONS AND ASSESSMaNT OF TAX BLANCHE H FILa NO. 21 97-0517 ACN 101 DAVID T lATSHA EXEC 3401 N ~RONT ST PO BOX 5950 HARRISBURG DATI UTAn OF DATI! OF DEATH FILa NUMIIR COUNTV ACN BLANCHE PA 17110 UTAn: OF LATSHA DATE 05-18-98 TAK RETURN WAS I (X I ACCE~TED AS FILED RasaRVATION CONCERNING FUTURa INTEREST - SEE REVERSE APPRAIsaD VALua OF RaTURN BASED ONI ORIGINAL RETURN 1, ,..1 E.tot. IS.h.dul. Al 2, Stook. ond lond. (S.hodulo II S. Cloa.ly Held stock/P.rtnership Int.r'.at (Schedule C) 4. "art...../Not.. Receivable (Schedule 0) I. C..h/lank O.polltI/HIIC. Perlonal Prop.rty (Schedul. E) 6, Jolntl~ Ownod ~roport~ (S.hodulo FI 7. Tranaf.r. CSc~.dul. 0) ., Tolol A..oto I CHANGED NOTE: To Inlur. prop.r credit to your account, lub"it the upp.r porUvn of thl1 for. with your h)( pay..ent. .00 743,749,00 ,00 ,O~ ,00 397.448.00 ,00 (8) UI 121 (51 (41 (5) (61 (7) 1,141,197,00 APPROVED DEDUCTIONS AND aXEMPTIONSI 9. Funar.l E~p.n.a./AdM, Coats/Hi.c. Expen... (Schedule Hl 10. DObt./Hort,o,. Llobllltlo./Llon. ISchodulo I) 11, Totol Doduotlon. 12. H.t V.luo of Tox Roturn IS. Chariteble/OovernMent.l Beque.ta; Non-elected .11S Tr~.t. 14, Not Voluo of E.toto Subjo.t to Tox 46,811,00 ,DO Ull (2) U51 U41 (91 llDI 'It.All nn 1,094,386,00 ,00 1, 094 ,386, DO (Sohodulo JI If .n ......m.nt w.. i.su.d pr.viDu.1Y. lin.. 14. 15 .nd/or 16. 17 .nd lB will r.fl.ct figur.. th.t includ. the tot.l of ~ r.turn. .......d to d.t.. ASSESSMINT OF TAXI 15, A.ount of Llno 14 .t Spou.ol roto 1151 1'. ...aunt of Line 14 te)(.ble at line.1/CI... A r.t. (16) 17, AMount of Llno 14 toxoblo ot Collotorol/Cl... I roto (171 1', ~rln.lpol Tox Duo TAX CRIOITSI PAV"ENT DATE 08-28-97 NOTlI 161,641.00 M'OO, 932,745,00 M ,06. ~.!!.M,15, U'I ,00 55,965,00 .00 55.965,00 RECEI~T MUHIER AA211685 DISCOUNT It I INTEREST/~EN ~AID (-I 2.798,25 63,000,00 AHOUNT ~AID TOTAL TAX CREDIT BALANCE OF TAX DUE INTERIST AND PEN. TOTAL DUE 65.798,25 9,833,25CR ,00 9,833,25CR . IF PAID AFTEft DATE INDICATED, SEE ftEVERSE FO. CALCULATION OF ADDiTIONAL INTEftEST, IF TDTAL DUE IS LESS THAN .1, NO ~AVHENT IS REQUIRED, IF TOTAL OUE IS REFLECTED AS A "CREDn" lCRl. YOU HAV IE DUE A REFUND, SEE REVERSE SIDE DF THIS FORH FDR INSTRUCTIONS,) H ''''<' iF ~ I~~ (1: i! {ii- ~~ \' _.. (_1 iT' (\l N , ~ ( i Ci a :,,: 6 ~ i. alcn ::no .... Ui~ c:: hi. S. :f'::I CD RESERVATION, E,tete. of dec.d.nt. dylng on or b.for. D.~..b.r 12, 1'12 .~ If InY future Int.r..t In tht ..tet. 1. tran.f.rred In po.....lon or ,njoy..nt to ClIn I (oolllteraU blnlflcllrtl' of the dlc.d.nt Ift.r the 'l'lplrttlon of "'11' ..tit. for l1fe or for y.er., the Co..onwl.lth hlr.by IKpr,..ly r...rv.. the rleht to IPpr,I.. Ind ...... \rln,f.r Inh.rlt~. tl)ll" et thl hwful C1I.. . (colllt.rlll ration Iny .uch future Int.rut, fltiRPOSE OF tIOlICEI To fulfill the rlqulr'...nU of Slction 2140 0' the Inhtrlttnlll and Eltatl TIM Aot, Act 21 of 1'95. (12 P,S. Sactlon 9140), O.tloh thl top portion 0' thh Notlet and .ub..U ~dth your pay..nt to the R.ght.r of Wlllt prlnt.d on ttM rlv.r" .Id.. --Hlk. chick or .on.y order paYlbl1 tOI REGISTER OF MILLS, AGENT PAVMENTI REfUND (eR) I A rlfund of . t.M cr.dit, which wa. not r.qu.tt.d on th. leI< R.turn, .ay b. r.qu..tld by coepllUne an "ApplluUon f.or Rlfundof p.nn.ylv.nla Inh.rltanet and E.tet. TaM" (REV-U13l. Appllcatlon, Irl a",alllbla at the O,Uel of the RIOI.tar of Willa, any 0' the 23 R.",enul DI.trlet Off Ie.', or by e.ll1ng thl .peolal 24-hour Inlwerlno ..rvlc. nUMblr. for for" ord.rlngl In Plnnsylvanll 1.800.362-2050, out.ldl Plnn.vl"'.nl. and within 10011 Harrl.burg ar.. (111) 187-1094, TOOl (717) 712-22SZ (H..rlno Iep.lr.d Only). Any p.rty In Inter..t not ..tl.fl.d with the .ppr.I....nt, allow.ncl or dl..llowlnc, o~ d.duction" or ~""'.Int of hM <lrKlludln~ dllcount or Int."..t) a. .hown on th1l Notlc. IIU.t obj.ct wUhln .IMty (60) d.yt of r.caipt of thlll NoUc' bil'l ~.wr1tt.n protllt to the PA o.parte.nt of R.",.",,,, ftoltd 0' APP..ll, n.pt. zeloZI, Hltrl~burg, PA -~.l.'tlon to h.v. the ..tt.r d.tarllln.d at audit of the account of the p.r.on.l r.pr...nt.tl",., --IPp..1 to the Orphan.' Court. 17128-1021, OR O~ OIJECTIONS, ,,"IN lSTRATIIJE CORRECTIONS I F.ctu~l .rror. dl.co",.r.d on thl. 8.......nt .hould be Iddr....d In writing to: PA D,plrt.ant of R.~enUl, lur'lN of Indl",ldual TaM", ATTNl POlt A.......nt R.vl.... Unlt, n.pt. 280601, tlarrl.buro, PA 17121-0601 p~lon. (717) 187~6505. S.. paOI 5 of the bookl.t ''In.tructlon. for Inh.rlttnce hM Aaturn for e Allldent Dec.dlnt" (REIJ.1501) for an 'MPlanatlan of adelnl.tratlvalY corrlctlbll Irror', I' .ny tax due I. paid within thr.. (3) cal.ndar ~~th. aft.r the daCld.nt" daath, . fl~. p.rc.nt (S~) dl'Gount of the tOM paid I. allow.d, Th. 15% t'l< .~..ty non-partlclpation p.neUy It cDllputld on the total oftha taM and Int.r..t .......d, and not paid b.fotl .January 18, 1996, the Utlt day aft.r tha and of the t.x a.nllty p.rlod. Th1l non-participation pah.1ty h apP.lllbl. ln the .a.a .ann.r and ln the the .... tiel p.dad II you ...ould app.al the tllM and In~It..t thllt h.. b..n .......d a. Indlc.tld on thl. "otic.. Int.rl.t I. charo.d b.,lnnlng with fir.t d.~ of d.llnquency, or nln. (9) aonth' .nd on. (1) day 'roe tn. dlltl af death, to the date of pay..nt. Tal<a. whlch b.ulI' dlllnqulnt b.for. J.nuary 1, 1912 bur lnt.rllt .t tn. rat. of .Ix (6X) p.~c.nt p.r annu. calculat.d .t . dally r.tl of .000164. All tIlM" which b.c... dallnqu.nt on and Ift.r J.nuarY 1, 1'12 will ~.r Int.r..t at . rat. which will very '~oe cal.nder y.ar tu ~al.ndar y..r wlth that rat. .nnouneld by the PA Depart.lnt of R.~.nuI, Th. .pplleabll lnt.r..t rlt.. for 1'82 through 1998 .r.' '!!!! Int.rllt Rlt. Dally Inter..t factor :!m tntlr..t lIate 0.1111' tnt.r..t Feetor l'8Z 20~ .000548 1911 9X .on0247 19U 16X .000418 1'88-1991 11% .000101 1984 11;: .000301 1992 9% .000l47 19151 UX ,000356 1995"1'94 n .OOO19l 1916 lOX .000274 1995~19" 9% .000247 ~-lnt.tI,t It calculatld .. follo"'" DISCOUNT I PENALlY I INTERESt I IHTEREST u SAUHCE OF TAX UHfUO X NUNBER OF DAYS OELIHqUEHT X DAILY IHTEREST FACTOR .-Any NoUc, I..~d aft.r thl tlM beco..' dallnqu.nt will r.Ulct .n Inttrlllt oaleulation to flftllln (1S) dlYI blyond the d.t. of thl ......II.nt, If p.IIHn\ It e.d. after the lnternt COllpuhltlon date Ilhown on the Hotl~., 8ddltlonll Inter..t .u.t bl c.loulat.d. {,r:~~1 j0 .-l IURE~U OF 1llD1V1DU~L l~MEII lMHEAnAMt~ IA~ D1V1SloM ' \Il!PI, lIDADI 1W\lI111lJIO, PA 11UI....1 COMMOMWIALTH OF PIMMSVLVAMIA DIPARTMIMT OF RIVIMUI ttn4E.RtTANCE. TAX STATEME.NT OF ACCOUNT ." r\...,.f ..~.llt' I~ .n Itt.", 06-08-98 LATSHA 05-31-97 21 97-0517 CUMllERLAND 101 ----- .- ~.ount R...Hted ~ llLANCHE H DATI ISTATI OF DATE OF DIATH FILl MU",IR COUMTV ACN DAVID T LATSHAEXEC 3401 14 FRONT ST PO BOX 5950 HARRISllURG PA 17110 - MAK! CH!CK PAVASL! AND REMIT PAVMIMT TOI REGISTER OF WILLS CUMllERLAND CO COURT HOUSE CARLISLE, PA 17013 on" ., ..... ..... ..-" ,. ,.. .....', ...., .. .... ,,"" ., ".. .... ".. ,.. ... ....... "" ....... ,," "" ~ ...". "." ,.."", ,,, ,........... .. ...'"b'" .;r....-li...'..-,-.-.....;;.iiiiiim.....lA;r.".........'.""""".. ."...-........ ........ ....n OF """ """.., ,'" NO." ".oS" ". '" DAn ......" .m ...._ p ........" ...... M'. """'" ...... M .. ..........." - ....... - on" p. - " .. ....,"~ ...... .~"....." ~, ........ ." ""... ....-. ... . -"'...., b. PROJEClED 1HlUElll allURE, DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT' 05-11-98 """,... ." ",. "."" " PAVMENTS (TAX CREDITS)' AMOUNT PAID --- DISCOUNT (+) INT~REST/PEN PAID (-) 2,798,25 ,00 \ II PAVMENT DATE .-' 08-28-97 05-20-98 RECEIPT NUMllER AA211685 REFUND 63,000,00 9,833,25- TOTAL TAX CREDIT SALANC! OF TAX DU! INTIREST AND PIN. TOTAL DUE 55,965.00 ,00 ,00 .00 -- . If pUD ~f1ER 11115 DAlE, sEE REVERSE SIDE FOR C~LCULA1ION OF ADDI1IONAl IM1ERES1, ( IF lD1Al, DUE IS lEIIS ll1AM U, lID p~VIlEKT 15 REqu1RED, 1F 101~L DUE IS REFlEClED AS A "CREon" ICRI, .._. y,. .E DUE A REFUlID, IIEE REVERSE SIDE OF 11115 Follll FOR 1NS11lUCnOllS' J P.VIENT, REFlIID (CRh REPLY TO. DISCOUNT I Pt!~LTY, INTEREST I ... o ~~ N ':'t N 0.. r- (j t~ .g: :,10.; , ,.' \: iL;;; , n I:' =; l'.~"i'!h tho tOP portlC\".r.l thll Not I.. end ._It .lth .our ..._t - .....1. to tho .... end oddr... ltod on ~ r.y.,! i!do, . Gd . If RESIDENT DECEDENT .... oMok or eOMY or.r plylibl. tal REGISTER OF WILLS, AGENT. If NON-RESIDENT ~CEDE"T .eke check or ~y order paYebla tot COHttONWEAL TH OF PEtfrlSVLVAHIA. . r.fund of . tlX oucllt, which "I' not r.que.teet on thlll TI'I)( Raturn, ..y be reque.ted by COIlPht!ng en ftAppllcatlon for Refund of penn,ylvanll Inherlt.nca and E,t,t_ llx" fREV-1513l. Applications .r. IV' Alibi. at tt. officI of the Regiat.r of Wllls, MY of thtt 23 ",_venule District OfficI' or frOll thti o.p.rt.....t'. 24~hOUr en'Nerlne ..rvlcl ~r. for for" order Ing I In Plnn,ylv..,!_ l-eOO-36Z~1050. out.ldePenn,ylv.ola .-d within 100.1 Harrhburg at" (117) 787-8094. TOOt (117) 112~22S2 otearlnQ 1..,.lred onh'), ou.atlonl r...tdlng .ttor. cont.ined on this notice .hould b. addra..ed to: p~ o.p.rt-.nt of, R.Y~, lur.eu of Indivldual '.)C.', AfTNI pe.t ........nt R."l.... IJrllt, Dept. 280601, UarrhbUrg, PA 17126-0601, phonft (717) 767-650S. If any t.M dUe 11 paid w1thifl three (l) cllllnda,. ~th' Ift.r the Me.dent'. d.ath, a flva percent (SZ) dhcount of ttt. ta)C paid 11 aUOIIMCI. 1~ 152 tlM .-na.ty non4partielpation penalty Is c~utad on the total of thl taM and !ntara.t .t....ad. end not paid befora JMuery 18, 1996, ttK. fi,..t day aUar the and of the tel( MM.ty p.riod. lnt.ratt 11 chllrll8d beginnlng with fir.t day of dflllnquanOy, or nIne (9) IlDnth' end one (1) day frOll the data of dHth, to the data of paYlMlnt. 'a)CI' whioh beO'" delinquent before January 1, 1962 tMlar lnt.r..t at thl ntl of ,l)C (61.) pereant per ~ calculatad at I dally rat. of .000164. All ta)Ca, Nhioh bae... dell~nt on end aft.r JanullrY 1, 191Z tllll baar Intll.,.t at II rat. which ,d11 Vlry frOll c.lanc.1er y..,. to oalandar y..r ",lith that uti ."nouncad by tht PA DepartlMlnt of R4Ivanua. The applicabl. int.re.t rlt.. for 1962 through 1996 aral V,ar Jntara.t Jtata DailY Jntara.t factor Vaal" Int.ra.t Rate DailY lntaratt fllOtor -- I"" 20:< .000S46 1961 9;( .000241 1911 16X .000431 19&8A991 11;( .000301 1.14 11X .000101 199' 9% .000241 I"'S 15X .0001S6 1993-1994 n .000192 1916 lOX .000274 1~S-1998 9% .000247 -~lntar..t I. "loulatad a. fol10\lt'I INTEREST . BALANCE OF TAX UNPAIO X NUNBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR ~-Any Notice ie.u.d aftar the ta)C b$cu.a. delinquent wIll raflact en Intere.t c.lcul.tion to flft-.n (IS) deVI beYond the data of tht ........nt. If pay..nt is aade aft.r tha int.r..t CMPutaUon deta shOWn on the Motio., additional Inter..t .u.t ba c.loulated. -~ "'-, ~.. '. ' /0;1 y6~1 COMMONMEALTH OF PENNSYLVANIA DEPARTMINT OF REVENUE NOTICI OF DETERMINATION AND ASSESSMENT OF PENNSYLVANIA ESTATE TAX lASED ON FEDERAL ESTATI TAX RETURN DATE ESTATE OF DATE OF DEATH FILE NUNlER COUNTY ACN IUREAU Of INDIVIDUAL TANES IMHlRIIAMtE lAX OIYIIIOM 11I1'1, ra1611 HAMJlIOItOt PA 1712I-I"U DAVID T LATSHA EXEC 3401 H FRONT ST PO BOX 5950 HARRISBURG PA\~7110 L C/ * Uttoo4u..""m."1 08-23-1999 LATSHA 05-31-1997 21 97-0517 CUMBERLAND 201 A'"""'t R..ittlld BLANCHE MAKE CHECK PAVABLE AND REMIT PAYMENT TOI H REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE. PA 17013 HOTE I To inou... p..-r orlldit to your acoount, .ubooit the _r portion of thh fo... with your t.. p._t, CUT ALONG THIS LINE .. RETAIN LOMER PORTION FOR YOUR FILES ~ iiiv:4irix--AFP-To7:.-'9r----ii.-Nofici'-op--lii'i'iiiiiiiiAiioli-Aiili-ASsiiiiiiNy---------- _m_______________ OF PENNSVLVANIA ESTATE TAX lASED ON FEDERAL ESTATE TAX RETURN .. ESTATE OF LATSHA BLANCHE H FILE NO.21 97-0517 ESTATE TAX DETERMINATION 1, Cr.dit For st.t. D..th T.x.. .. V.rifi.d 2, P.nn.ylv.ni. Inh.rit.nc. T.x A......d (Excluding Di.count .nd/or Int.r..t) 3, Inh.rit.nc. T.x A......d by Oth.r St.t.. or T.rritori.. of the Unit.d St.t.. (Excluding Di.count .nd/or Int.r..t) 4, Tot.l Inh.rit.nc. T.x A......d 5, P.nn.ylv.ni. E.t.t. T.x Du. TAX CREDlTSI PAVMENT DATE RECEIPT NUMBER DISCOUNT (+) INTEREST/PEN PAID (-) ACN 201 DATI 08"23-1999 37.358.00 53.166.75 .00 53.166.75 AMOUNT PAID TOTAL TAX CREDIT ,00 IALANCE OF TAX DUE ,00 INTEREST AND PIN. ,00 TOTAL DUE .00 .If 'AID AfTER THIS DATE, SEE REVERSE SIDE llf TOTAL DUE IS LESS THAN Ii, HO 'AYMENT IS RE~IRED fOR CALCIlLATlOH Of ADDITlOHAL I",EREST, If TOTAL DUE IS REfLECTED AS A "CREDIT" ICRI, YDU KAY DE DUE A REfUND, SEE REVERSE SIDE Of THIS fORH fOR INSTRUCTIONS,) .00 ,,,.,,. '.4,~""I,V~ '.....~';,,','~~., ~UF MOTlct:1 To fUlfill thI requlr..-ntl of Section Zl~6 (b) of the InhlrltlnOt ~ Eat,t. t,~ Act. Aot 21 of 199.. (72 P.S. Seatlon '1~1). PAYMENT, DetMlh the top pottlon of thll HoU. end .-It with your peiYHnt to thli Rllllt.r of Wllh print_ on the r.ver.. .Ide. w. .... ohMk or IIOnftV or.r plylbl. tal REGISTER OF MILLS, AOEHT. REf_ (CR)I A r.fund of . tlUC credit MY bit r......tfld by OOIIPI.UnI In ";.,.pllo.tlon for Refund of Plnnlylvlnl. lnt.ritMOl end Eat.t. 11M:" (REY~lJlJ). Appllo.don. In .vll1lbl. It thli OffiH of thli Rllllt.r of- NUh, ~y of thl .3 Revenue Dhtriot Office. ar froe the Depart..,.t'. Z4~hoUr 1tt1....r1og ..rvle. f'lloMIra for fa..., ordairinll1 In Penn.yh.enl. 1~"0~!62-Z0S0, autsl. ~'Ylv,"l. end wlthhl 10011 Klirrllburll er.. (111) 7.,.1.9tt, TODI 1~1".,"1-SorO (Slr"l~ for tlMPIvtra with .,.e1.1 he.dog .wt ipAklna nMCIlI). OIJE:CTlOMSI Any party In Inter..t not ..tlsfltd with the .......-nt of t.~ .. Mown on thb notice RY object within .1M:tv (~O) ~. of reoelpt of this Notice bYI --written prot.st to the PA Dlper~t of R.v~, Board of A~al., Dept. 281021, HarrlabUr" PA 1712'~1'21, OR ."slectlng to hev. tM ..tt.r dlterlhMd .t Mldlt of tM penonel repr..ent.Uv., OR ..-.....1 to the Orphen.' Court. AIlItIN- ISTllATlVE COAII!CTtOMS, ' faot~1 errora dllCluvarld on ttlb .....Mlent .hoUld bI eddr...1d In .,rlUne tOl PA Dep.rtlMflt of R.v...., aurllU of Indlvldulll 1I~.., Al1MI po.t A......'lt ",,,,'ew Unit, Dept. Za0601, HarrhtKlrSl, PA 11U6-1601, Phone (117) 717~650S. See P'" 5 of the bookl.t "In.tructlon. for Inherltanc. tlX Rlturn for I R..ldent OIoIdlInt" (REV-ISIU for Wl .xplanatlon of _lnbtr.Uv.ly correot..l. errors. FEMALTYI The ISiC' t.M eMelty non-ptlrtlolp.Uon ~lty II cMPutad an ttM tot.l of ttw taM end Int.r..t ......, end not Pll~ blfor. JInuIry 18, 1996, the flr.t dI~ sft.r the end of t~ t.M: .-n..ty period. lhl. non-p.rtlcJpatlon ,*",1 tv h IPPMllbl1 In the .... .....,...r end In the the ... U.. per lad .. you MOUld .,..1 the tlM end lnter..t thllt hes been .......d .. indlc.tad on this notlc.. INTERest I For d*t.. of dIIth on or .ft.r 10-S-'I, Pennlylvanl. E.t.t. tlX ba.ed on ttM Feder.l e.tst" ,.~ return blooM. dllInqbent .t the 'MplreUon of nine fO') IIOnth. froe tt.. etat. of delth. For cIIt.. of dIIth prior to 10~S~'I, hnn.ylvenl. E.t.t. rl~ b..ad on the Fldlrel E.t.t. tlM: rlt"rn beoORs cMlI~t .t the 'M:plr.Uon of .Itht.." (II) ItORth' .rOll thl det. of d..th. T.cl. which *- dlllnquent before Jenulry I, 1982 bllt Inter..t et the rlt. of .1M (6:':) percent par ..,.. o.lwl.ted .t , dilly nt. of .OOO16~. AU t.M:.. which bee_ dllIoquent 0fI or Ifter ~r" 1, 1911 wIll bHr lnt"..t .t . rlt. IWhJch will very frOll c.landlr y..r to ellender y..r with thelt rlt. ennounCItJd by the PA Depart,,"t cf R.VIf\UI. the app1lcabl. Int.r..t rlt.. for 1912 through 1999 .r., V.., Int.,.st Rat. DillY Int.r..t Feotor V.., Inter..t R.t. ~lb Int.re.t hctor 1912 :"X .ODO~' 1'18~I99l 11:< .000501 1913 lOX .000451 1992 9~ .000247 19M II~ .e00501 1993~1994 n .OOOlU 1915 15:( . .10556 1995~ 199. 9~ .000247 1916 IO~ ..00274 I_ n .IOOI9Z 1911 9~ .00OZ47 --Jnt.r..t I, o.lcul.ted .. follow'l IIITIRB8T . IAL.l.NCE OF TAX UNPAID ~ II\IIIIER OF DAYS DELINqum X DAILY IIITBREST FACTDR ~~Any MQU.. 1,1Wd Ifter the tlX bIc~' dlUl'tqUiMt ..Ul refleat In Inter..t C1IIClllhUon to flft"'" (IS) dlY' beYond the det. of the .....lMf'lt. If PlPlnt b ... after the In~.r..t CCMIPUtlUon dI~. .heMIn on the NotIOl, tddltlonel int.rest IUtt be CIalcul.tld. /5--/'1(" -/ COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF DETERMINATION AND ASSESSM!NT OF PENNSYLVANIA ESTATE TAX lASED ON FEDERAL CLOSING LITTER DATE ESTATE OF DATI OF DEATH FILl! NUHlER bOUNTY ACN BUREAU Of INOIVIOUA~ TAKES IHHERITANC''[ TAM DIVISION IlfPT, 210m HARRIS.URO, PA 11128-0601 DAVID T LATSHA EXEC 3401 N FRONT ST PO BOX 5950 HARRISBURG L PA 17110 ,\ c'/ *' UW.,i4UA" m,"1 08-30-1999 LATSHA 05-31-1997 21 97-0517 CUMBERLAND 202 Aooount R..l Hed - . BLANCHE ~ MAKE CHECK PAYAILE AND REMIT PAYMENT Tal REGISTER OF WILLS CUM8ERLAND CO COURT HOUSE CARLISLE. PA 17013 H HOTEl To in.ur. proper oredit to your .ooount, aub.lt the upper portion of thl1 for_ with your tax p.~t. CUT ALONG THIS LINE ... RETAIN LOWER PORTION FOR YOUR FILES ~ Rifi:73J;-ix-j(FP--io7:-'91-----.-.-NOificE--oF--piTE-RHiiiifiiiN-Aiip-AS-iiSS-MiNy----------------------------- OF PENNSYLVANIA ESTATE TAX BASED ON FEDERAL CLOSING LE1'TIR .. ESTATE OF LATSHA BLANCHE H FILE NO.2l 97-0517 ESTATE TAX DETERMINATION 1, Cradit For Stata Daath Taxas as Varifiad 2, Pannaylvania Inharitanca Tax Assessed (Excluding Discount and/or Interest) 53.166,75 3, Inharitanca Tax As.assad by Othar States Dr Tarritorias of tha United statas (Excluding Discount and/or Intarast) 4. Total Inharitance Tax Assassad 5, Pannsylvania Eatata Tax Dua 6, Amount of Pannsylvania Estata Tax Praviously Ass.ssad Baaad on Fadaral Estata Tax Raturn 7. Additional Pannsylvania Estate Tax Due TAX CREDITS I PAYMENT DATE RECEIPT NUMBER DISCOUNT (+) INTEREST/PEN PAID (-) AMOUNT PAID ACN 202 DATE 08-30-1999 37,358.00 ,00 53.166.75 TOTAL TAX CREDIT ,00 BALANCE OF TAX DUE ,00 INTEREST AND PEN. ,00 TOTAL DUE , 00 _If ~AID AFTER THIS DATE. SEE REVERSE SIDE elf TOTA~ DUE IS ~ESS THAH 11. NO PAYMENT IS REquIRED ~OR CA~CULATIIlN Of ADDITIDNA~ INTEREST, If TOTA~ OUE IS REf~ECTED AS A "CREon" (CRI, YOU MAY IE DUE A REfUND. SEE REVERSE SIDE Of THIS fORM fOR INSTRUCTIONS,) ,00 ,00 ,00 , , pUlt'OSE OF NOTICE I T. fulfill .hO r,qulr""" .1 100.100 21~' (bl .f .ho Inherl..... and E..... T., A." A.. 21 .f I"'. (72',1, mUoo ~I~'), PAVtlM11 Dltaan the top portion of thb MoUoe .nd .ubIllt with your pay.."t to the RIgbt.r of "'1111 prl,nt1d on tM r.....r...ide. RR .... chMllc.or IIOIMY order plvllble tal REGISTER OF MILLS, AGENT. REfUND (CRl, A r.fund .f . .., .r.dl' ..y .. r.quo.tod .y ....1..100 on "..pllo..loo for R.fund .f ponn.yl.onl. Inherlt.nol ~ Eltat. tax" (REV-I)l]), Applications .r. Iv.l1thl. ftt t~ OfficI of the RIII.tar of Will., on, of thO 2' R...... DI..rl.' Off I... .r fr" tho ....r...nt'. '4-""ur .....rloo oor.I.. .....r. f.r for" .rdOrlntl In p~.ylv~l. lRIOO-S62-Z0S0, out.idl p.nn,ylvlnla and "Ithln local Harrl.bUrl .r.. (717) 1&7-1094. TOOl 1.'OO-441~]OZD (s.rvlce for tlxpayar' with ,plclal ~el'lng and .~aklna need,), OIJECTI~I An, p.rt. In Int.r..' no' ...I.flod .1'. tho .......... .f .., .. .hoYn 00 .h1. no.I.. ..y onl..' .I.hln ,IKty (60) dlY' oi racelpt of thl. Notlee bYI --.rl"" pr.'," to ".0 PA ..p.rt.... of R....... ...rd of APP"'" D.pt, 281m, H."h""ro, PA 17!Za-1D2I, OR --.'toting to haV' the ..ttar detaralp'd at audit of thl plr.onal repr..~t.tlv., OR .--weal to the OrpMn" Court ADlnM- IITRATlIIt C(MtRECTIOHSl fectual .rror. di.cov.r.d on this .......-nt .hould ~ addr....d 1n wrltlng tal PA u.part..nt of Revenu8, lureIU of Individual tIXq., ATlHl po.t AI"'IIM,t Revl.w Un,t, Dept. 280601, Harri.bUrg, PA 11128-0601, Phone (717) 187-6S05. S.. P~ ~ of the ooo-":let "lnltruotion. for Inh.ritanc. T8X R.turn for' R.ddent Deoedent" (REV-1S01) for ~ IMpl.oatlon of ~lnl.tr.tlv.IY corr.ctebl. error.. PEMALT~l ThO ,!X t., .....ty non-p.r.lolp..I.. p.no", I. .......d on tho t.t.l .f .hO .., and In..r..' ........, and no' p.ld .,f.r. Jor~r' ,a, "96, tho fir" d.y .f..r .hO .nd of .hO ... .....t. porlod, lhl. no..-p.rtl.lp..I.. ....1 tv I. .....1..1. In tho .... _nor .... In .ho .ho .... t1.. p.rlod .. yoo yould _., .hO .ox and In..rut that he' lIMn .......d II indlcat.d on thlt notice. INTEREST 1 'AddltiOMl p.mlylvN\la t.tat. laM ".sa..ed a. a r.,ult of a chenoa on the Federel E.t,ta 'aM elating lett.r baOOMe' dell~t at the eMplratJon of one [1) ~nth frDe the det. the finat notic. of the iner.... in Federal E.tlt. 'IX i. r.oetv.d. ll)(1I Mhloh tMtO... .11flCtl*\t before JllnU8rY 1, 1982 bear interest at thl rat. of .IM (6:<) parcent per Mln'M ..I..I..od .. . d.ll' r.t. .f ,000'04, All ..X.. Ohl.h b..... d.llnquont .. .r .f'.r J....r, I, ,.a, .111 .,.r intera.t at a rat. Nhlch wUI vary frOll calandal' yaar to catandar y.ar with thlt rata lIMOuncad by the p~ o.part.-nt of R.v~, ThI appllcabla intar..t rlta. for 1'82 through 1999 ara, '!!!!: lnt.re.t Rata Dally lnt.ra.t Faotur ~ Int.r..t Rat. Dally Intera.t Flctor 1.1l !OX .100itta 1918-1991 11:< .000301 1'15 16:< .0004Ja 1.,.,2 .X ,000241 1.64 11:< .000301 1993-1994 7X .000192 I'a! 15:< .00nSb 1995-1'" 91: .11I00247 1.66 lOX ,000214 ,... n .000192 1967 .X .000247 --tntarl.t I. caloulatad .. follow" INTERElT . BALANCE OF TAX UNPAID X NUNBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR --Any Hotie' i..ued of tar thl tlM blCOIII delinquent wIll rafl.ct an tnter..t ollout.tl~l tn fifteen (15) d.y, beYond thl data of thl ........nt. If peYHIlt is .... eHer the lnter..t ClOllPutaUon date shoWn 00 the NoUc., additional lntarut ...st be c.louleted. ~ . ? T !\!\JLI\.E.rg,,~LI.J.!lDE ~__ RU ~_~L6~~_~~ Name of Decedent ,__'a(::,0_~_.~H r:.;,_.J1.<-- t...t1 T S l"A Date of Death :_---'i.1-~0-,9.7---.--..-- Wi 11 No,. 'Z- I -_'i:2:_g,,-~.12--p Adm in, No. --- pursuant to Rule 6,17. of the supreme Court orphans' Court Rules, I report the following with respect to completion of the administration of the above-captioned estate: 1, State whether administration of the estate is complete: Yes NO__~_ 2, If the arH;W~H is No, st.ate when the personal representative reasonably believes that the administration will be complete :_...J0...e<,j_~1'-I___]".Q.c::>_9__-.---- ], If t.he anSwer t.o No, I is Yes, state the followingl a, Did the personal representative file a final account with the court? YBS._.__._ NO_,._.___ b, The snpal-atco orphans' Court. No. (if any) (or the personal representative'S account is: c. Did the personal representative state an account informally to t.he parties in interest? Yes No -- d. Copies of receipts, releases, joinders and approvals of formal or informal accounts may be filed with the Cerk of the orphans' Court and may be attached to this report. Date:~jL~- ~~~J~;/)~~ /.-~ signature /. (:/J ~ ( . Ol'l,-"D T, (..,A,,\c~HA Nan\elPlease typeClr print j- ~':I.L_~~..'!!~.-1l.l! r.;: Address (..(;: (r)OI(""t:: ) PA-, 170 '-13> 1'), 1_.~Z:2,,:f'7?_- 'l'el, No, If2"Gt/S~~';D W~P1IZN /(>CC~/?I 7'T--.2. ,yd.2, 6<>; a 11 Capacity: __~_.personal Representative _._counsel for personal representative (AAH lrmU AM3)