HomeMy WebLinkAbout97-00528
\~ ',~
\"'~,'",;:':~,
"'1,
;,~ .' "I
'.~: "'..
\",<
"\
~'l
\~,,' ,
.":)
\'l<\',
"y'
1JS
Ii
I,n
"':~
.
o
Z
a
~
..
\'U
P..:TITION "'OR IJROHATE und (;RANT en' LKfTERS
~\.~q1-:,~-
ll'.~tale of ,..llaI;J:Y -K. [).-1ibloJ:
al.~tI klloWII (/.1,
No,
ro:
__~__~____ Keglster nf Wills for the
,~,_..,....._____n____ __, ne(,"(/.\'I'II. ('ollllty of CUIIlx'_U"f]cL,._ in the
Sodal Se('ur/ty NtI.LZn~! 6-4QJ~ ('ol1ll1lonw"lIl1h of l'ennsylvanill
The pelltlon of the underslglled respeetflllly represellls thlll:
YOllr petltioner(s), who is!llre IN yeurs of lI~e IIr older IIn Ihe esecUILl-X
in the IlIst 11'11101' the IIhovc demIL'nt, dilled _ May 20
and codicll(s) dilled , N/II. .
__n_____________ nllmed
,_-~", 19...9.6-
(~lllll' rckvuut dll'lIm~lIltll'l." t'.~. ICllllUdlllloll, dClIlh Ill" t'\cl'Ulor, CIC,)
Deeendenl WIlS domiclle'd III delllh in _ n_ C\.UIOOJ:J<ltlQ______.. , '__ ..... County. Pennsylvania. with
ILls___llIst fllmlly 01' prlndplll rcsldel1l:e III-n~:g~l~oHTTIAV~RWJ~rorr---'-------
____________..... __________1.,., . .,..._. L__________~___,_______
(list slr!.'!.'l, llumher IIl1d 1Il1l1\1..'lplIlityl
[> d' t I' 75 , I'. I' d ,June 11 19<;2
ccen en I Ilen _______._. ,years 0 agel ( Ie _.... ."m._________~*___~_.......,.._R____'
al_.....8lUe...Ridge___lli.l\Len--we.6.tNUJ:.flin\l--UQlTlh,CalT!;!-JIi I 1, PA 1 7011
Escept as follows, decedenl did notl11l1rry. WIlS nol divorced IIl1d did not have a child born or adopted
after execution of the will offered for probate; was notlhe victim of a killing and was never adjudicated
Incompetent: _..1'111'---_________.__________________... - -------~-..--,------
Deeendent at dellth OWrled property with estimated vallles liS follows:
(If domiciled In I'll.) All personlll property
(If 1I0t domiciled In I'll.) Personlll property In Pennsylvania
(If not domiciled in Pa.) P(,rsonal property In County
Value of real estale In Pennsylvanlll
sitUated as follows: __.___n..'_...._______
$ 10,000 00
$
L
$
WHEREFORE. petitioner(s) respectfully request(s) the probate of Ihe last will and eodlell(s)
presented herewith and the grunt of lellers t.est.anen~a,.y
(lcsuuncntary; admlnlurllllon c,l,a.; administration d.b.n.c,l,a,)
theron.
t
'0e
",g
-g,g
"'il
1~
iii
//
:,/;,
_-cl..'~_ do!./ .'
,
..~..~' ,
~,L .. 4-}1 ,,-1,_ "'.._ .J
f'~ )" I'
'r':-iJ..,.j- <:~,~"- J .. ...0~_i')"'~/..i .L ~. )
__ IIIU/'/d;.F {,,:/tI,Il/^JC.
6/1 (I (--,,-andJyr"LJ) Ih'f
J~ ).LiI, ,t, '7"(1
OATH 01<' PERSONAL REPRESENTATIVE
COMMONWEAI,TH 0)<' PENNSYLV ANIA } ss
COUNTY 0)<' CUMBE;lu.J\ND
----------~
The petltioner(s) above-named swellr(s) or affirm(s) thllt the statements in the foregoing petition are
lrne IInd correct to the besl of Ihe knowledge and belief of pelitioner(s) and that as personal represen-
tallve(s) of the above decedent petitloner(s) will well and truly administer the estate according to law.
~I I
/, ~/ / I '
Sworn 10 (~r affirmed ~B~H Sllbscrihed~ _, U-LLUL ,e -"0~ " .d_,_.",_"
hefore me J\~Ef~-_:-- --, d~~1 01 (iJ~-------
~1lft-~~~!P&UrffLt{~~ liii---
\ t) - \ e,lo - \ (
.. tIl
l'
~
....
~ -.. J .-~' - ", -1"-'
'........__.-~"....._a
'..--.-.-- ..
.
";'." ~
'-::::~-~~~~'r-"'~"1Y ~,....,..,
,'r. j 'i, .. _f
~\~",,:':~!~
It: ;,~.,;;.fo,'
\
~. )~;..,-
N 21 . 97 - ~)2B
o.
Estate of
(-lan:y K. DeJblet:
I Deceased
DJ;~CREJ;~ 01" PROBATE AND GRANT OJ;' LETTERS
AND NOW ~,~___ _,,__~,_~uNI_n-,,----------- 19,'!L--. In eonslderRllon of the petition on
lh~ reverse side he'reof. sRtlsfnelory proof having been presenled before me,
lT IS DECREED thut the Instfllmcnt(s) dated_!4BY 2Cl1..JJ.9~-,-_.._-----
described therein be admllled to prohRlc and flied 01' record as the lasl will of
Hat:r:y K. Deibler
;;;iL~=-=_==yeSla~t~'i__~=~==----'-"---
are hereby gran led to ~_ Paul Jne Galdino -
--
-.-----.-----......----.
9n.
FEES
Probate, Lellen, Etc. ..,."... $ 60 . 00
Short Certlflcates(4 ) ...... .., $ 12 .00
Renunciation ."..... i , , , , . ., $
X-pages $ 9.00
JCP' --- -~
TOTAL _ $ B6;00..
Flied..... ~.~N,~. f.~,. ).9,~?..........,..
Ron Tut:O, 34334
ATTORNIJY (SliP, Ct. 1.0, No.)
32 South Bed~ str:eet, Carlisle, PA 17013
AOORIJSS
(717) 245-9688
rHONIJ
Q0
u.. (r,
~j
';'0
'-f\"C,",
'D
~J
(....-
~,
,0;'
N
co
-0
--'
_"'-.. ,t:)
J-~, i"" U1
Called 'attorney on 6~24-97,
n..llfM4f
~
"INI~HT
IlAC<<1Hl(
'1'\1\.1 i, '" Il'nilyl\1,,' tll<' inl""",,';"1< 11<'1" 1',1\'<'11 " ''''','\111 "'1>1<'.1 "'"11<11 ""1',<11,'\ ""tI'"II" 111,1.-,1111 dill) r,ktl wi,\1I1I<' ,(\
lm,,\I(('gim,\I, 'I'll<' "111',111,'\ ,,'nill, "',' will 1><' ,,,'\\,1"1.'.1 '" ,Ii. \"",' "",,\ H",,'.!. (\111'" I", 1""'11,<11<'11' IlIilll','
WARNING: Ills IlIllgal to dupllcato this copy hy pholoslnt or phutogtaph,
lit,t' fur lhl~ l:l'ltI(ll,\lt', 'fi,l,,()O
'Iillllr,;jl"",~
,'ii,ii~~\j\\, Of P(~"'-,
~!4rl~~~' t. t~~.~\
3[,(, '~
· 'f..' " - ,.". / .-
~ ", -", '. / ~
~~" ..' ~/
. :9'MfNl ~\ ~~""',
~lJtJ.i}JJJ!~J
ILL~ dU<U,<. 1{~~J ~..,,:tj..
I If( ,d n('V.t~(I,ll' 0 a
-i1{,I'~'
.---.....-----~----~~~-~~~--
li,.L'LYJ.
!),ltl'
4306849
~~..~,."~,-~"..
No,
UI061~,"1 ilJt1
COMMONWEALTH Of PENN6VlVANIA _ DEPARTMENT Qf HUUH' vllAL AECOAVS
CERTIFICATE OF DEATH
;
!
tWI'~I"'-"
~"""'''''''''iTi;'';;;'~. II f<!.~--;---- : - )/"~~.~-"- --- --- -~:"^lfI-; ;--~~~8''':''"it-=--;;~~,~'.f;;'7,~i -;---
_~=-~.-'~li '_1:J~.--L_'1--J2 __- ---- ,.~___-_-_-_LL: __,'l!L-
_11.....-'1 ~i~ ~ ...!1!*l'1\~ ~.Arl!."',,~ttl ~~,JoC.(r,.,..,I, ~_~~~!?'~H~~'!':~'!~~_~~!'....~'!.~..~!!!!' =--" --- ---- -------...--
_ _ _.]~. '_1- -" -. ,-, -f,'~ ."" ,~"'''' 0'''"
~?~~'~_ _ _.___ __J.----. .~.6.._ ~-I.-.jC0. L~!_.~!~.d '?'.'~~'_ .........:~.l--~:::~~~- POAll =-' rJ ~__( 1 _=. _#II?.... ..-
....."OIIl1RII em ,r;ttOfAl'H 'AC.!1VH,Ul[\~I~~'''''U., .........,...\ol"'.,"., wr..-~cJllC I' Ml', WI
/"' r /"" /U 6"'" {II", A,U ~tiY_[J,..._~- '.....W"
C uN/"i~LMJD ?' <-,,~t ..,,,"" < ''''' f'.lDotc -- t.. -.............. >L_...!.!ll. E__
a........::.pI~I....,..!U~~~~.- -~......iil.ii!iliM,~iWUiliij" r'DiCf~~~iIi.~-----iilfriiHfSfDijC~iOH --;;w..,Al't4Ui;..tl......- Sl.lI'NWlNOWOUIiI
_____ ..':.:l:'.:i:'~"::'::~:::T -.-.- -------,-." <".... ." .~~'l."''l-'- -..::,':::,,,-~ ,,- ...--
.. p,'" _-.-.llL!L.?f~\!r-"e~~ ,::.~."'[I_ 1L_&;/}L_-l ":':1',, DN""-C'~D;zr;;:;' '
nlCllOlN'-AWAlllHGo\DOMlI\t>,... ,,,,11....,, SIoIIIl"C..IOI lllClUI'HI" f'l ~~ L:r' .. ~ ~ ,;J^
77D r'''''<Ai 0)'" ,'" I"' I> ",,,.. '" ."_ _ .], . .., II... - .....-.---- .-"'.'-. . ..H6!<".r!u< ,----
('/-)/,.(11 {JiLt flA 170 1/ ~~'.'::~H =:.~
"""",,,.,,, ,.,_.. CUI'\""'""''''!''' ...'....' ".11::.:'.'.':'':::'" -" "" ,- . - - """"
L___._-"1kNl.'{.-[L- UClc.(c-,'_ __ _' --- IL_ _ _ ___,-- .=_~!'--~'u.'J'<L~----
iNII0f\IIUIH1' ~w-ji,~ IHfl)l_I'W.*,IHQ..oofIl..\S'I_~lI'bon*""l"'C'"
___=".~~t:'?c-~U..-~dWL"'IL-."-.. "I- . - ..- ..-- -- 1"';':~.2._,(i,A' ~N'JVIL->~ AvE' -J:" ,.(~!:',t:-ii.':.o. j~L!J"!L-
.....~'" ,~,.''V ""."'."".,~ .~.Oi'.....,.,o1H':.......,_....,,- ""."'---~
.....ltIlv [;,""'01....11 ....,.,,..~'''~Ii401l{ I ,........,0..._1 llIlP*rI<It. A
~ii:~i._. - - - - "'L ." /I- 'lI - "~'-1i' ".~ OM_""'"' -,,"'~ ,,11---
" ... ~1J4U:~':""'" 1:;!7i't": _. ..C:~~:'~~tl-IIrM~~ H;,....P~,!WL,
I ....C" ~"""'" t"'-"'''''.''''''~,Jotlll''''''''''''oIl''''''''<l&l..".a''''''.''"11 ~lCOI"iiW" ~.
""..~.~.-.-'-" '..-..,,'~, - ""-,
-"'f~"'-
.......~..;;:-~_ ___ _ . _ .,.Oftiiftl ~ -- \l}~lifflOOOl'~IO~Ab-li;i.",(i;"j "i) - --.. .,..cA'if'/Ili;ti\fiiii'ifl...110iC.iLli-UiiiiiWC "'..J(
....:"::~~....__ _____ IL C;.2.ri':'~ u. L!JILf'2 _ ." .'- - IL__.__ -".'.12-.-,
"...." ,..N__ _".._.__,"..-iN~,"' ",""""N_.l'... ~"",._""......,., ,_"N""_' .....- ...... --..--.......- N
lAMIIOIAII:::~I:,"_""_I'''''' . ~ ..I ~= ~."......_--"....,
;:::::,=. . 4~1t,~;2 ,"",.(it:1 // .r'~Il)V --.-----
_~~-" \" "" C~""- .__<;;,:~::.:r A....~r>~. .d~(~, . - - . . - -.- -.-
11.......-.....- 11lJt101~\.....HUl>lOllCll('{O'.1 ,- r I
........-~...,-
..-,,-,...'. ' - -- ,--- -------
"..........._.. (IllI1U(O.....~...llll':il'-".IItc:t'''1
,--.u...-'Il,ul
.
."iMf'u'roPli -'lWtNioTI1bPIY'INDINOJIoI.lHloiiir.'iiiilii;l~ -- ----. ~-.~---r"iili;ii;iiiW"'--- 1';wOf ~,~ -J..tlUflfiJ-wo.lIii-\o.1C_~~'tOCt;--vMin--
l'I"'Of\IIIIU' '.ii.lt.al......I',.:JH1'O ,1oI<..,IJ./......I
t~"'IOHOfI.;...U':j.t il.l I
Of or"'''' NOI''')N-. I....'~~.. - II ,..( I
"'._. II r...,,"ol'"'''''''l''''' I
fIIll" _ (I IiUII ....... \ I LUo+J...u.."'.""'" 1\m.l,;lllfIH11Iln AlI'a;>,,,'..~r"'I"'-'Qollll.'''! III t;'OCAlII:'H'il='~oIyI""""~" - -~---"--
'r 1._>\1...''>\....,1
_._'!!-_ _!!. ~_ Mil ~
..",lfllllt ilKJ~-\1fI& TIlI'lX'''''III'-~if--~ -~- ---~_.
'~;;If~~~:r,.\O'~",,",,~:'OI~~'I"""'" ,....' .1..' ".....'" ,..,1" '.",.' ,,,....,, It-' ,,,,,,,, .",.;,,, ",;,,"1,'" w
'....M".11III1................""..Clll'__.....'...MI......R''''''''..tlll... I) I"~ ,-"">>1'.(.....h ~
',',',1.- '~.^~?1~.:. '-7~;: c-.~ - TCIR,"-..,~~~I.~zt<C_-~;i.-_~_~~~ -~..
.......-...."'''........"''''...'''......''''...''.'"'....' ",,,,,,,,,'"""",.." u.-....... ... "- ~ 10 !'Jtt L - ---
'...._".f ~........... ........c...,...~... _. f'lt. ""',............. .~_ WlMl.....I.l..... "'.MII.. .l_l.-l .\Iiili\OClfi"Ut# ,.'7.~lOCQlol'IITfDC1olJ.. Of Cfl Ii
<J1"" ~1' :....,,'~ . ~",{t' At>,
......" m....""'...... ~ . ~,~ ~
=::':.~;:~m~"M_~"..~"~"""'"..,...""O",'.""...'"'..."''''''''''~.",''.~'H~:.~.".,,"~~'"..'''..~ (I ~ . ,/ /:- J
... " t.l.~t!.f~"?L(rt~ 1J~_.5_~A1< :iI...
.:"~~::.:::::"'2;~~c)..Q'I'''tj~ l~ l'~~_~~j :.~'~'~::T(L!f!7_.._.__
,
,
~
I
"'\,)" ~'''!t,V~~'(~Y~' ,,-" ~,,_v~,~v ,,'" '\.'" -<,~r / /
"'-u" ~c ~~~ ~,/ c.~ '--'oS!' "., ,.i~ / / /
\" oJ:- 'i: ~ 0 ,/ J~~- <'~ "', //
, ) ~ ~~ ~ ~~ , ' ~ " 'V
\- ~~~~~ ~~c,~.' ,.,.",\~1.' .,' ~'/_...o;/ v&'<..'
~ q:~~~/ 0 '" ~'" '\,
~o -'- / ",' .,.'" "f.o,) 0'<.. /
~ ~v '< ,=,' ~,,,, ~~ 0} ~ .0." {/" /
"~//. ~.",c~ ~~.'~ ,~~....'\:;~". .f.~""',p.'<,0':..^,<;)/{/
/ ...-", ...0 ~ o~~~'" 0.....' ~.... ~o ~ o:"l"t- g(.- "':>""....
X~~~ ~"\,, ~l u ~ h ~O ~~ '<..' " ~/.. ~.".
~~ ,;.{~~~ ,,-0' "....) ~,' '" it~ ~~\e.}'6.~~~~""/'.....,,,~ co~,e~..;Y" .. / 7''\.' , ////
.:.:..'" /f?~ ~:-.~~' ~~", ~~~ '~a'" ~.,..o.v.a. ~O~o# n:Y.....'o /7 , // " /
..;..";::,\. r:.~ ~ ~....'" '\ ~>),.).~ ^'~~'"\......... t: ,,:>1.' ,:0--// .." / / '\. '0 ./ /
~oI'~.,p'(~'~*-. .,~.J:'~ ,""'" I) \~Q':I...b~c..O~n""'~ (;'i> /..\)~. // / /// - - R>> ~~ '
\,-", , ,..;:\ ,." ,,~<) ",0 ~'r- / \}' <;)<;), / -' ,/ ,,0,"0,/,,:,/ ,/ .f'
\'{. ,,:-$' " ','\ ~ ~~/ 7'::-- / <;):--'~/ // / \,.'" '0' ,~",,:// ",0/' (./
1i-~, ,.,' "..'~' ,-" ~...~/ /:f -' /~, <;)<;)/ / / ,/ ~y ./))($# ,
...C' ~~~~) ...," /A,~/;:7 ,,/ /? / ~:7..,'/" / / :/ . "// '
,'.,- ,~, ,-> ir/ /- ,'- / / /\),o/ ~ ,/,/ / ~ / /<;);.. <;)~/
'-c...~~ ,t).."-J \i.'~"" ~ --' //"', / / '// C)~ / / ,/ ~ / / ~ ~" ~-' ~
~ "V;;"".,"" ~.'~ .O~~'II. / /-f \,,'\,"'-' 4~ <;):,.~~,/ // / ~~~~/ ~ _/ ^. <;),..:';
\q;/~......,\ ~ ~. V E" , "/ / ~... ." ~ /. "'J \ /
/,~(.."" ~~~ ~o .....O~~ ~~ ",~ ,. "\. // /' // / \::-~ //' // ....'l,.fo.
;,., ;O~CS ~,,~ "O~~~ r>~/ " ,,/ 00. ,~ /,// ,/" r-...~ // /,/. \V'o
~. ~Q:\ S~/ / h" 'o.~:"\'" 'to' / ~/... .'
Ao-,' ~~ ~.~<O~~ SJ/ / ,..' '1\ fl" ,,~,-/ / <;)/ '
,-" ~ <' ~ 7 / '0'0 /- ~< <) ..,0 \,. / k +'. " .
,," <)~~,o ...ti ,0/ "",-><J // ,,;:' ~~. ~~ '- / // / <=>"
,,'0 '-.; So... ~/ ' ,f7 _, ~ ~. ~. ..0 Q + ' .
~~~) off. / ~~ /' oi' ", ,~~" ...' ",/ / ,"
~~# ~ G ...p~$...1+- ');..;~.. o~. ~.o~ t..~~ J"fb o~.. ~.. ~~ + ' '\::~
..~, /..,.~ /. ~.~" ,~. ~. o~. ~.o ~~ //' //
~" ~~~y; ~ 0" ~~ ~.~ ~~ ~"\. ~(j l"\.~" ...~,
1'~'.p,"\ ~o o~ ;f .. _~.. ....~. f..e / '\oJ ~ " ~
,/ ~~"\,,~ 0'" ~,o ~. \r-~- eQ ~ ~.. /" tJ \.~
// ~~~ ,'\: ~ o.~ ~o o~~.. ~~ O~fb:\,\ ~..' '" //'€-.f::J'O" .,<-' 0} '"
~. ~.. ~. o~ 0" 1\'" ~e '" ~o b.~o ~.J !:o ~.\..
,. ~,o ~'" ." (:l~ ~.\. ~ ~." ;:....J.fb~. ~ / ~" 0,\.' <-,~ ,~
'v cO'" ~oCi ~ '\.' ~,o 0' ~-s ,($- ~t.;. ....~. / ~'? / OJ'
~ ~' ~o~ ~ ,Ci"t,~. ~.o b.~. ~~ti- ~~~ ~.t:-",~ ,~~.Q ,")")/ ~ ,~ /
-- bo' t.o."~ts-. 0:\ o~ ~ts-. .....'.. ...?:>~ ~'fj'" Q '" ~t:-. ..~~ '::'$:'~/ ~~ ..I......~'\ "'
')" ~~ ':!..o"''' "'.... ~.....~~. ;I~ ,t:-." ~~~.. ~.~ ~..",,:-- .'o':S~.~. ..::::.""
....0 ~.. 0,0 ~~>>o '$ ~\; ~ ~ ~.~ ~~/ 0' o~.~
. b' '\.....(i. a. ~,,~~~ oct ~~Ci- ,~. ~~ ,'\./ ~~~tf'
~ '\, ...o~ ~(j." :,,\q) ..~ ~" e~ ./ $'~<:> ~ ~""\
'.. ~. --, ~.~.. 0'" 0(::< ~. ~ ~(:'., 6. f..0-1- 0 e '\
. . ~~_ ~'Q.,~.:~,,+~.'::O-..,~ ob.~~ ':!..'\.~o Oo.J.e"'~ "o/'Y:..~.oq,.~~e' ~o~eO~ ~""\ O-.0'~o~" x
~ Qti ~<:J ..\.0 ....b. .,,0/ 6~c..~c...~e ~~,--,~c.; _,e >..~tJ ~o.~ co."
,
" ..
:::...../
~
IIIV-liIlUf"_"1
,__ _.~ "~"~.,,,r''''.,....~. "On,
SCHEDULE H
~:,';~ FUNERAL EXPENSES,
C()MMONW'Al,.l 0' PlNN'Viw\NIA ADMINISTRATIVE COSTS AND
INHfflUANCf lAK MflURN MISCELLANEOUS EXPENSES I '
"!lOIN! OICfOlNl P .0" P,lnt 0' Typ.
Imn'6imc- -<'"" ".'-----...- - ".,. '_T_ 'T" - c"iiNUMIIIR m --==-"=
lIaITY K. Deibler i 21-97-0528
_~_._~___ ___~""---,____'__~__----""'_'_____'___' M~__'_____"'~___~__~~__~__';~_~h'_~_.......L-~..._.~_~ ___~_.__~_~___
ITIM
NUMBER DESCRIPTION AMOUNT
__"_._n___._. "__"_~""___"..________~...__~. __.__.H..'..._..._..____._~__,___..__~....__.____._ __....._,___._......
A. Fun.,al Exp.ns.s:
1. NeLlI Funeral 1I0me, Inc.
$6,535.00
8. , Admlnlst,atlv. Cost"
4.
C.
1.
2.
3.
4.
5.
6.
7.
8.
1.
Persan(J1 Rep,e,entatlve Comml..lon.
Social Secu,lty Number of Personal Represent(Jliv"
Yea, Comml..lon. paid
$
0.00
2,
Atto,ney Fee.
$1,300.00
3.
Family Exemption
Claimant ___ Relalion,hlp
Add.... of Claimant at d.cedent', death
Street Addre..
$
0.00
City --- State __ Zip Code
P,obate Fees $ 86,00
MIsc.llan.ous Exp.ns."
Capital Self Storage $ 96.16
~'hi.elemann I s AntJques (apprai.sal fee) $ . 50.00
CUllDerland Law JOUl:nal $ 60.00
The SentJ.nel - Not.;ice $ 71.00
TOTAL (Also enter on IIn. 9, Rec(Jpltulalion)
IIf mo,. spac. I. n..d.d, In..rt additional .h.... of .am. slz..l
S 8,19B.16
"
- ..
J-.I - c(1 - 5zi
,
,
lAHlLt SBTTLBJQ;NT AND FINAL ULBASI
BSTATB OF BARRY K. DBIBLBR
KNOW ALL MEN BY THESE PRESENTS, that Harry K. Deibler, late
of Camp Hill, Cumberland County, Pennsylvania, deceased, died
testate on June 11, 1997, having first made his Last Will and
Testament, which was duly executed on May 20, 1996 and probated
in the Office of the Register of Wills of Cumberland County, on
June 23, 1997.
WHEREAS, the said Harry K. Deibler, by the aforesaid Last
Will and Testament, named Pauline Galdino as Executrix of said
Last Will and Testament;
WHEREAS, Letters Testamentary on the Estate of the said
decedent were duly issued by the Register of Wills of Cumberland
County, Pennsylvania, to the said Executrix, hareinafter called
personal representative;
WHEREAS, the personal representative has gathered the assets
of the Estate of the said decedent and has gathered assets
consisting of personal with a total value of $19,016.15 as set
forth in Exhibit "A", which is a copy of the Pennsylvania
Inheritance Tax Return filed and approved by said personal
representative, and which is attached hereto and made a part
hereof, and marked Exhibit "A";
WHERF.AS, the debts and deductions, including the payment of
inheritance tax in the said Estate, which have now been paid
leave a balance for distribution of $17,187.23, also as set forth
in the statement of said personal representative, which is
attached hereto and marked Exhibit "B"l
.
,
WHEREAS, the balanoe for distribution as shown in the said
statement marked Exhibit "B" has been reduoed to oash and has
been distributed as herein indioated in aooordanoe with the terms
of the tast will and Testament of the said Deoedent;
NOW, 'l'HEREFORE, Kim Shive and Pauline Galdino being all of
the heirs under the Last wi.ll and Testament of the ss.i,d deoedent,
and being those persons entitled to inherit under' said Last Will
and Testament, do hereby each of us acknowledge that we have this
day had and received from the aforesaid personal representative,
in full satisfaotion and payment of all sums of money, legaoies,
bequests, and davises as are given, devised and bequeathed to
eaoh of us respeotively by the said Last Will and Testament, the
amounts due us under said Last Will and Testament, whioh amounts
we have reoeived this day or prior to this day; and, eaoh of us
do hereby stipulate that in order to avoid the expense and time
involved in the filing of a formal acoount and schedule of
distribution, we eaoh agree that no aooount i.s necessary and we
do hereby agree that we do oonsent to di.stribution being made
without the filing of an acoount and schedule of distribution,
the same to be with the same force and effeot as if they had been
filed pnd confirmed by the Orphans' Court Division of the Court
of Common pleas of Cumberland County, pennsylvania.
THEREFORE, we and each of us, do hereby remise, release,
quitclaim and forever disoharge the said personal representative,
Pauline Galdino, her heirs, executors, administrators and
assigns, of and from the said estate and from all aotions, suits,
payments, aocounts, reokonings, olaims, and demands whatsoever
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
'*
IUREAU Of INOIVIDUAI. TAMES
INtE'UTMtCE TAM DIYIIIOH
DEPl. 210611
KARAt'IUIU, PA 11121-0l01
NOTICE Of INHERITANCE TAK
AffRAI~EMENT, ALLOWANCE OR DISALLOWANCE
Of DEDUCTIONS AND ASSESSMENT Of TAM
.n.tlHU ." U'-'"
RON TURO
52 S BEDFORD ST
CARL ISLE
DATE
ESTATE OF
DATI OF DEATH
FILE NUMBER
COUNTY
ACN
11-24-97
DEIBLER
06-11-97
21 97-0528
CUMBERLANO
101
AItO""t R..I Hod
HARRV
K
PA 17015
[
MAKE CHECK PAVABLE AND REMIT PAVMENT TOI
REGISTER OF WILLS
CUM8ERLAND CO COURT HOUSE
CARLISLE, PA 17013
CUT ALONG THIS LINE .. RETAIN LOWER PORTION FOR YOUR RECORDS ~
Rlv: 1&4'1- ix "AFP" i 09':97"i "tiioTii:i--o; -INliiR" i f ANci" TAx" ~-piiiiAisiMitii:r: "ALLOWANci" OR no - -" - --" -" - - - --
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ISTATE OF DEIBLER HARRV K FILE NO. 21 97-0528 ACN 101 DATE 11-24-97
TAM RETURN WAS' I X I ACCEfTEO AS fILED
RiiiRVATION CONCERNING FUTURE INTEREST . SEE REVERSE
APPRAISED VALUE OF RETURN BASED ONI ORIGINAL RETURN
I. R..I Estot. ISeh.dulo Al
2. Stocko end Bond. I Schedul. II
S. Clo.ol~ Held Steck/fortn.r.hlp Int.r..t ISchodulo CI
_. IIort...../lIot.. AItO.hoblo I Soh_I. 01
I. C.ah/l.nk nepolltl/"llo. 'erlonal Pro~.rty (Sohedule f)
6. Jolntl~ OWned froport~ ISohedul. FI
1. Trenoforo ISohedul. 01
.. Totol ^..ot.
I CHANGED
NOTE: To Inlurl prope..
cr.cut to )lour .ccount,
.,obolt the UI'l>.r portion
of thtl for. with your
t... pev-.t,
11 I ,00
(21 .00
Ul ,00
1_1_ .00
UI_. Z7 .214 .51
161 .00
C1I .OQ..
III
27,214.31
APPROVED DEDUCTIONS AND EXEMPTIONS I
8,198.16
.. Fun.ral E)(p.n.../AdII, Coati/Hila. Exp.n... (Schedull H) (lU
10. Debto/llorte_ L1obUIU../LI.... ISchedul. II 1101 .00
11. Totol DeduoUon. 1111 II . 1 98 16
12. HotV.lu.of To. Roturn tl21 19,016.15
U. Ch.rltoblo/lo..rnso.nt.1 ,.que.hl Non-ol.ot.d 9115 Tru.h ISohodul. JI IUI .00
1_. Hot V.I... of lltot. Subject to lex tl_1 19 , 016 . ~
NOTEI I~.n a.....m.nt w.. i.su.d previou.1Y, line' 14, 1! .nd/or 1&, 17 and 11 will
r.~l.ot ~igur.. that inolud. the tot.l o~ ~ r.turn. .......d to dat..
ASSESSMENT OF TAXI
1&_ Aoount of Lln. 1_ ot Spouo.1 rot. 11&1
16. A_t of L1n. 1_ to.obl. ot L1n.oI/Clo.. A r.te 116l
11. A.aunt of Llno 1_ t..oblo ot tollot.r.I/CI..o I roto 1111
II. frlnolpol T.. Due
TAX CREDITS I
fAY"ENT
DATE
08-21-97
.00 K .00.
9,508.00 K .06.
9,508.'i5 K .15.
1111
.00
570,48
1,426.25
1 ,996.71
AECEIfT
NUM8E~
AA211665
DISCOUNT 1.'
INTEREST/fEN PAID I-I
99.84
1,896.88
AIIOUMT fAID
TOTAL TA~ CREDIT
BALANCE OF TAX DUE
INTEREST AND PEN.
TDTAL DUE
1,996.72
.01CR
.00
.OlCR
. IF fAID AfTER DATI IMOICATED, SEE RIVERSE
FOR CALCULATION Of ADDITIONAL INTE~EST.
IF TOTAL DUE IS LESS THAM tl, NO fAy"ENT IS REQUIRED.
If TOTAL DUE IS REfLICTED AS A 'CREDIT" ICRI, YOU "^Y II DUE
A REfUMD. SEE ~EVERSE SlOE Of THIS FORM FOR INSTRUCTIONS. I
RESERVATIONt E,t.,.. of OIQedlnt. dVlht on o~before Dlceaber 12, 19a2 -~ lf any future lnt.r..t ln the ..t.t. 1. tr~.f.rrtd
In po.....lan or 8RJOYMnt ta Cl... . (oolllt.r.U bentf1cl.r1.. of ttM d.cedwtt eft.r the .)tplr.Uon of Il"IV ..tat. fOf
11ft or for ye.r., t~ C~w..lth h.rebv .Kpr...lv r...rv.. the rlght to appr.'" and ...... tr.n.f.r Inhlrltanc. TIM"
at the l..ful Cl,.. I (collftt,ral) r.t. on any .uch future lnt.r..t.
PIJIllIOIEllI'
NOTICE I To fulfill the requlrlMnt. of Section 214tO of thl Inh1lritll"lCl' and E.tlt. TllC Act, Act 21 o' IMS. (72 P.I.
SIcIUon ,lito).
PAVI<<NTl DltltClh thl top porUon o' ,hit NoUce and .Ub.1t with your pa~lnt to the R.gltter of W11lt printed on thl rlyer.. ti..
...... check or IOR'Y or.,. Pllyllbl. to I REGISTER OF MILLS, AoENT
REFUND (tR)1 A r.'und of . t.lCllrtdlt, lifhlch w.. not r~.ted on the T'l( R.turn, ..y De ,.....ted bv cOllPl.U", .... "Appllc.Uon
for R.fund of Penn.vlvante Inhlrltanc. end E.tetl '-"'" (REY-UU), Appllc.tlon. .r. Iv.llebl. .t the Offlc.
of the RlIIIltter of Willi, ,n\l of thl 25 RIII~ Dhtr let OffICI', or by calli", thl .plcl.1 24t~hOOr
In.werlnt ..ryles nutbar. for for.. orderlngl In Penn'11vllnl1 1~600-J62.Z0S0, out.lde penn.vlvanta and
within locII H.rrl.burg .r.. (717~ 7a7~10'" TOOl (717) 17l~12~2 (Ht.ri~u J.,.lr.d OnlyJ.
OBJECTIONS I Anv plrty In Inter..t not ..Utflld ..1th thl .ppr8h..lnt, allowanc' or dh.llt....IWt<:l af dlducUon., or ......Mnt
of talC (includlng dllcount or Inter..U II .hown on ttlll NoUe. wu.t obj.ct ..Uhl" .bh (60) day. of rlCllpt of
tnl. MoUcI bVI
..wrltten prota.t to the PA Dlp.rt.."t of Rall_"UI, Board of App.al., D.pt. 211021, Harrl.burg, PA 17121-1021, OR
--.lICUon to ha". tha ..tter dlt."lI* .t audit of thl account of tha plrson.l r.p,....ntatlll., OR
..."... to tha Orphan.' Court.
ADMIN
l~TPATlY!:
CORRECTIONSI
Faotu.1 Irror. dl.oo~.rad on thl. ......-.ot .hoUld be .ddr....d In writing tOI PA Dapert-.nt of R'~.nut,
lur." of Indl~ldu.l T.lCII, ATTNI po.t A.....HOt R.vll" Unit, u.pt. 210601, Herrhbur'g, PA 17121.0'01
Phone (717) 717-6505. s.a P'" 5 of the bookl.t "In.tructlon. for InhlrltlnCl Tal( Return for. Re.ldent
o.cldant" (REY-IS01) for an .lCp1.natlon of IdIlnl.tr.tlvlty correctabl. .rror..
DXseOlMlI
If any t.1C due It p.ld within thr.. U) el1endar IOf'lth. Ift.r the decadent" d41.th, . flvI percent C5X) dlMN't of
thl talC paid It IUowd.
PENAL TVI
ThI lS~ tlM .."..tv non-p.rtlclpatlon pI".ltv I. coaput.d on the total of the talC end Int.rl.t ......ed, and not
pald bafore January 11, 1996, thl flrlt d.y .fter thl and of the t.M INlMllty period. Thh non-particlp.tlon
penaltv I. IIPpelllbl. In the .... .anner ~ In the thl .... U.. period II you Nould app..1 the tal( ..w lntar..t
that he. bien ......Id .. Indlcatld on thl. notlr...
INTEREST I
Int.r..t 1_ ch.rgad bllllnnlng with flr.t dav of dellnquancy, or "In. (,) .onth. and one (1) day frol the date of
dlath, to the data of pay.."t. T'MU which baca.. dellnql...nt bafor. JMtuary 11 1912 blar Intlr..t .t thl rlt. of
.IM (':0 "rtllnt ,.r ennui calculat.d at a dally r.tl of .00016_. All tl!ll(1t which bIG.. dlllnquent on end aftar
JIII'IU.ry 1, 1912..111 b..r Int.r..t .t . rat. whlch will ".ry frnll uland.,. y..r to cal""r y..r wUh that rat.
.nnounced bV the PA Dep.rtaant of Rlvanu.. Thl .ppllc.bl' Intlra.t rnt.. for 19.2 through 1997 .r'l
'!!!! tnt.ralt Rat. D"ll>l Intlr..t factor :!!!! Interl.t R.t. Oelly tnt.rut f'lICtor
1912 ZGX ,00054. 1911 .~ ,')QOZ~7
19n 16;( .00043. 1981-1991 11;( ,000501
19" III . ~oOJDl I"? ,~ 0001~7
1915 15X .0001S6 \,1'J!'19'4 n .QCol92
1916 10;( .OflD27~ 19951.1'''7 .. .oOOZ~7
-~Inter..t It Clleuhhd " '0110...1
INTERElT . BALANCE OF TAX UNPAID X NUNBER OF DAYS DELINQUENT X .DAILY INTEREST FACTOR
.-Any Hotlce IlIued eft.r the taK bleo... .lInquMt will reU.ct In Int.,...t C.lClll.tlon to flft.." OS) d,y.
blyDnd the dlt. of thl ......IInt. If pav.ant I. .ftdl aft.r the Int.te.t cOlpUt.tlon d.t. shown on thl
Notlc., Iddlt1on.l Int.r..t lIlJ.t tt. calcul.tld.
R!Y-I'OO IK+ 11-9'1 J
'*'
COMMD~~.m~\Wr oJ, '/ry~~'Jr .NI.
01" lI060\
HAIUIISDU"O, ,,, 11 'l1-0601
meN"S HAM. (lAST. fill". AND Ml[.oOlf INITIAlI
Deibler, Harry K.
SOCIAl SlCUIUTY NUM'U Fa1 DEATH [lMlroTiilllH-
178-16-4039 l~1/97 I 6/11/22
'" ~:~::UII"oy':.a ..oo",i"':~" "." "o"""';""';;;-J 'oc':' !feu"" NUM'"
IXJ I. O,lgln.1 R.lurn [J 2. Suppl....nl.1 R.lurn
[] A. Umll.d e.lal. [] 40, Future Inl.r.., Comproml..
Ifo, do'.. of dsolh .h., 12,12,821
[K) 6, Ol('ed"nl DI,d T,ttoll 0 7. Decedent Maintained a Uv1f19 Trull
IAlloch c.py of WillI IAttach copy of T,ulll
.A~LCOllnPONDINCI AND CONFIDINnAL TAX INPOIMAnON SHOULD'1I1 DIIICTlD TOt
NAMf . COM'UTE MAIliNG ADOIlUS
20, If Lin. 19 I. gro..., ,han Lin. 18. .n.., 'h. dlll.ron" an lint 20, Thil is Ih. OVIR'A YMENT.
110
21. If line 181. great.r than lInt 19, enler ,h. dIH.r.nce on Lint 21. Thl.II Ih, TAX DUE,
A, fnll' thl In,.,..! on ,h. balanc. due on Un. 21 A,
B. En..r ,h. 10101 ollln. 21 .nd 21 A on Lin. 21 B. Thi.l. ,h. BALANCI DUE.
Make Chick Pa.yall., tOt ..,l,'e, of Will., A,.nt
~ ~ liE SURE TO ANSWER ALL QllESTIONS ON REVII5I SIDE AND TO RICHICK -MATH ~..
Und.r Plnchl.. of perjury. , d,dorl lhot I hnv. 8I(olYlined Ihll return, including accompanying Ich,dul" and Ilo'em.nU, and 10 lh, b.,1 of my knowledge and b,li,f,
iI i. Iru., correct and comple'l. I dedar. that all real .,Iale hat been r.ported allrUfl mark.t value. Oeclaration 01 pi'par.r olh.r Ihon lh. plnonal rtpr...nlati..... is
baled on alllnformalion of which prepare' hOl any knowledge.
110 U.. Of ""ON .mo "10' ""NO mU'N ;.;; ,b;/~..Lo;.J//..d a=t.____,_4 )/.d~. :: '?',_!.. __
3~OR~_R<._c1J!~_p ,~__ c;Q~I.,-Jf!f---- "~"_j~
I '70{ 3
l!!
ii!
il
..
/ .\ ,;, / I
INHERITANCE TAX RETURN
RESIDENT DECEDENT
(TO BE FILED IN DUPLICATE
WITH REGISTER OF WILLS)
I/}
/
.01 DATIl O' DIATH Ann 12/31191 CHICK HIRI
lP A S'OUIAL .
'0\111" CRlDIT II (LA1MID [J
'fill NUMIII
97
YEAR
0528
NUMBER
i
!!l
21
COUNTY COOE
Oft 0 N "! COM'lfTe ,A,bORfU
10 House Avenue
Can-p lUll, PA 17011
Co", Cwrber land
AMOUNf IIfC!I'I~O ($!! INS1J1UCllnNSj
[J 3.
05
.Q.a
Remaind.r R.lurn
(lor dat.s of d.ath prior 1012.13.821
Fed.ral eltat. TaJl; R.lUrn Required
T 0101 Numb.r of Sal. Dl!tpolit Boxes
RonTuro
TIl"1f'7' NUMIU 245-96BB
32 SOUtli Bedford Street
Carlisle, PA 17013
:0:
S
!
II) 0.00
121 0.00
131 0.00
14}. 0.00
151 ~,214~.2L._
0.00
I. R.al E...to (Sch.dul. AI
2, Slock. .nd Bond. ISch.dul. BI
3, Clo..ly H.ld S'ockIP.rtn."hlp In....lI ISch.dul. q
.t. Mortgages and Notes Rectlvobl. ISd,.dul. 01
5, Cash, Bank D.pos!tI & Mlle.llaneouI P.nonal Property
ISch.dul. EI
6, Joln.ly Own.d Prop.rty ISch.dul. FI
7, Tr.nsfer. ISch.dul. QIISch.dul. LI
8. Total Grall AII.hltolalllMs 1.71
9. Fun.ral Exp.ns.s, Admlnistratlv. COI", Mhc.lloneoul
Expon... ISch.dul. HI
10, D.bll. Mortg.g. lIobillll... lI.n. ISch.duls II
11. T 0101 O.ductlon. (10..1 lIn.. 9 & 101
12, N., V.lu. of ElIoto IlIn. 8 mlnu.lIn. III
13. Charitable and Governm.ntal Bequllh (Sch.dule J)
14. N.. Volu. Subj.ct 10 To'llln. 12 mlnu. Line 131
15. Spou.ol Tronlf'''lfo, dol.. of d.olh oher 6,30,941
S.. Inllrutilons for Ar,pllcabl. Pereentag. on Rev.n.
Side. llndude valulI rom Schedule K or Schedule M.l
16. Amount nf line 1A toxobl. at 6% raft
llnclude value. from Schedule K or Sch.dule M.}
17. Amount of Line 1.4 10 Kable 01 15% rate
(Includ. val~1I from Sck.dul. K or Sch.dule M.l
18, Prlnclp.I,.. du'IAddla.lrom Lln.. 15. 16 .nd 17.)
19. Credill Spousal Poverty Credll Prior Paym.nll
+ .-----..
16}
17l -
0.00
27,2l4.31.
( 81
191
0.00
110) --
B,19B.1.6
1.9,01.6.1.5
0.00
1.9,01.6.1.5
1111
1121
113)
1141
115) 0.00 x._=
1161__ 9,50B.~~__x ,06 =
9,50B.15
117) , __._____X .15 =
0.00
570 . 4B
1.,426.23
:0:
Ii
i
Q
U
S
1181
1,996.71
Dllcount
+_~.B3 __ _
Int.rlll
99.B3
1191
1201
(llllk ht,!l' II you till' fl'qIH'\llnq II 1("lund 01 y(l\JI (lvt'lpnyrn\ 111
I.,B96.BB
---------0-.-00
.____LB96...8B______
1211
121AI
121BI
.
,
'-,"
l- -t':' 'f
~
'+n .,
(. r-~J
Il
~
d
L;;?
'~r;:
,
, , ,L' f~ ~
(i) l-L p, Q)
LC 13 (,)
" ,
"IIV,!Si1ll1t,(".11
~~
1 SCHIDULI H ~
FUNERAL EXPENSES,
ADMINISTRATIVE COSTS AND
MISCELLANEOUS EXPENSES I Pl.a.. Print o!"!yp.
FILE NuM.IR
21-97-0528
COMMONWIALTH O. fllNNSVLVANIA
INHIKlTANCI TAl mUKN
KIIIDINT DICIDINT _~
(STAT. OF
Harry K. Deibler
ITIM
NUMIIR
A.
1.
DESCRIPTION
AMOUNT
Pun.rallxp.nH'1
Neill Funeral Home, Inc.
$6,535.00
B. , Admlnl.tratlv. Cast..
1.
2.
4.
e:.
1.
2.
3.
4.
5.
6.
7.
8.
$
0.00
Persanal R.p....ntatlve CammllSlanl
Social S.cu,lty Numb.r af Personal Rep'...nfQtl....,
Y.ar CommllSlonl paid
Attorney Fe.s
$1,300.00
3.
Family Ex.mptlon
Claimant
Add.... of Claimant at d.cedenl'. death
0.00
$
R.latlonshlp
Slr..t Add,elS
City Slat. Zip Cod.
P,obat. F..s $ a~.oo
MI.c.llan.au. Exp.ns...
Capital Selt Storage $ 96116
Thielemann's Antiques (appraisal fee) $ 5.0.00
Cuniler land Law Journal '$ 60.00
The Sentinel - Notice $ 71.00
TOTAL (AI,o ent.r on IIn. 9, Recapitulation)
, (If ma.. spac. I. n.ed.d, In..rt additional sh..t. of sam. sla..)
S B,19B.16
.
..
Jut ~ue anil
,.
(~1\lnf
-
HARRY K. DEIBLER
r. Harry K. Deibler of Camp HIlI. Cumberland County, pennsylvanla. beUIg of sound and
dIIpoIIng mind, memory and understanding, do make. publlal1 and declare thla to be my Last WIll and
Testament, l1ereby revoking and ,"Airing void all prevloilS Willa and Codicils heretofore made by me.
mST
1 order and direct my personal representative hereinafter named to pay all of my jUlt debts,
t\Jneral expenaes and expelllles Involved or connected with tile adminlatrallon of my estate fIB soon after
my deatl1 as is reasonably possible. However. my penonal representative need not accelereta and pay
t11088 unmatured ob\igatiollll wllich. In 11la, her or ita opinion. it might be proper and more advantageous
to retain or renew and pay as tl1ey become due and payable. Ifl do not own a burial plot or a grave
marker at tile time of my deatn. I autl10rize my personal representative, In hia, l1er. or ita sole discretion.
to purcI1aae a burial plot and to erect a suitable marker at my grave, and to expend llUIlIlI from my estate ,
for this purpose.
SECOND
I llive. devise, and bequeatl1 my entire estate togetller witl1 aU Inllurence proceeda tIlereon of
wbate\ler' nature and wbel'e8lMlVer situate to my daug\lter, KIm Shive, of Mec.banlcIburlI, Cumberland
County, PelllllYlVIIIIia and Pauline Galdlno. my dear friend, In equal shares, share and share oIike. per
stIrpee, providing that they survive me by sixty (60) daya.
%';f j( p<!d;kA./
15-:-/P6.//
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
RON TURD
32 S BEDFORD ST
CARL ISLE
DATI
ISTAY! OF
DATI OF DEATH
FILE NUMBER
COUNTY
ACN
11-24-97
DEIBLER
06-11-97
21 97-0528
CUMBERLAND
101
AlIOunt Rul U.d
c~
~
UV.tIOlkmm,"1
HARRY
I
MAKE CHECK PAYABLE AND REMIT PAYMENT TOI
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
CUT ALONG THIS LINE ... RETAIN LOWER PORTION FOR YOUR RECQRDS ..
RIIi: iiiit'lriX"AFP--niF9'7Y"NOYicr-OF -iiiiiiiiiT ANCE -YA'x-ifPPRA'isEiiEN'r;- ALi"owANci-iilim..- _.._m ----
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ISTATI OF DEIBLER HARRY K FILE NO. 21 97-0528 ACN 101 DATI 11-24-97
IURIAU OF INDIVIOUAL TAMil
UHRlIAIlCE IU DIVISION
DlPf. "0601
HAARIIIURU, PA 1ll'I-O'OI
NOTICE OF INNERITANCE TAM
A~~RAISENENT, ALLOWANCE OR DISALLOWANCE
OF DEDUCTIONS AND ASSESSNENT OF TAM
PA 17013
E
TAX RETURN WAS I 1 X) ACCE~TED AS FlLEO () CHANOED
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ONI ORIGINAL RETURN
I. R..I E.t.t. (Sc~dul. A)
2. Stock. and Bond. (Scn-dul. BI
S. Clo..ly ~Id Stock/~.rtn.r.hlp Int.r..t (Soh.dul. CI
4. Nort...../Nct.. R.o.I..oI. (Sch.dul. D)
I. C.Ih/Bonk D.,a.it./NI.o. ~.r.en.1 ~rap.rty (Soh.dul. EI
6. Jointly awn.d ~rap.rty (Soh.dul. FI
1. Trenlfarl (Schedul. Q)
B. Tot.1 A...t.
U)
(21
U)
(41
IS)
(6)
(7)
,00
.00
.00
.00
27i214.31
.00
.00
(8}
If .n ........nt w.. i..u.d pr.viou.ly, lin.. 14, 15 .n~/or 1&, 17 .nd 11 will
r.fl.ct figur.. th.t includ. the tot.l of ~ r.turn. .......d to d.t..
AIIEIIMENT OF TAXI
II. AlIOunt of Lln. 14 .t Spou..1 r.t. (II)
16. AlIOunt af Lln. 14 t...bl. .t Lln..I/CI... A r.t. (16)
17. AlIOunt of Lln. 14 t...bl. .t Coll.t.r.I/CI... B r.t. 117)
lB. ~rinclp.1 T.. au.
TAX CREDIT8l
~AVNENT
DATE
08-21-97
APPROVED DEDUCTIONI AND EXEMPTIONSl
.. Funerel Expen..,/AdM, Coats/Hilo. Expan,.. (Sohedull HJ
10. D.bt./Ncrt.... LllOlllti../LI.n. (Sch.dul. II
11. Totd C._Hen.
12. Net V.lu. af T.. R.turn
IS. Ch.rltlOl./Go..rn-ont.1 1~.t'J Non-.I.ot.d 911S Tru.t. (Sch.dul. J)
14. Not V.lu. of E.t.t. Subjoot to T..
(9)
UOI
8,198. 16
.00
NOTlI
.00
9,508.00
9 ,508.15
RECEl~T
NUNBER
AA211663
DISCOUNT (.)
INTEREST/~EN ~AID (-I
99.84
ANDUNT ~AID
TOTAL TAX CRlDn
BALANCE OF TAX DUE
INTEREST AND PEN.
TOTAL DUE
1,896.88
M .00_
M .06_
M .15.
UB)
NOTE I To insure proper
credit to ~ou,' lMIoount,
.ubnlt tho upp.r portion
af thi. for. with your
to. p.y-.t.
2'1 ,214.31
eu)
(121
US)
(14)
. A .10A 11.
19,016.15
.00
19,016.15
K
. lF ~AID AFTER DATE lHDICATEO, SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
IF TOTAL DUE IS LESS THAN .1, NO ~AVNENT IS REDUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CRI, VOU NAV IE DUE
A REFUND. SEE REVERSE SIDE OF THIn FORN FOR INSTRUCTI~.I
.00
570.48
1,426.23
1 ,996.71
1,996.72
.0ICR
.00
.0ICR
RESERVATIONI E.t.t.. of d4~.dent. dvl"l on or blforl Pta.lbtr 12, l'Ar ~~ If .nv future Int.r..t In thl I.t.t. I. tr~.f.rrtd
In po.....,on ar tnjov-.ntto C1... a_(col1.t~r.l) benlflcl,rl.. af the d.cldlnt .ft.r thl .~plr.tlon of InV ..t.,. fftr
Ilf. or for VI.r., thl Co.-onwtllth her.bv IMPr...ly rl"rv.. the right to IPpr.I.. end ...... tranlf'r Inherltenol T.~"
It the I...ful CI... . (coU.tlrIU r.t. on MV .uch future Intlr..t.
_01'
NOTtCE1 To fulfill the r.qulre..nt. of S.ctlon llftO cf tM InMrttlf'lC1 ,1M E.t,t, TIle Act, Ac' 21 of 1995, (12 P,S,
SICtlon flU).
PAVHENTl Detach thtl top portion of thh Notice and .ubtH with your ~'Y'lflt to thl Alllhtlr of Will' prlntld on the rlVlr.. .Idtt.
..."_. check or llOf'l.y order p.vllbh tOI REGISTER OF MILLS I AGENT
.,,*1:1 (eA)! A r.fund of . taM credit, whleh wn not r.qullted on thl 1Ix n.turn, ..v b. r.qu..tect by cOllPIIUne In "Applle.Hon
for Rlfund of Penn.ylv.,l. InhtritlM\O' end E.t.t. '!Ill" (REV4UU). Applle.tlon.'''' .vall.bl. at thl Offlal
of the Aelll.t.r of Will., env of the 21 R.venue DI.trlat afflc.., or by e.111nl the .p.cl.1 Zft-hour
",.werlne ""VICII ~.r' for for..orcMrlnel In Plnn.y1vlnla 1-800-562-2050, outtld. P.nn.y!v..,t. Il'Id
within Incll Herrl.bUrg .r.. (117) 7'74109., TOOt (717) 712-2252 (H..rlnll l.,.lrtd Only).
OIJECTlONS, Anv p.rty In Int.r..' not .,thfled wtth the DPprehl..nt, allowanc. or dl..llowenc' of dtutuctlon., or ......""t
of t'll (Including dl.count or Int.rl.t) .. .ho~n en thl. Notlcl lO.t objlct .lthln .I~ty (60) d'~' of r.calpt of
thh HotlCI bYI
--wrlttln prot..t to tha PA Oepart.lnt 0' R.vlnu" laard of App.ah, nip\. Z110zt, H.rrltbUrCh PA 17126-1021, OR
--.I.ctlon to hlva tha ..ttlr dlt.,..,lnad .t audit of the .(lcount of the Plrnn.1 rlpr...nt.UVI, OR
--apPI.I to the Orphan.' Court,
ADMIN
ISIAmVE
CORRECftONlI
F*CtuII error. dl.cov.red on thl. ........nt .hould be tddr...ad In .rltlnl tOI PA O.part.-nt of A.venut,
lur..... of tndlvldull lall..,ATlNI po.t A......ant R.vlaw Unit, DlPt, 280601, H.rrl.burg, PA 111ll-0601
"*'" (117) 787.6S05. S.. p... 5 of the booklet "In.tructlon. for lnherltanc, 1'111 R.turn for. Rllle"nt
Dlcacllnt" (REY-ISO!) for In IllplanaUon of IdIllnlstrllUvah corrlotebl. .rror..
DaCOUNf I
If any tal( duI Is PI'd .lthln thr.. U) c.lltnrl.,. aont". .ft.r the dtclnnt'. de.th, e flv. pare."t (SX) discount of
tha tall plld I. .lloMld,
PENAlTVI
TM U:.: tall .."..ty non-ptrUclpaUon p.ntlty h cOIIP'Ut.d on the tot.1 of thtl t'll and Intlrnt .....sed, and not
plld blfore JInUIl"y 11, 1996, the flr.t del' after the end of the tax ..,..ty p.dod. fhlt non-p.rtlelp.tlon
panaltV II lIPPIallbl. In the .... allMlr end In the the ... tI.. period n you MOl.tld IIPPIIl thl till and Int.,.lIt
th.t ha. been ......Id a. Indlc.t.d on thl. notlel,
INTEREST,
Intarnt It char lid big Inning with first day of dIUnquIMY, or nln. (9) .onth. and on. (I) d.y fro' the dati of
death, to thl d.t. of p.y.ent, l.~.. which ble",ulllnquant blfor. Janu.ry 1, 19.2 bear Intlr..t at thl r.ta of
1111 (6X) percent per annua ulculatad at a d.lly rata of .000164. All t.ll.. whlah bec... delinquent on end .ftar
J.nulrv 1, 1'12 wall blar lntera.t .t . rat. which will vary fro. cellndar y..r to cal~ar VI.r .1th that r.t.
ennounced by the PA Dlpart..nt of R'VI~I. 1h. .ppllcabl. Int.rl.t r.ti. for 191% through 1"7 .rll
U!! !nitr..t ~.te Dallv Intlr..t flctor !!!r Inter..t Rat. Oallv Int.r..t hotor
1982 ~O~ ,OOOSU I'll 'X .00D2ft7
1985 lOX .OOOUI 1918-1991 11:( ,000101
1'" llX ,000101 1992 9Yo ,000247
UCS lSX .DOnS6 1"1~1994 ]X ,000192
19.. lOX ,000214 l'I)S.1991 'X .00O%~7
ulnt.rnt l. oelaulat.d.. follow'l
lKTEREBT . BALANCE OF TAM UM~AID M NUMBER OF DAYS DELIMQUENT M DAILY IMTEREST FACTOR
44AnV Hotle. I..ued Ift.r thl tall ~OII' d.llnquant will r.flect an lntere.t clloulltlon to flftfln (15) dlvi
b.yond thl data of the ......-.ot, If p.~.."t 1. .,de aft.r thl lnt.ra.t cotpUt.tlon date .hown on thl
MotlO', tddltlonal Internt lNtt b. calculated.