HomeMy WebLinkAbout97-00658
IJE'I'I'l'lON lion I'IUlnATE IIl1d GltANT (W IMl"nmS
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OATH OIIIJEHSONALltEPlmSENTJ\TIVE
COMMONW~AL1'1A~'IIENNS\'LVANIA '}' I:lll
COUN'I'\' OJt' _Wl~ 'ry(,(..J;3A([) -
The I1Ulhl\l!lOI\t.)IIIl(lV~~I1I,'l1Ic<l Iw.JIlr(s) ur III'f1rl11(N) lhlll Ihe NllllOl\\unlsln the foregolnll petltlonl\fO
Iruo 1I11\l.o)llrrOUlln Ilw hUM 1'1' Ihe Knowludge IInd hullur'of pu\illllnur(s) IInll Ihnllls llorsonulrOllresouo
1Il1Ivu(N) ul' Ihu III111ye ducudl'lu putill\1I10rll) 11'11\ wollllnll truly nlll\\lnlster tho uslnlo 110 'orllll\g to law,
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'4.
A, ShoUld my llIa~d son predeoease me and be survived bY
any dhilc;\'t'eni t.hfm hiI;'! sha't'e s\,\all c;Jc t.ohill ohild't'en -
~. Should my said llIon "predeoeaae me and not. \:Ie llIurvhBd \:Iy
any ohildren, t.hen his liIhare shall c;lo t.o The sa3,vat.ion Army I
our't'ent.lylooat.ed at 1122 Green street, P,Q, Bol( 2205,
!' Ha't''t'1J1bu't'Cil, pennsy;vania 171011.
B. Should one of my named c;lrandohildren have
pred80eUI;'ld me and have been aurvived by. a brdtlwr or aist.er aI3
t.heou$ may \:le, t.hen suo'll deoeased C;Jrandoh1ld'a Sha't'e sha3.l C;Jo
" ,." . '
t.o suo'll sui'viviM brot.ha't' or Elister afil t.he oase'may be. ShOuld
bot.h of my named c;lrandohildren have predeoeasedme, then t.heir
sha't'es shall go to their natural father, Denton B. Burd, Jr.
Should he alSo' have predeceased me, t.hen auoh sha't'es shall go to
The Sa3:va~icl)'l Army,our't'ent1Y looated at 1122 Green street., p,o,
BO)( 2206, Har't'isburCil, pennsy3:vllnia 17106,
6,
,ShOUld eit.her or' both of my name4 grllndohildren be lesa than
t.he, aC;Jeof t.went.y-five (25) yeara at t.M time oj! Woy deat.h,' t.hen
t.he respeot.ive residuarY shares of any g't'andohild leSS than t.he
age of t.went.y:'five(25)YSarlillilhall \:le plaoed in trust, my said
son Denton B. Burd, Jr. t.o be trustee, or ahould he be unable' '6r
unwillingt.O serve for any reason or oauS,e what.soever" then OONB
BA~~ NA t.o be ,t.he alt.ernate or Eluooessor trustee, for the
fO;lowin9 purposesl
A. The inoome from said Trust ,~stat.e, as well as
so'muoh of the,prinoipal as is reeded adoording t.o't.he
diso't'etion of t.he Tl;'uatee, shall be ,used 'a,nd expended
fo't' the support and maintenanoe, indludinc:l medioal,
surgioal and hospital oare, and oollege eduoation, or
other suo'll fo't'maleduoation., suo'll as anY internship,
"
apprent.ioeshiP, residenoe, 'oler~ship, or the li~e'/ of
said g't'andohild. The deoision of my Truat.se as to the
oomplet.ion of formal eduoation by my said c;lrandohild
" shall!befinal.
,i
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(B) ~h. amount ,to be paid for ~he benefitot my
said qrandO~ild .hall be determined from time to
tims by the need of the sdd 9randohild, ,and the
amounts and times of said ,payments shall be determined
bysuoh need. The said ,payments may be made by my said
Tru.tes dinotly, to the sda ",randohlld, or it, in the
sole' opinion of my Trustee, said qrandohi1d i. of 'Uoh
, aqe and ability to handl. properly the func;!,e they may be
, '
paid direotlyto'suoh qrandohild, or may be made by ,my eaid
,
Trustee direot1y to the person havinq the oustody and care
of the said qrandohild, or may be made by my said Trustee
direotly to any institution entitled to suoh pllyroent by
il' ,.
reason of servioes rendered or to be rendered to the said'
qrandohild,
(0)' To PaY the aoouml.\leIted, inoome and prinoipal
theli r,e\1laining in its ,hands to th.'sa!d qrandohild, when
the 9randOhild shall have attained the age of twenty-five
(26) YlllarS.
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(D) I direot that the interests Of all benefioiaries
in the '1'rust henby oreated, whethet' in the prinoipal or
inQome thereof, shall be free from liability to attaohment
br other leqdpt'ooess issued at the instanoe of any
oreditor or assignee of suoh benefioiary, and I direot
t~at no payment shall be l1Ia~e by way of antioipation of
,sums 'whioh may thereafter aocrue to, I:\ny, benetioiary,
(E) If the Trustee has taken into the Trust Estate
any real estate, and as Trustee oonsiders .1't fElI~sib~e
to, sell the same, I hereby authorize, empower and dire6't
the said Trustee to sell at pUblio or p~ivate sale or
sales, and to oonvey any suoh real estate to the pl.\r~
ohaser or. Puroha~.ers thereof, and ,to qJve qood and
sUffioient deed or del:lds for the same.
(F) ~n the event that my s'aid grandohild should
survive me, but should die durinq the term of this trust,
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then his share shall be distributed accordinq to the
instructions in paraqraph 4(b) above if he was a minor, less
than the age of eighteen (18), at the time of his death.,
,
Should $uch9randchild have attained the age of eight.en
(18) before the time of his death/ then his ahara ahall, be
controlled by his last will and testament, Shou],d he not
have executed a lut wil,l and testament, then his share,
.hall be cOl'ltrolled'by the intestate laws, of pClOnsylvania.
Should he leave no surviving heirs within the necessary
degree of ccnsanquinity, t6 take under the intestate laws,
then this share shall gq to the salvation Ar.my, aforesaid,
I'
6.
I nominate" c,onstitute and appoint my son,' Denton a, aurd,
,
Jr, as Executor of my Estate. In the event that he is unable or
unwilling'to serve in such capaoity, I appoint the CCNB BANR NA
to be the Executor in his place and stead, I direot ~hat they
shall not be required to file a bond to secure the faithful
performance of their duties in any jurisdiction.
"
7.
I authorize and empower my personal representative, in his
sole and, absolute discretion, to purchase or otherwise ,acquire
/, ,
'and retain any investments of which I die seized, or any real or
,personal property o,f any nature, tc sllll, leMe, pledqe,
mortqage, 'transfer, exohange, dispose of, or grant opticns in
,regard to any or all property of any kind forming a part of my
Estate, for such terms and such prices as he may deem advisable,
to borrow money for any purposes oonnected with the protection
and preservation of my Estate, to mortgage or pledge any real or
personal property forming a part, of my Estate, or to join in or
secure the partition of same, to compromise any olaims or demands
, of my Estate against others or of others against my Estate, to
make distribution in kind and to cause any share to be composed
of cash, property Ot' undivided fractional shares, in property
difterent in kin4 firom any other share, and to exeoute and
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PA Rl!V-1llOO EX (1-11)
80 . I e Add""1
STReeT ADDIIESS
226 th 16th street
Page a
OITV
STATE ZIP
JilA 170
(1) 109,054,14
1,
a,
108,142,51
5,452.71
a,
IntlrOlllPenilty II IlPplloalllo
P,lnt.-
8, Penalty
Total Credlte (A + In 0) (al 113, 595.22
, TotallnterOltlPenalty (D + II) (0)
4, If Hne, a II gr'.ler Ihan line 1 + line a,lInter tho difference, Thle Ie the OVlRPAYMeNT,
' ~ box on P8ll' 1 Une 1t 10 1tqIl'" a fe1u"d (4)
D, If line 1 + line a II greater than line ~, ontlr the dlfferonoo, Thle la the TAl( PUll, (II)
A, linter tilt Inl'- on the tile due, (eA)
8, 'Intlr the totel oll;lne 5 + eA, Thlllt the lIALANOIl cue. .-. . (58) .
Mal<o Chool( payablt tOI R8QIlITJR OP WILLI MlINT
-", . "",l\'JWilI~~lll1!llil~iliJIJl"llll''-M<W__,' '~~"",,*m,'Ml'i"'t'mlff~Ift'Wii!iiflt<\tl),.1r.il'g"1l'l{4i'1lli'l;'\l:(f@~1tt7f,jlll>\'Wlnijf:l~fU~Wil};Mml"in~r.w.""'l<!!(jlNS~I~i\\!Yln
~'!ili~fmm,'fII>i"'"f,")"",,,,,'1f:\1"'Ii\li\"~l!'!I,;A~lirtNiiwiR~i!f~~"~olfa~fr&"Q5iA~'O~if8ijx'",""'''',.".w~.'I"x,.li~<r.t~''>l\ll'1t.,\",,,,,,,
BY PLAOING AN "X" IN THE APPROPRIATE BLOOKS
1, Old deoedln' make a l1analar and I
a, ret"n,the u~ or Income of the property "'an*ferrtdl,',;, , t I ., t I ,. I I I I ". . , , ; ..." , I ',' i'i,., '"
II, rataln the r1ght to deelg~ate who ehell U88lht proparty l1anaf8ITod or Ite lnoomol, , , , , , , , , , , , , , , , , ,
0, r.taln a rtvtf'ltonllY lntereetlor, . ,'" II , , , I j , It' I. ; ,', I , '1,1, , I I 1'" , , , , ,', . f j , , ..., , I III'
d.reoetvtthepromt.eforl"eofeltherptlyment8. bun_ora"'?I, I j, ~". I, j I. I"., "1"'" 1111.
a, It dlath ooourrod on O( before Ptoombar 1a, 18llll, did d80ldlnt Within two vam
prflOldlng,do,th l1analerproptr\y Wlthou\r8Ollvlng adoquate oone!dlratlon71f dlath oocurrod
ah.,. O8OImbttr 1a, 1882, did dooadenl l1analer propertY Within one year of death WIthout
r.vl"g ldequate oontfd.ltfon? I , 1,1 , I I . I f I , , , . ! ! I , I I I I I t I . I , , I , , , , , , "', f . . . I , , . , , , , , II , I ,
0, Old d80ldent own an 'In llUetlor" or payable upon doath blnk aooount or _urtlY
.t hi,' or h.r d..th7 I I I,' , ".' I , I I I I . , , , , , , , , , , I " , , I I . , I , I ,'. I I I . I I , I , , , , , , , , f , I . I . , , . I , , .
0.00
4,541.08
! i
"
4, Old d800dont OWn an Indlvlduel rellromont aooount, annuity, or othor non~prqbatoproperty?, . , , , , , , , , , ,
o #
~ ~
IP THI ANSWER 'TO ANY OP THE ABOVE QUeSTIONS IS ,YES,
YOU MUST OOMPLBTE SOHEDULE G AND PILI IT AS PART OflTHE RBTURN
?2 P,S, 18118 (.) (1.1) (I) prqvldod lo( the roduotlOn 01 the tile (ate Imposad on lha not vllluo of tranelera to or for tho U88 01 the eurvlVlng epou88lrom 8% to
G% tor datoe of doath on or aller JUI,v 1,1884 a,nd beloro Janu8l)l1, 1885, , , '
72 P,S, 18118 te) (1,1) (II) plovldod lorlhe reduotlOn olthe ralo ImPolOd,on the net Yaluo 01 tranafora to orlOrlh, UIO 01 the eurvlvlnilspoU88 from q% to 0%
lor datOl 01 death on or,aher JanU8l)l1, 1885, Tilt atalute d08llnot oxol1l/l1 a tranalor 10 a eurvlvlng apou88lrom tile, and the atatutory requlromenta for
dllololure 01 ...oto and IIIIn9 ,a tile roturn Xl'0 atlll appllO'lIle ovon If tho eurvlvlng epoulo la tho onlV benoflolary,
FOil DATeS OF PIlATH OHaR AFTlII\ JANUARV 1, 18t1--Ploa88 answer tho follOWing qUOltJon by placing an 'x" In the epproprteta 811_.
Old IItI doootdtnl crllla e ~al or .Imllar Imlllll'm.nl whloh II lolely lor lito autvlvlnlllpOUH'1 benaftllor hie or her InUra IIIttIme7
Vae 0 Ho:f9c
If you answorod yoe to tho aliovoquoetJon,11lt tile on tho truet olelmllXl' 81rangomont II poetpOhed unul tnodlalh of tho 8800nd apou88, at WhlOh time If Will
be lully tlleablo a' tho ralo(l) epplloablo to tha romelndor, bonoflolary(loe), Enter tho Yelue 01 t~. truet on llclhedule J, PIIt 1I,I,n o,rdOl to remoYa If from tho
celoulation 01 tho tile dUO In thle oa"\8, You may wllh to flIoSohodulo 0 In ordor to mal<elho olootlon avellablo under SootJon 811G, If the IlIKltlon II mado,
Ihelruet or Ilmllar arrangoment la tlleedln,the eatata 01 tho,llrat deoodent IpOUlO, tho pOrtlon of tho llUet or limitXl', arr.ngoment whloh beneflta lho surviving
IpaulO Is tsxsd at tho aero tax, r.to, and the, (emalnder Ie taxod at the (ato(l) applloable to the romelndor benelloI8l)l("*), If you Oh0088 to make the eIootJon,
you must a"soh Sohodulo 0 to a tlmelY-fIIod tlle,roturn, along Wllh SohodUlo(e) K and/or M In order to ehow the apporllonmenl 01 the llUat or 8lmllXl'
arrangement belWeen tho lurvlving SPOU88 and the remainder benollol.rv(loe),
7 PA11100a NTF lalla "
COPvrlght FotmI8ollwa,.Onlv,111' N.foo, '"0,
~~
SCHEDULE B
STOCKS" BOND'
mATI 01' PILI NUMII"
Dlnt:a'1 p. SUrd ,
All fHIllllny IolnllV"OWMd wtIh ,rtth1l1f 8llMv"'h1p mUll be \lllClloMd on Iohtllult P.'
!TIM
NO, DIIIIORIPTION
1 Po:l:d ,M:ltor O:l. a..Il,...1 st:ocIk, aJB~P No. ,345370100, 132 Shares of
o;:.."",,,.uClQ:1:if:!.ClIltec;t S~ aM 187,514 8harea in .a:l.v:l.~
:ue..:lnvuI:n*\\:I plan . $40,876 pet' ~ (h:l. $41.15, ~o$4o.aS),,'
2 <n'lll Q:l.l:p. 0;m\'a1 s\:Qck, CUlIp No. 362~20i03 , 90 PaI;t:!.Qipat:I.neJ
EIhuu(I\I::lot., D:l. :j.14"7422) aM 606.648 shatesin div:l.c1em
:ue..:lnvul:mlr1tplan . $45.6563 (11:1. $45.875, 10 $4504375) .
,
3 :11M a..1Il""l':Itook:, 112 ~ :l,n I>>II~~I Certificated Stool\: arx1
8S0.662 ~ in divi~ :re-:l.nvu~t plan',. $107.0313 (hi
$108.4375, 10 $106.625). '
Janua ~. ~ ,l\CClC:RJnt No. 201233652-4, CUlIP No. 471023853,
.48~',904 IIhlu:U 1'$19.04.
Qabel3,i anall ~ C3rcwth Ii\md, Ref. No. 1127361S, J\o:lcu\t No.
100349174-1, 1840,60 Il1at'es 0 $23.16. ,
MRP <koWl:h arx1 ~ ll\1nd., .I\coc:\Int: No. 202099819, 162.436
8haxeso $58.86. "
~oan eent\U:y"20th~ Ultra ll\1nd., l\CClC:RJn~, No.
022~000597140, :j.822.68S ~ II $35.76.
, ,
Har.d.s SiIv:Lt~ llankCl::C'11ra1Stool\:, c,usIP No. 414670101, 2,000
aI1a:retI of O:mlalc:lln;'t:ificated Stool\: I $86.4688 (h:l.$86,3126, 10
$84.628). .' , .
9 PP&L Q::mralStcil,'lk,c,usIP No. 709061106, 200 IJhax'u in ~\k,"'1
certificated Stoc:Jk arx1 3,917.436 siw:'e$ in div:l.&Ind ,
re-:l.nvesbtlBnt Plan I $19.6663 '(11:1. $19.B7SC, 10$19.4378) I
4
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"
6
7
8
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II
7 OPA31 NTP 10101
Copyright PCHml 8Dftwal' OnlYI tn" N.IGD, InG.
21-~p97-006S8
VALU8 AT DATIl
OP DIlATH
13,060.13
31,806.37
106,244.83
8,642.33
42,628,30
9,073.67
65,178.14
:j.70,937.60
,
80,933.36
62B S04. 3
f""",
, '
~t:e of, Dent.cl'l B. Bw:d
SOlll:t'Jl1t1ll H, IiWU' B -- Mninistrati'Yl!l O:l8ts
:ttem
No.
. DelilclripUcn
-
7 O:lIIt:ea' s J\l.IcIticn servi~, c.'allp Hill, PA
,. "
8~t:e feu
51 1dv8rt:ising:in Jfarrsihu:g Pat:riot NewII-Ml!lb:o West
, ' ,.
10 Mvertising:in C\.ITberlarxi J,aw Journal
11 .lldd:l. UalIll P.l:'c:bate feu
,12 Shr:lrt cm;tificatu - addiUcnal
13 Filing fee for PA Inheritance Tax Return
, '.-
14 Illxpens&B telat:eCl to sale of 226 Sb.lth 16th Street, O!lnp Hill,
Realtor's O:mnissicn to Prudential-~ Wood
IlllIpX'ess Mail fee to central Penn settlement servioes
Tran8acticn Pee to' P.rudential-'lbaTpeal WoodRealtotS
Notaty Fees
Realty Transfer Tax
,
Bc:1t.'erS P,st O:rltro;L Ir1speoti~
sewer to Borc:u3h of ~ Hill
3.8 Bell Atlantic
16 PP&I"
17 Pa. .lln'eridan Water Cb.
18 Waste Ma\1.agenlElr\t of central Pa.
,I;
151 Pa..lln'erican Water Cb.
20 ,NaticnwiCle fyt1tual Fixe Insurance
21 tQlt:oJr Oil serVice Cb.
22 . O!lnp Hill, Borc:u3h - .sewer
,. roliAr... (Olrry forward to main sche\hlle>
t . . . . .
Ila!ife 2
21-111117-00688
J\m:U'\t
1,083..50
247.00
57.18
60.00
245.00
21.00
15.00
Pa 0.00
3,7517.00
15.50
125.00
..6,.00
1,05151,00
30.00
60.00
22.13
58.06
10.57
"
38.70
8.59
187.00
125.516
60.00
7,36'1.19
"...._~.
,~
5Wde 3
21-19117-00668
~t:e of I 0lInt.cl'l B. Burc1
SQIIl!I"fIT:jll H, PARr B u Mninietratiw Cl:1lIts
,Ic.n
No.
-
Duaripticn
J\m:U'\t
23 NatiCl1Wide fyt11:1.1al Pire :rnsurance
24 , PP&IJ
,
25 Waste Manag\!mlnt of central Pa.
26 . Ma1t:o.lr Oil Cb.
27 Bell AtlanUo
28 m:l Bank - 01ecl\: OOlIte
96.50
112.61
313.70
130.40
34.56
30.25
8.56
2.13
5.43
28.48
12.13
13.72
25.92
12.32
12.44
32.63
18.44
3.00
213.82
16.52
137.85
1,720.31
,;1
24.00.
29
Pa .l\n'erican Water Cb.
&ell Atlantic
PP&ti
Pa .l\n'erican Water Cb.
Bell AtlanUc
,
PP&IJ
York Waste D~sposal
Bell Atlantic
,.
30
31
32
33
34
36
36
37 Bell Atlantic
38 PP&IJ
,
, 39 Pa 1lmerican Water Cb. '
40' tase/Ml!lllcn Sl1.anb;)lder's service fees
41 Bell Atl~tid I ,
42 PP&ti
43 Ma1tOJr Oil Cb.
44 J\I1n M. ~ey, Tax Cblleat:or
46 Vital Records
rorAL. (carry fcn:ward to main schedule)
. . . . . ,
2,639.72
10/02/1998 13147
71719!lN73
, -
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, '
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,....'1' WTLL. A.'1~ 'l'lfa'l'A.MlIlN'l' o. rUIIM1rnN "6 IUfRD
x, DmKTON P. PURD, Qr t~. aorQUq~ Q~ Camp Kill, Quunty ot
ClWlll:l...1_nd, _,nil CQIIIIIIQnw.al11~ or P.nn.yivania, bein", Qi! aOl.\ncl and
Ili.p..in, mLnd, m.mory Ilnc.t unc.t....t.llndi"q, do iliA Ice , pl1bli",h and
de.lara t.ni. t.o be my ~..t, Will and Te.t,.mant" h.~.by ravcklnq
."'\~ ",.kin. void .11 Cor-m.... WU1,. by llIe .t, any t.illl. nell:.t.ctn~e
..lla.
,1.
X IU""U" tin. p.vmlilntl Ill! all my ~U.1:. d."'tla anc;\ llunell:.l
,all",.n... .., 1lI001'1 .. dlllnvaniant,ly may ba .~t.... my ca.l:I.....
a.
t .1v., d.v1.. an~ baqu.at.h cn.~llO\.l~h (1/4t.h) c~ un. valu.
u' MV ....... .'~.II: .he p.ym.nt.Q~ .~1 ~\.le" C;\.bt.., .MP-n.."
al. ..... f ohll"'.', ,... and lIn. lik.-, to my b.l,ov.d wLll. i H.lan K.
I"'w., i. ba1n, -r 11'1".nt,101'1 th.t 1:.nia on.~~curt.h (!/4th) .h.r. b.
Ine '1'14 IIl..1l' u. aU ..c.t.n1 ..t.at.. And penn.ylvArih inha..iir,.no.
llllC.., whi-on t.IMa. ua t.. b. bo!:'na by tn_, reddUell:')' portion of illY
.......
a..
.h~uld IIY ..id wit. p~.c;\_~.... ... 0~,d1. .t ,.boUt bn_ .....
tlL.. .. x di., _UUh .. in a d1...t.ell: Qommon t.o both c~ "'., th.n
h....h.t'. _hln lap.' IIlncl IIhall b.l;loma pall:t\ Q~ my ....i.s\U'...y
,
..t....
3.
All tn. ....t., .....ic.t~. .nd ram.ind.r Of my m'UAtl., ....1,
p.r.emll .1'1'" mLlC.d., w~.t,.allve" Ilnc;\ wh.r.aoev.r a!buM:., X Ijfiv.,
c;\.v!.. And baq".~t,n, in .qual ahar.., .. 1l0110w..
,II, Qn.~thJ.rlOl (:I,/~) ta my aon,Dent.on a. Burd, Jr.
QU~~enllly '~~ 4 D~iar Lena, Calllp Hill, P.nn.ylvani..
.. Ona..t:hh'\Ot (1/3) t:Q my qranc.t.on, O.nt.on B.
auarll, XU.
C. On.-t.hil'l'J (1/31 to my qranddaUljfhtar,
MiQhM~l. M, Burd,
."" "rrHf!"t r',~r." """l~'1 tT~'':'''.r';'):'
",'I,:"T'''''.;'f", "".,,;,""mof}f't-;'l'.'" ...,~:'
,..t: t ..1 "', ',1 . ,t" .,1...fII '.. I ,I~, ~'A
.r..... ' L'" j'I' __ . ''fl.
'''Tl 1 '..al......." . ........'-"..,~'--.... j .........._
.., '.J.. ,(, .1..." 1
'tJ........'L ~1 ..!.~ .......l....l.....;~._..: ,I. ,',i'_,"-,":',~ ,
.iM'i' ,..'(r.", 1:1'.:,.........t\~ "io........;
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71771117473
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10/02/1111 13147
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A. IIIhoUld illY IIIl1id .an pr.ca.o.... II. .nd 1;11 .\&~tY.d ~lf
any oh11d&'en, Ch.n hi. IIIha... .hal1 90 t.o hi. obi~dr.n ~
.hi~... Should IIV .lIid .on pr.d.o.... II. and no~ 1;. .uWV1Y.d by
.ny O~11d&'.n, ~h.n hilll .h.r. .nall ~Q ~o Th. ..1Ya~ion AzoaV,
oU&'r.n~lv 100.t..d.t. 1122. Gr..n 'ura.~, P.O. BOH aaoa,
Ha&,&,1.I:I\III9, ..nnlllylVania 'J.7;1.I;8.
a. Sho~ld on. 0# my n...d ~r.ndoh11dr.n h.ye
pr.d.o....d 111." an4 hay. b..n .UlNiVad by a bro~h.1:' 011:' a1.call:' ..
~~. g... aay be,. ~h.n .uoh d.C1....d 'ill1:'andf'hl1d'. .h.r. .hal1 qo
co lIIuoh .ulNivinCj/ b"Q~h.r or 1II1.~lIIr .11I Ub. 0... may 1;.. IIIhgUld
both o~ all" na..d 9r.ndohildr.n hay. pr.c.t.o....d .., th.n uh.tll:'
eh.r.. IIIhall 90 co Un.ill:' n.t.u&'al cath.I:', Dan~on a. aUlI:'d, JII:'.
'Should li". .1.0 hav. pr.c.t.o....ci __,ch.n lIIuob IIIh.lI:'lI. .hal1 90 CO
~. 'aly.u1on A"'~I ou..r.nt,ly looaUlId ~c 1121 Gr..n SCll:'.,~, .,0.
BOK aaOl, H.r..t.I;UIl9, p.nn.ylvani. 17108.
15.
.hO\&14 .LUbe&' Qr bot.h ot my "...d 9rand~ildl:'.n 1;. 1... Cha"
t,h. a9. o~t.w.ncy-tiY. (28) y.ar..u t.1\. cia. of ay d.aUb, un.n
, .
t,h. I:'..p.ouiv. r..idua!:'Y .h.r.. o~,anv Cj/randobild la.. than ch.
,.9. o~ cwency-tiv. (IS) y.an .haU 1;. plag.d in u~.tl,.V ..td
, .' ,.' I,
, .on D.ncon B. 8u&'d, 3r. t.o b. cruIllC.., 01:' .1\0Uld h. 1;. un.b~. or
, ,
~nwil1in9 t,o .a~. ~or any r.a.on 01:' o.u.. whau.o.y.r, th.n CON.
8AN~ NA uo b. ~h. alt..rnat.. 011:' .uooa..ol:' c~.t..., ~or Ub.
tOllaw~n9 puz:opO...'
A. Th. J.nooll. troll .aid Tru.t. ~.tat., .. w.ll ~.
.0 muoh a~ ~h. pr1noipal ... i. ri..d.d aOQordinv CO uh.
c11aot'.t.ion at t.ha Tru.t,.., snal1 b., u..d anI! .lCPanc.t.cS
~or t.he .~ppol"t. and mainuan.no., inoludinv ..d10.1,
.~~91oal and 'holllpiualoar., and 0011.98 .cluoat.~on,'or
oun... .Uon formal eduoation, sUoh.a any lnuarnahtp,
.pp~.nt.i08ahipi ",..idano., 01...kanip, or t.h8 11)c., elt
..iel ,9r.ndohild. The deoi.ion o~ my T~.t... a.'to th.
ooapl.t.ionQt formal .c.tuo.cion by my .aid OrandCnl1d
IIIhall ba tinaL
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11 1"I?~U
,~
e., Tha amaunu ~Q b. paid ~OV uha b.naf1~ ot my
...... .nl'l"Oh~id ,"hill "e 4na,:ll\1r'lal1 bD1!l ~im. ~o
_t., br \h. n..d at! the ..ai4 o~.ndQh11d. and ~I'I.
a..un.. and ~1_a. ai'.ail1 p~ym.n~. an.il ba da~.~in.d
W aUM 1'1..4. Th. ..id J,1II)'"lllan\. mav b...ad.'I;I,.. lIIy..Ld
'&Iw.ta.. 4h'..t.ly 1:10 t.ha "aid ijjl'andGhUd,O" ii", in tine..,
..1. opin"on ,,~ lilY TI'\lall.a i ....d 'it.:andah"ld ia OC! ,.uch
_,. and a"I.U1\V toll handh P':Gp.':lY t.ha,tun'd. tih.y llIay b.
, ...id di...,.a\\ly t.o .uoh 9,/:,.ndahUd, Ot:' m.V b. mad. by lilY, ,,'\....
Tru...........Gtily tio tih.p....an havin9 ~. ou~tiody and a.~.
o',~. ....d ,..andohl.ld, II': mall' be 'made by ~Y ".id Tru.~ae
d"W.~lY \0 anyin"tiit.Utiion an\l.\\l... tao aUGh paya.nt. by
......n o. ..~io.. ...n4.l'ad a~ tio be~.nd.".d ti~ ~. *.id
9l1'.ndahL:l.d.
(Or ''1'0 pil,.. tih. .aa\1llula~.d 11'10". .n" pl'inoip.l
tih.n ...,ainin' in in. h.nd. to ~h. ..id 'I'.nd~hild"wh.n
tah. 9~.ndQh"ld .n.l1 h.v. .~..ined tah. a,. a~' tiwantiy-tiva
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(D' :z: cU.l'aQh .tlhu bha ..nti.....ti. 0~,'.11 bena1'lGhll:'''..
Ln tha T~...h.".b,.. ol'a...d, wh.~.t:' in tn.,pl'l.nal.p.l 0'"
inao.. t:tIliu~'eoll, .hall l;Ie ~l:'lI!. f..GIlI UabUi~v t.CI a~.aohlll.nti
~"O~I" 1.,al pl'oe,.. L..uad .t. ~h. 'tn.cane. o~ an~
a~,~itaol' a.. .....9n.. of .UG~ ban.~tct.I'V' and ~' dir,G~
~ha~ 'no p.l(m~n~ .h.~~ ~a .ad. bV w.y ot .ntitotp.tiian o~
.""". whili'h ..v ~h"'.'ftl.r .caru. tic anv' beneticial:')'.
(I' U tlh. Tl'u,t... ha.t..ken, Lntla' tn. '1'1'\l'~ 1Il.~at.
any I'.al ..t.l't.e,and ..'1'I'\l.,1:" Clonll,icSet'. it. tI...i):l~e
to, ..11 t.h. ..lIIa, t nereby autlho~L~e" e.poWlr and eStreat
the' .aid '1'I'\l,..'. ~CI ..11 .. publLo at' pt'L~.t~ .al. ,Gr
..1aa, and ~o oonvey any .ucn t'1.l e.tati. to tihe JjlUI'-
an.e.r 01' pUl'aha..r. uhGt'aot,' and t.o qiva ,ood anc.t
aurfi."Lant d~'d, or c.t..d. tot' tn. .am..
(I!'I xn t.ha avant: that: my,.a:l.d IjJll."IndcshiU .hould
auni". III. i' but:, ahQu1i:t dia dudnc;t ~ne t..n of 1;.l'Ii. t:~.tl,
3;
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-~
~han h1_ ahna a".U ,b. di.tlJiib\&~." aQQol\ltin9 UCl \me
Ln.ll'F\lQlliQn. 11'1 ..u.,,~.!jIh 4 (b) .boY. if "a ",.a' . -.."..., :I..,..
~h.n tlh.... o~ dt,tnt...n (:1.1), .11 the ~!.aClf h1. da~im.
.ho~~" ."Qh 9~.ndchi:l.dh.YIII .~t..1n.d tha atlll of a1,,,...n
(U) b.II!O~. 1:Ih.. 1;.b'. of hi. c.t..t.n,' 1:In.n nf,. .h.... ",h.U. ~.'
" ,,' '
QClnt.~CI:I.:I..dbY hie 1.a1:l Will -rei t....._.nt.. ahQ":Ld han01:l
have aK.out..d $ 1..t.",1:1.1 .nd t..~.~.nt., t".nhi. ~h.~.
a".:I.:I. b. oon1:l1:',,11ad by .t.h. in.......... :I.."'. ,"f..nn.lf:l.v.ni.~
8hO\&ld h. :I...V. no .u~1vS.n9 h.1~. within t.n_ n.c......y
d.9~.. c:r~ ~lllll\..n9U1nf,tY' 110' t.lc. und.... t.h. Ln'l:...t.at. :La",., ,
t.han t.hf,.- .I:l..ll'. ."a:l.l 90 t.o t.hlll' salVlllt.i,," ","if, aIClw..a!d..
'II.
it n9:1.n.U., aana1l:l.tut.. and .ppaini:l lIly.on, !)tant.on Il. ."\adj'
a... aa .i.a\1t.ol' of ~y .at._1:I1II. Xn-'t.h. av.nt. 1:I1\at. h. :I..un&b:l.. 0..
, '
unwllli", 1Ia .all.'V. in auah d.paalt.", ':a: appoint. t.h. ClCQfa ~ ,,1\
1;00 1;1. t-n. sxeollt.ol' in 1\1. pl_0. and .tead. 't, d.h.~ t,hat ~lr'
,
.ha:l.:I. nat. b. ~.q\1i".~,t.Q fi:l.. ~ band. t.a ..au~. ~. l.i1:lI\'\11
p.~~o...ana.af t.".il' d\1t.i.ain any ;\1~1.diot.iQn.
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UO \:;1o~CIW 1II0n.Y ~Ol:' anY",p\.ltPo... Clon".QtI.d ",.t.th t.n. !jIrat..otlS-on
.nd pr...rv.tlion Or 'my &.1:Iatl.' ~O 1l\Qrtl,a,. oJ:' P1.dq.'any 2:'.al QIl'
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~a,~"a' CONB 8AN~, H.A., SH.outo~ ot the D.tat. ot
," ':" B.tty .7ln. BoW.n, ht. ot the Bo~oU;h ot Olmp
~.'",j'I'" 0,.:..H111, Oumb.rland Oounty, P'nn,Ylvln.l.a, D,o,"ed,
.,'. '. GRAN'1'OI\
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.. AND ..
bBNTON B. BURD ot th. Bo~oU;h ot Clmp Hill,
Oumb'~land County, P.nn.ylvan1a, GRANTS!
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ntbtrt,ull B.tty Jan., BoW.n' dite! Janua~; 118,198:l, I ~..id'nt'ot
~.mp Hil , Oumb.~land Oount.y, P.nn.ylv.ni., awn in; It th.tim. ot
h.~ dtlthl' .l.nte~ alia, the hereinatUn d..or1b.d rill .Itatal ane!
.
WHBRBAS, th. .aid d,o'd.nt l.tt a La.t Will Ind Te.tamanu dat.d
S'Ptemb.~ 13, lP'9, wh.roin .h. .ppoint.d CONB B.nk, H.A., O.mp Hill,
P.nnlylvani., SX.outor, whioh ,o.l.d will wa. til.d tor probate with
th_' Oumbe~lancl county Ra;iltlr ot Will. 'eb~Ulry 9, 1982, It whiah
tinl4\ th. laid CONB Bank, N.A. WII .ppoil\ted 'X.outor ,ther.ot to
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Made t'~f I' 'I ' , clay ot February
Ntnllt611n If,u,1I4reel and, Ninety-fivll (I ~9.!l)
.,t.,," DENTON B, BURD, a single man, of the Borough, of Ca11lP HU1,
Cumberland County, Pennsylvania,PartY of the F:l.ret Part,
, tn the 1/(la"
AND
Grantor
DENTON B, HURD and DENTON ,B, BURO, Ill, of the Dorough of Camp HU, Cumberland,
County, Pilnnaylvan:l.a, w:l.t~ r:l.ghta of aurvivot'ah:l.p, P\\rti811 of the ~!loond' Part l'
, Grantee a
1hihu..,tht that t,~ oO/l-sicleriWon of
~~'. and 'no o\te-hundr8dthe ($1,00) ..-....."'........--...............................--....--............................ Dollars,
tn. hemcl patel, th. e reofltpt whereof ta hereby aok/l-owlealeGt, the satel Grantor .dClla
hereby IIrant and oonvoy to ,the Batd Gra,~t6e -i i the:l.r hetrs and aaatlnB,
ALL THIIT CERTAIN, tl.'aQt or p\\roel of lan.d BitUate in!,ower Al1en TOWllahip, 'C!Jmbllr"
,laM COUnty, Pllnhaylvenia, more partioularly bounded' and deaoribed aOQording to
" aurveyof D. p, Raffenspllr~er, Registered Surveyor, dllted May 2S, 1953, ae
follows I
BEGINNING at 0 point on ,the Northorly aide of Cumberland Drive (formerly
'Avllnue "0") (50 feet wide) at a ,dbt\\Me of one hundred forty"fo\lr and fcrty
onll"hundradths (144,40) feet measured North eighty"six (86) degrees forty"four
(44) 11l:l.nUt8S East, from the interseot:l.on of the said aide of Cumberlend Drive
(formlrly Avanue "Oil) w~th the Eesterly. side of Wayne Road (form,rly Av,nua "!,")
(SO f!let wide) (both produced) Ithenco leaving aaid sido of Cumberll.l,nd Drive
(formerly Avenue "all) and along !'ot No, 116, North three (3) degreea nine (9)
minutoaWeot, a d:lotQnoe Of ninety.,nine and sixty on~"hUndred the (99.60) fMt tn
a pointl thenoo along Lot No. 142,North fifty"oight (.!l8) degreea twentYni"e
(29) minutea E;\\at a ditltanoa of thirty-two and sixty one-hundrodtha
1,~2.~0) feet to a pointl thanoealo1')g !'ot Nil, 118, SOl1th thirty"ona(31) degree a
tllirty~ono (31) minuteo East, a d.is~anoo of one hundred twelve and thirty"nine
one-:hundrodtha (112,39) fee t to a ,point on the Northerly aide of CumberlLlnd
Drive (formerly Avenu~ "0") I thenc0 Weatwllrdly along add aide of. Cumberland
Drive (formerly Avenue "0") along a Une curV,ing to the right hliving a radiua of
two hundred nineteen and ten one-hundrodtha (219.10) feet the arc diatanoe of
eighty-four and tWlnty-three ono"hurtdrodths (S4.23) feet to the firat mentionod
point and, plLlCe of B~GINNING,
Baing ,!'ot No, 117 on Plan of Cumberland Park, aaid Plan bei"g racorded
in Plan nook 4, ,Page 8~ I Cumberland CO\lnty reoorde, together with the improve11lents
thareon ereotad,
HAV.lNG thereoneteatod e ane"atoryfra11l8 dwslHng known as No. 105
Cumberland Drive, Cumberland Oounty, !'ower Allen ~oWllahip, Pennaylvania.
BEINO the eame premieea which Edward + t\lm Ournos and Anna Curnoa, hill
Wife, by their Deod datsd Septomber 2, 1960, and recorde,d in the Offiaeof, the
Recorder of Deeds in and for Cumberland County I in Popd Book liZ',',
"Vol. 19, Page 926, granted and oonveyed unto Ponton B, Burd and Effie M,
Burd, Ilie Wife, daoa8Asd August I, 1980, Grantor herein,
grandfather and~
This dood is being transferred from grandfathor to"grandllon and is the,refore
eHempt from realty trLlnsfor tl\xea,
bOOK 118 PAGE 883
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Pirst (])a'-'J, Investor Services ~,oup, Inc.
(])reyfUs pamiCy of PundS
p,O, Box 9671
Provldenoe, RJ 02940.9671
Charles B Shields 11I.
AttQmey AT Law
6 Clouser Road '
Meohanlosburs P A 17055
RB: DreyfUs Pennsylvania Munlolpal Money Market Fund
A.coount Number: 104.3342292194
Dreyfill Appreclatloll Pund
Acoount Number: 141.3342292194
DreyfUs Municipal Bond Pund, Inc,
Acoount Number: 054.3342292194
Reslstratlon: Denton B Burd (deceased) TTHE
Denton B Burd TNst ,
FBa Denton B Burd,Tr Dtd 06.05.90
. ,. . -".
November \\, 1997
Dellr Mr, Shields:
Thank you for your reoent Inquiry resardlns the referenoed DreyfUs accounts, As of
July 25, 1997, the aooounts had the followlns:
Account Number Total Shares Price Per Share Balance
"
104.3342292194 54,97\.620 $ 1,00 $ 54,971.62
141.3342292194 ' 1,237.011 $32.47 $ 40,165,75
054~3342292194 22,316,352 $12.69 $283.194,51
"
The balanoes were calculated by multlplylns the total'number of shares by the price (net
asset value) per share, Please note, the dividends are paid in 08sh on a monthly basls,on
these aocounts;
Pleasekeep.ln mind that the balances may chilOse dally because of chanslns market and
economic conditions, Also, past performance is not a guarantee of future results,
In order to redeem these accounts, please provide the following:
(De
A letter of InstNqtilW Which Includes the Fund names, acoount numbers and clear
InstNctlons, The successor tNstee(s) must sign the letter and the slsnature(s) must be
Signature Guaranteed ~.
~"........~
",
/""
JJsQ1 UIulta ~ ~
Credit balance $1.00
Bull &. Bear
Dollar Reserves 2,098:71 $2,098,71
Anheuser Busch 400 43.875 $17,550,0
f,rIl'Islrons WQrld 109 71.75 $7,175.0
, Calerpllhir ' 200 56,5935 ' $11,318,70
aarthsrallls 16* 36.4845 $583,75
Fortune Brands 200 35,2815 $7,OS6,~0
,Oalf.hef Oroup 200 18,2815 $3,656,30
Ihl'lBuslness Mach, 200 107,b~IS $21,406,30
Merak 100 ' 103:406 '$10.340,60
Nuveen Ins Munl 978 15,8435 $15,494,94
Nuv\lCn Perfol1Tl 301 15,5625 $4,684,31
Sprint 200 49.469 ' $9,893,80 '
360 Commun, 100 17,7815 $1,778,15
Wl\8te Mgml 200 31.3125 $6,262,50
Wal-Mart 400 :37,969 $15,187,60
AMP 100 50,9375 $5,093,75
" ,.~
plvidends, From 1/1/97 - 7/25/97 "
TaXAble Dividends $1, 106,99
"Ntll\.laxAble Dividends $632,88
'" ;'\.I ':l~\ ,t
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;} I
~NDED REVOOABLE T~US~ AQREEMEN~
FOR ~NnB)C.
PI!1NTON ~.. BI,l~D
THIS AGREEMENT OF TRUST eKGcuted in duplicate thil ~ day
~t ~/ 1990/ between DENTON ~. BURD, or the Borouqh or
oalllJ/HiU/ cul1\berlanl;\ county/ penhlylvan.ta (hereinafter oallea
Settlor) and DENTON B. BURD (hereinafter called Truete.).
WITNESSETH I
RBI ORIGXNAL AND SUCCESSOR TRUSTEES I
In the event of the death ot 'PENTON B. ~URD, or ~f tar any
, ,
realon whatsoever he ceases to se~e as Tru~tee hereunder, DENTON
B. Bl,laD, JR./ son at Settlcr, shall be nominated and a~poihte~ to
serv. as Truste8hereunder withcut the approval of ,any oourt.
In the event that the said DENTON B. BURD, JR. should alSO,
tor any reason whatsoever fail to become Trustee or to 'cea.. to
serve al Trustee hereunder/ OONB BAN~ NA shall be nominated ana
j, I' ,
appcinted to serve as Trusteil hereunder without the approval of
any oourt.
The word "Trustee" in this instrument shall also be
,
umierstood, to include "SucCl$Ssor Trustee" where oiroumEltance. and
"
"
,context make luch unaerst~nding applicable,
FXRSIJ;',I Settlor qrants, asSiqh., and' !lets over to Trustee
ana his sucoe.eore all the pr~p.rty described in Schedule A
'annexed hereto and said prcparty/ togeth.rwith all 'other
property, real or personal, thot ,l)Ioy be odded to the trust (SUClh,
property and adl;\itions beinq hereinafter o~lledPrincipal), shall
,
be held bYTrus~ee / IN TRUST; upon the following ternls.
SBC,QNDI Trul!ltee shall monaqe 011 property comprising the
prinoipal of this,trust aha ehall colleot the inoome therefrom
and accpeUonsthereto and shdl pay the net inoome andhola and
distributei:h. principal of sddtt;'ust as fcllows.
A, Trustee shall pay the net inccme therefrom" to
settlor for and durinq hisnaturaJ. lifetime, SUbject
"
to the provisions of Item FIFTH, in ,suoh periodic
,
ih.tallments as Trustee shall find convenient but ot
" "
least a. often ae quarter-ahnually,
1
~
..
,
.
,
,
.
1";
.i.tet a.the ca.. may be, then.udh dedea.ed gtanddhild"
.hue .hall go to sUdh lIut'Viving btothet' Ot .bte,t aI'the
, "
da.e may b.. Should both of my, named grandchildren have'
predeceased me, then their share. shall go to their natural
father, Denton B.' Burd, Jr. Should he allo have prede..
, '
, oelll.ed me, then such shares shal;l. 90 to' The SalVation Army,
Qurrently lccatec1at 1:1.22 Green street, P.O. BoX 2:\015,
Harri.burg, pennsylvania 17105.
4."
Should either or both of my named qranddhildren be le",t1'1an
,the age of twenty-five (215) years at t~e time of my death, then
the re.peQtive reliduary trust shares of any qrandchild le.., than
the age of twenty-five (26) years shall remain in tru.t~ my said
son Oenton B. Burd, Jr. to b,\I trustee, or shoUld he be unable or
unwi11inq to .et'Ve, for any reason or. oaUse whatsoever, then CONB
,BANI< NA to be thealtlarnate or succeSsor trustee, for the
following purposes I
(A) Theinoome frcm said Trust E.tate, as well as
so much of the prinoipal as is needed aocordinq to the
disoretion of the Trustee, shall be us~d and expended
,tor the support and maintenance, including medical,
surqioa;L aM hospital oare, and colleg8 e~\1oation/, (lr
other such t:ormal edUcation, such a~ any internship,
appr~lOtioes~ip, residelOce, clerkship, or the like I of
said qrandchild. The decision of my Tru.tee as to the
oompleticmof formal education by my .aid'qrandc;shi'ld
IlIhall be final.
(B) The amount' to'be paid for the benefit cf my
llIaid qrandohild IlIhall 1:1111 determined from time to
time ~y the need oftpe said. qrandchild, and ~h.
,
,amountlll and ti~e. of said payments shall be ,determined
by such need. The sa~d payment. may be, made by my .aid
Trust.. 'directly t~ the said qrandchild, or if, in the
,
sole opinion of my TtUtlltee, said grandchild ill of llIuch
aqe arid ability to handle prcperly the funds they may be "
3
.
'.
"
.
'P~.i,d cUr'~t!iYto IUQ!\;t"nd~M;Ld" qr)n,y b" 1II.r.1., ,bY.''''~.a:t~
>, ,,' ", .. i
'" ""'" " , , "
~1"\l,.tl. 12t1"lct;Ly to t;~1 PlII1"lotl having the ClU.t:or.1y" an" 0'1".
,
~"':I" ~0l.9"~~11~. ~. !!\llV ~. .... OV ':i..t~.~........
aireot;Ly to anY'inlt.it~tion ent:it:l~d to Cluel'! paYll\.nt;by
r".on ot, ..rviee. rendered 01" to ber.nd_rld to thl..1d
' - .. . . . - .
;,
!JrandClhi;Ld i"
(Q) '1'0 pay,th. accumu;Lated ineom. ana"prinoipal
" _ i
tnln :rlmaininq in tt. hand. to t~1
th. ;randchild' ehall ha,ve attain.d
',call) y..ars, ,
, ......
(D) Id1rlot,1:hllt the inter..tl ot all ben~tiaia1"il'
in the '1'ru~t herlbycreated, whether .in the pringipal Or
, "
'!nciome th'reot, -haUb'tr.e trom liability to attaohment' '
, ,
01" other leqal P1"oge.. i.auea at ,the , inetancie ot any
Q1"!lIditc>1" or assignee of aUch blillleticiary ,and t direot,
I "
that: no paym.nt'"sha~l b, maele by way ot antioipII~.ion9t
'U1111 Whioh may thlilreathr accrue to any,benetioi.ry.
(E) If ,the ~rl.\s~ee hll8 taleen .:1.nto" thl '1'l:'US"t ESt~te
! , .'i",,,'
any real "Itate, and.. '1':i:ulIteeconaid'1l'Sit feaSible
to, sell th, .ame, I her,.by" autho1"iae,empowliIr ancl direct,
,
thesdd'1'rultee'to .,811 lit 'PUbliQ
"
.dd ;~andoh;t,la, when
the .gl ot 'twlntY-tive
jf H
;'
(F) In thlil ,vlllntt~at my";aid, q1"anelcihild .hoUld
' "
~~,fViV"ll)er~Utsh~Uld cUe ,d,Ul:'inq' the, te1"lll, oM, thilllti:ol,l.t,
tlle'n)UI 'hare 8hlll'1 b. d:t~ti1"ibuted l!IOcorcUnq to the
, in8t:t'UQ~ion. in ~a~l!Igrllph '4 (b) l!Ib~V8 'it he Was a mino*,
leu than Fhe l!Iqe 9feigh1:e,n(18)/, l!It the i;im.. ot hill'
,
"ct8~~h, Snou;Ld .uch g1"andch!ld,haVeattaihect the a9_ ot
' - .. ; ~ , .... . ,',. ;
,
" \!licphteen.. (lS) betci1"e the time oihi. ctellthrthen hill"
,. 0""', ". .., ". ;_...."....,
,- ,-
,.h~J;''' ~~all be 00l'ltrol1ed ,by hb 1~8t wiU andt..t~tllent.
Sho~lct: he not have exeoutlilel a last wi1l~nd testament,'
the,nhls ~hal'e ."a11 ~scont1"olled by the intestl!lte law.
ot PennSYlvania, ShpUld he lenve'no sUrVivinq h.~:t'1I Within,
4
.
.
.
" . the n.c....~y degr.e of oon..nguinity, to t,ke under .the
'inte.tate laws, th.n thi~ .hare 'hall ;0 to theS.lv.tion
'" Any, atore.aid.
.. THIRPI The principal ,nd income ot this truat .hall be free
from antioipation, a..ignment, pledge or obligation ot Settlor
and ,h.ll nct be sUbjeot to any exeoution or .tt.ohment or to
volunt.ry or involuntary alienation.
POURTHI Truste~ .hall have the ,following power. in .ddition
, "
, to" tho,ave.t.d in h~,m by l.w .nd by other provbion' of thb
, . ,
trult, applioable to all property, whether prinoipal or income,
"
exeroi..ble without ccurt approval, and etfeotive until .otu.l
di.tr1bution of all property,
A. To retain any or all of the ....t. of thi.
t;-ult:,real or pereonal, includinq .took Ot Truetee,
without reqard to any prinoiple of diversitication or
I :t'i.lc.
'.
a. To invllt in 11,1 foms of property, inolurUng
.tock, oommon tru.t fund. and mortq.ge inve~tment
fund., without re.triotioh to investments authorized
tor Pennsylvania fiduoiaries, as he deem. proper,
without regard ta any principle of diversification cr
risk,
"
o. To sell at pUblio or private. sale, to ,exohange,
,.
or to lea.e for any period of time, any real or
perldnal property .nd ,to give ~ption. for .ale~,
exchanqe. or lea.e., for suoh prioea and upon auoh
temlor condition. as' it d8el1l',prop.r,
D. To allocate receipt. and expen.esto pr;noipal
or inoome or partly to ,each as Trustee from time to
time think. proper in hi. .ole discretion.
II.,. ,.,
'E. To hold property in the name of Settlor, or
in hi. name without design.tion of .ny fiduoi.ry oapaoity,
I " '
or in the n.me of a nomine. or" unreq bter.d.
FIFTH' Tru~tee may apply the net inoome of this trust for
the .upport of Settlcr .hould h. by,reaeon of ag.,i11n... ~r any
I
u
!I
,.
.
.
.
.
!i
"
'oth.r ~.u.. in the opinion ot Truste. ~. incapable of ~i.bursing
itl an~ Tru.t.e is further authorized to ,xpe~d or-apply 'trom the
principal .ot thb trust suoh sums as he in hie sole diecreticn
may, trom time to time thinK a~visable tor the suppcrt of! settlor
to ma,int.ain him i~ the stat;ion of lite to whioh he is accustomed
at the oreation ot this trust, or during illn... or emergency.
s:(XTHI SUbject to the approval of Truliltee, anyone may add
propetty, real or personal, to the principal or thia trust by
deea, will or otherwie..
SEVENTH I Trustee may receive reasonable oompenaation at
prevailing' rat. a , for fiduciariea should h. be ~isposecl'to request
comp.n.a~ion for services renderecl. such. paymenta shall b. made
from time to time during the period over Which its a.rvices are
performed.
EIGHTH I Settlor reaerves to himself the right by an
instrument in writing intended to take effect auring .Settlor's
.lUetime &ligneabY settlor ana aelivered to Trustee to revoke or
elmend this agreement. in whole or in part proviaedthat the
duties, ,powers and lielbilities'of Truste.e shall n9t be
f:lubstantia~ly Changed wi,thout his written cons~nt.
NINTHI The situs of this trust for adminiatreltive an~
aocounting purposes shall be in the county, of cu~ber1ancl and
, ,
Commcnwealthof Pennsylvania, elnd all queations pertaining to the
construction or vellidity of the provisions of ,this 'instrument
shall be governed bY the laws of that commonwealth..
IN WITNESS ,WHEREOF, Settlor and Trustee has hereun~o set his
hand the daY and year first aboVe written.
witness I
/' " //( J~ .. I
c. ;l~"'l.::<r (..,( , A,Cd,
. (./. V.
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J~selo; J 4. - J1?
(SEl\I1)
($'/I.tl" /;./I}', 9. 'jv.!., II
"/ " j".-'~'
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a..~~__< . ;3 B..- }:;f (SEAII)
Trustee ..
(l
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SOHEDUt<lll ~
I'
S'l'OCl<S
3" C01\lpatly
G'l'1ll ., ,
PP&L
IBM
, Allied siqnal
Ford Motol:'
HaleS By.
Denton B. Burel
140
415
100
:1.12
118
66
H.~d sy. '
CompanY
47'
3.ll15
6119
208
276
4
, .~..
FUNDS
Dr~yfu. strataqio Aqqre.aive
Dreyfue Liquid. A.,..t. "
OreYfUa WorlelwieSe "oney,Market
Bull anel Sear capital Gl:'owth
IllVel:'gr_.n 'l'o~al R,turn
Dreyfua 'l'aXIllXempt Bond..
lB15 '
10,1598
26, 046
5,9153 '
, 625
115,10'6
"
~.~,Id 'IJ...~ ./
Denton B. Burd
, 0/.~1rO
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.
.
.
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A. Sho"ld my said Ion predece~sw me and be survived by
"any' children, then hil IjIhare shall qo to his chilclren Jali:
Dtir~~,. Shoulcl my Raid Dcn praaeceas. ms and not b, survived by
any childrljln, th.n his share shall qo to The Salvation Amy /
'currently located at 1122 Ore.n street, P,O. Box 2208,
Harrisburq, Pennsylvania 17108.
B, ShoUld one,ot my named qrandchilclren have
predecea..cI me and havs b.ell survivecl by a brother or sister III
the: cau may be, ,thiln such, eleceued qrandchilcl's share shall qo
,'" , -'.
to such survivinq brother or sister as the cas. may be, ShOUld
both ot my namecl qranclohildr$n have predeceasecl me, then their
shares shall qo to their,natural tether, Denton B, Burd, Jr,
Shoulcl he also have predeceased me, then such shares shall qo to
The Salvation Amy, durrently locateel at, 1122 Oreen Street, P.O"
Box 2205, Harrisbl.\rq, pennsylVlI.nia :j. 7108. '
'j,
6.
" '
Shoulel either or both nt my namecl qranelchilelren be le.s than
Ii
the aqe of twenty~tive' (:l5)Y8llrs at the time ot'my eluth, then
the respective residuary share,S' of any' qrandchild le.. than the
' " " ,
aqe of twenty...five (211) years shall be phoed in trust, my sdcl
son Denton B. Burd, Jr. to be trustee, or shoulel he be Unable or,'
unwillinq to serve fcr any reason or cause Whatsoever, then CONB '
BANI< NA to be t,he alternate or sUooessor trustee, fltlr, the
followinq purposes I
A. The incqme from said Trust Estate, AS well as
so much ot the principal as is needed ,accordinq to the
discretion of the Trustee, shall be useel and expendeel
tor thCl I"pport anel maintenance, includinq medical,
surqical and hospital care, and qclleqe education, or
'other such formal eelucation, such as any internship,
apprenticeship, residence, clerkship, cr the like, ct
saiel qranelohild. The elecision of my Trustee a. tc the
oompletion ~f formal eeluoation by my said qrandch11d
shall be Una!.
2
, '
II
! i
.
.
"
"
(8) Tile amount to be, pai4 for t~e beneUt of lilY
.. .aic1;r,n4gllilel ,hall be determined trolll time to
tilll.e ~y tll. l1eed of the laiel grandohild" ancS the
alllounta ancS tilll'. of laidpaYlllente Ihall be determinld
~y augh need, The laid paymenta lIIay be lIIade by my said
Truetee directly to the laid grandchild, or if, in the
eole opinion cf lilY Trustle, saidqrllndchild il of auch
Me an~ ability to handlfl prop"rlY the fUndI they \nay be
paid direotly to luch grllndchild, or may be lIIade by my add
T~.te. directly to thl person-naving ,tile custody and care
of. the s~id qrandohil4, or may,blmade by my .aic:t Truatee
direotly to any in'stitution entitled to SUOh payment by ,
!,
"
rlalon of service. rendered or to be ~~ndereel to thl.aid
grandchild.
(0) To p~y the aooumulated inooma and principlll
then r.mainin9 in its hand. to the ..ic1 gral'\dohild,' .....\'I.n
the qrandohild shall have e:t\:ained the age of .tw.nty-five
(215) yearl.
(0) I diredt that 'the inter.atl of all beneficiariee
in the ~rust herebY oreated, whether in the principal ,or
income thereof', sllall be free from liability to. attaohment
or' other le9alprooe.. issued at the instance ~fllnY
creditor or.assigne. ot such benefioiary, and I direct
that nO payment shllll.be lIIade by way of anticipation cf
sums whioh may' therearter Ilocrue to any bener~ciary,
(E) If the Trustee hae taken into the Trust Estate
Ilny real estate, and aeTrustee ocnsiders it feasible
,to .sel:/. the sallie, I hereby authorize, empower and direct
the said Trustee to sell llt pUblic cr private sale or
I,. t
sales,. al'\d tOgonvey any such real estate to th$ pur-
ohaser or purohasers thereOf, and to give good and
suff ioient dasd or deeds for tqe same,
(F) In the eveh~ that lilY said grandChild should
I ' ~
survive ilia, but sh9uld d~e durin<l the term of this 1;rust,
3
"
.
.
"
~h'nhh Ih,at' Ihall bedhtdbut.d aec:ior~inc;r to the
~!'I.tru~tion. in,.panc;rraph 4 (~) abeve .it: hll Will a minor, 1...
th.nth..;. ot! eiqht.en (18), at the time of hb'd..t:h.
Should 8uoh c;rt'andehil~ have attdne~ the aqe,ct! e.1c;rhhen
(:1.8) b.llon tile timeo,t! hh death, then n,ie .han _hall l:Ie,
oontrolled by his last will and t~.tament. Should he net
haVe exeouted a last will and ta.ta~.nt, than hit .hara '
.hall be controlled by the inte.tate laws, oil pennsylvania.
Should he have no eut'Vivin; heit'. withihthen.eeelary
deql'e. ot! eohllAnquinity, to take uhder the, inte.tate lawe,
than th1l share shall gc to the Salvation . Army ,afol'eeaid.
;,. ,
6.
J: nOll\inata,. eonatitl,1t1 and apS;<;lint my 801'1, Dehton ,8. BUt'd,
Jr. a. txecutor of my Eetate. In the eVlnt that he i8 unable or
un'1ill~nq to ee!:'VI in luoh caJ;laeity', I appoint the OCNB BANI< NA
to be the Exeoutor in h1l place and, stead. I dire,ot that thlY "
shall nQt be required to file a bond to .eoure the faithful
",
perfo:rmarlce of their duties in any jurhdictiol'l.
7.
I authol'izeand empcwer my,perlonal repr,.entative, in his
I" ,
sola' and absolute discretion, to purChase or otherwi.e aoquire
and retain any investments of whioh I die seized, cr any real or
pe;,.onal property of any nature, to .ell,1ea..,pl,edqe,
'I
mortqaqer tranehr, 'exchanqe, dhpo.e. ot, or qrantoptions in
"
t$qard to any cr all property of 'any kind fOrming a part ot my
Ill.tate foreuch terms and such pdces as he may dum adVisable,
~o borrow money for any purposes, connected. with the proteotion
and preilervation of my Estate, tomo;,tqalj/e or pledlj/e anY.realor
personal property forminlj/ a pal't ot my Estate, or to join in Or
, . ,
se,ol.\rel t~, partition ofsamer 'to compromise any cla~ms or d.mancl,!iI
,
,of my Eetate alj/dhs~ othere or of others aqainst:. my' Estate, to
,.! .,
mllke ,distribution in kind and to oauee any Share to 1:18 composed
pfeash, property or undivided fractional shat;~s in Property
different in kind from any other ehare, and to execute and
4
,
\,'
"
"1__
.' ..1
O'i
PURPon O~
HOTl~.1 To INlfll1 Ih. roMNlro..nll DI ".Ilon II~O DI Ih. lnh.rllon.. Ind KII.I. To. Aol, A'I 1101 1991. (71 P."
"oll.n ,91~01o
PAVICHt,
O.tIDh Ih. to. porll.n oUhllHollu ond INb.1t IIllh VDNr P.Vllnl ID Ih., R.,III" of Wltll prlnt.d Dn tho
r,v.r.. ,Id'l '
.. Hok. .h... or .Dn.V Drdlr p.v.bl. I" RI01~tl~ O~ WILL', AOIHT.
A.~UNO'(CR)I A r,fijOd Df . I.. .rldll, "hl.h "II n.1 r'.Nlllod Un IhD t.. rllNrn, "V b. r..".ot.d b. DD.plllln' .n "Ippll..tIDn
fOr Allund .1 P.OOlvl,'nl. Inh.rll.nu. .nd 1,101, T.." (RaY-IIII), Appll..tl,no .r. ...11..1. .1 Ih. Dill.. .f
Ih"RogIII" ul WIIlI"nv Df,th. II R....nN. OI.lrlul Dill...'" bV u.lIlng Ih. Ipool.1 1~'hoNr .nlll.rIOll ....Iu
n"ob" , for lor.. Drdorlnu, In P'nnIVlvonl. '-100-111-1010/ Dul.ldo P'nnlvl.,nl. .nd "lthln 10..1
HlrrlobNr, "..' (717) 717-109~/ TOOl (717) 711-UII lItl"lng l.p.lr.d Onlv),
OI~I~TlOHIl Inv,portv Inln,tor"l not IItlll,l.d'IIllh Iho ..pr.I....nl, .IIDllon.. or dl..IID".n.. D' d.d",UDnl Dr ........nt
uf I'. (Inuludln, dll.D"nt or Int.r,"tl .0 ohD"n On Ihl. Hotl.. '0' obl.ol IIlthln II.tv (601 d..1 of r.o.lpt 01
Ihll H.Il.1 bVI
-'"rltl'n prot..t tD tho PI h..rt..nt 01 R"'nN', lurd of ApplOlI/ O..t, 111011, !torrl",,/D, PA 17111.1011, OR
...l.otln, t, h... Ih. ..tl.r d.l.r.ln.d '1 Ih. ."dll 01 tho o.oo"nt DI tho p.r.Dn.1 r.pr.l.nl.II... OR
M.app..l!to thl.orphln,l Court
AOHIH'
IDTRATlYK
CORPICTlOHIl
IHtlRllt'
Plo~ull Irrors ~1'ooY.r.d on thS. ........nt .ho~ld bt .ddf....dJn writing tal PA a.pert..nt of R.y.nu.,
RN""",ol Indl.IIlu'1 T..../ ATTHI PU'I A...,I..nl RIYI.II Unit, OKPt, 180601, ""rl'bur" PA 11118'''01
Phon. m71 717."",, ... pou. I uf Ih. bo,kl.1 "In,lruDllunl for Inhorll.n.. T.. R.tNrn I.r , ...ldOnl
D.o,dtn't" (AIY,UOt) far iIl".)Cpll"IUO" of,dlllnhtraUvlb ,Qorrutlble Irror"
If anv t.. .". IIp.ld III thin Ihr.. (J) U'l,ndor .onlhl .ft" Ih. d...d.nt'. d..lh, . fly. p.ru.nl (~HI
, dhoollOl 01 tho I.. plld," .lIu".d.' " ,
Th.,m t.. 'OI1"IV non.p.rllolp~llon p'n.IW ,II ~..pul'd .n th' 101.1 01 W. I.. .nd Inlor.,'t .......d/ .nd,n,t
p'ld b,l.r. d.nu.rv II, 1"6/ th, Ilr.t,d.v .fl.r'lh..nd ul Ih. I.. ,.n.olv p.rlod, Thll nOn-p'rtlolp.tl.n
p.n.lh 10 'PPl~I.bll In Iho o~.. ..n..r, ond In Ih. Ih. .... tI.. porl,d " ~.N ".vld opp..llh. h. .nd l.t,,"1
Ihol h.1 b... olo"I.d .. lnato.t.d un thll nOllo.,
Inhrlltl' ,h.r.ld b..tnn!n. IIllh flr,ol ,0vDfdllloqu.nov, or nln. (OJ IOnlhl .nel Dnl ell d.v
Ir.. Ih. d.lo of d..\h/ loth. d.l. Df p.v..nl, T...I "hl.H b..... dllln'''lnl b.lor. d.n".r. I, 191'
b..r \nt..ut'oHhO r.l. ",11' (6~) p"oo.lp" onn". ..I.ol.l.d .t . d.IIV r,.1i .1 ,OOOU~.
All t.... "hl.h b..... d,lln.uont on or .11.r Jon"lr. 1/ l'laolll bo.r Int.rl'l It . r'll IIhl.h 11111 ..r. frD'
G,',ndlr Va.r to'olllndlrt..r with th,t r.tl Innounold b~th. PA Dlplrt.,nto.Alyenue, Thl.ppl1olbS.
Int.r"1 r.I.1 lor I"l Ihr."uh 1"1 .r'l
, '
OISCOUHTI
llllHALTYI
~. Inti,.", A.tl o.llv Inl.r..1 ,..IDr Vllr tnl.r.ll R.h 0.11V lnl.r.lt F..IDr
-
1111 UK ,000lQI 11I1 'H ,000147
1911 UK ,OOO~SI ""-1991 ilK ,000101
"10 IlK ,000101 I'll 9H ,000107
"" II~ ,000116 1991'1990 IK ,0001la
1916 10K ,000170 1991-1'91 'K ,00or07
"Inl.r.ot I. ..lo"I.I.d.1 f.ll.,,"
INTB_BIT . IALANCB a~ TAM UNPAID M NU"BBRa~ DAV. DBLINQUBNT "DAILV INTER~.T PAaTaR
..Anv Hotto. I..u.d Ift.r th.t.~ bIOO.I. dellnqulnt WIll ,.f',O\ In Intare.t olloul.tlo" to flft.,n'etS) d.yt
blvond ,tht d,tt of thl ........nt, 11 PIV'I"t II ..de Ut.r thl InUre.t OOlput,Uon dati ahown on the
Hattel, Iddltlonll 'ntere.t I".t be G.loulltld,
COHHOHHf.A~!II Of. PEHHmVAHU
Of.l'ARIHEHl 01' Rf.VI:HUE
RUHUU OF 'HOIVIUUAl IAREI
Uf.PI, 11060\
IIAHRIIIIJflO, I'A 17111'0101
*'
INFORMATION NOTIce
AND
TAXPAveR RISPON8B
FILa NO, 21 97-0658
AON 97143762
DATIl 10-14-97
tVPE OF AOOOUNT
EST, OF OENTON, B BURD ~ BAVINOI
S,S, NO, 183-12-3726 CHICKINO
DATE 'OF DEATH 07-211-97 TRUBT
COUNTY OUMBERLANDCBRTlF,
RBHIT PAVHBNT AND paRHI Tal
~B~i~~E~N~Fo~I~a~RT H~USE
OARLISLS; PA 17013
Ilf.IUII1&HII.tll
,JOANN M BURD
802 BRIDGE lIT
NEW CUMBERLAND
PA 17070
HARRI. IAVINo. BANK h.. .ro.I~I~ Ihl 01.11 IlInl Hllh Ihl In/.,..\I.n 1I111~ .lloH 'Hhl.h h.. nlln .II~ In
Cl8loullting 'hi pot,nthl h)C dUll lhelr "Icorti, l"eHOIt. the, It thl tll.th of thl 'bove dIOlflt"', vau w.r. " JOlntfowliu/b.n,fttll,ry Qf
thh laoount, If vo~ f.t. thh Infor.IUon h l"corrlGt, pl....,obhln wrlttln oorruUcir1 fro. thl nnl"olc.l In,\I\"Uon" ,Uloh .oopv
to '"'' for. ftnrl rlturn It to the "bOYll IUhfr..", Thlt, "f1n1'1lmt h t'l::__lhh In,nco(l('rd'''n wl~h .", l"h" IhMClQ 'IlH Lau, of UtO Cotlllonwlr.Uh
of PlnIIlltl"I"I" au..Uon, "'V bt .nl~.,.d bY olUl"o C111J 1.7"..,1l" ,
OOMPLITI PART 1 BILOW" "" III RlIVIR811UDI FOR FILING AND PAVMINT IN8TRUOnoN8
~ooount No, OB-00102068 Dlt. 12-06~83
l.tabU.h.d
71 J , 3~
561000
355. 67 HOTEl If to. .oV.lnll .rol'~1 Hl\hln Ihrol
U} lonth' of th. d.o,tl.nt', dtt. of dtlth"
,19 ... ..V ~I~.ol . IX dl....nlof Ihl lOR dlI',
Anv Inhl,".no. 'IN dUI Nil n..... d.lln",,"",
Pot.nUIl T." aUI 53,35 nln. UI ..nlh.ll\.. Ihl dltl ./ dulh,
Prrr .."",S,I.U"I~P.\~"~Qt41;~~~W,"1I'''1.;~;~~~~:l!''~::;li~'~:;;A".!I.t4~t4r'~'.lliQ,t4TH~.:tlQr~qai
Aooount Ilhno.
P.ro.nt TINlbll
AMount BubJ.ot to T."
To" Rlh
To Inl~r" prop." or.dlt \0 vour looount, two
(2) ClOP'" of this nClUal "u.t tOoUPlny vour
Plv..nt to thl,RtGl.tlr'a', Will., Hlki ohlqk
PIVlbh tOI "Rlght.r 0' Willi, AI.nt",
M,
H
[CHECK ]
ONE
BLOCK
ON LV
Thl.bOYt 1"lorIlIUO" .nd tax dijl ,l'C1orr.ot.
, Y.u IIvoh.... 10 rlll\ pIV.lnl '. Ih. Pl.hll' .f Hllh Nil. IH. 0..1.. .f Ihl, n.tI.1 ,o,obl.ln
. dl,oount or avoid tnt.rl", ar 'you ..V oh.ok bOM "A" tnd ".turn thl, 'notlc. to th. R.al.'e" of
j' Wlll',lnd ."'offlol,1 ........nt will b. l.lu.d bv thl PA h.part.,nt of Rlv.nV4t
I, ~ ThIlL'bOYI ....., hll bun or "111 b. ,.por't.d an'd 'tlMPlld "lth the P.nnhh'~"'. Inh.rlt.nol TIM return
~ to DtdUld bv tht dlo.dlnt', "lprl..nt"'Y'1 ' j
Q, 0 rh~ .bov,' In'or.,,\lo" '~noarr.ot and/o~ebt' and deduotlont "Ire PIld by ~ou,
Vo. ..,t ooo.lltl .A~T L!.J"n~/.' .A~' W nllOH,
If you i"dio. . . dUf.rl" ~N r. ., p .... I . . your
r.lltlonlhip to d.oldlnt,
A,
PART
[!]
TAX K~TU~N . CQHPU1ATlUN U~
LINB I. D.t. B.t.bll.h.d 1
e, Aooount Bll.no.' .
S, p.ro.nt T.""bl. S
,,4, AMount iubJut to T." 4
S, D.btl .nd a.duotion. I
6, AMount T.""bl. ,6
7, n" Rot. 7 w
S, TIN DUI a
'TAlI o~ ',"1I1N" ITHU.T ~llUUUN'lll
J\j...~. .. ,",
1-'7 II' ,"/ 'J ,
-r.. .. III
W c.7} ~I'o
~'~''';r'-r.:''/~
"=' . .
,9
'3 <-I~ t: '/'
/ r.l r~j
....- "Ii
I: . . , ','. OFPICIAL.USE ONLY .DM~
.:' >,P~l!~PAI{T"'.EI!T.OP'I{EV~N.!!L.Tl
':':~.~i;:i:~:" ..; :':r ""';:}:j;j:,:,;,':'i.;: j' '.""~"""'."'j:;r;,:';,'\;:,::;1:,'jf:::f.!';.:,',:'
::n!',tjj;:Z,i;:: '" '" . ;:;>.U::,;" ',::" '
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,: it"
,.11' .
;,' 6<' i','",' ).:" .
7
8 '''. ,.
"'il
.,',"
I',
,j
PART
[!]
DATE PAID PAVEE DESCRIPTION
~nt"A~"":" "~I" P"I ~'~lL"J :t-J :"j~:_ _
'M , ,,,.:, '" :;.i ... ... ,....;.....,- ,
Und.r p.n.1ti.. of p.rJury, I d.o1.r. Ih.t Ih. f.oll I hl.1 rlport.d .nOy. .r. tru., oorr.ot .nd
h to tho but of M~,knowl.do' .nd b.U.f, HOME ('II"!) "),/{/. / 9/f..
WORK (-;1)) :..}) (/ .: (., [' /. '1.
TELEPHlmE NUMB Ell 'TlATE
DUD
o 8
AMOUNT PAID
,-
...
Itllt/Ii )
,
GENERAL INFORMATION
1, PAILU"I TO "UPONO WI~L "UULT IN AN OPPICXAL TAM AIIUIHENT wllh IPpll..bl. inl.'lil hllld on In,....lIon
.ub.lIl.d b. Ih. fln.n,I.1 In.lllull,n,
2. Inherlt.nol "IC b.ao.... d,UhQU,n' III". .onU,. ,UIt' thl ".alu.nt" II." of d.~'h,
I. A Jalnt laODunt 1. ,,,ubll Iy.n thllillh th. dIOld_nt1. n.~ wu Idd.d,U .. ..tter of Gany.nllnall
~I AODOY"" (Inoludlng tho.. held hltw.." hu.band end wlf" whloh thl d.o~d."t put In Joint "ft." wlthl" on. Vier prior to
d"th Ire fullY 'IM_lil. .. ,,,,",fir..
I. Aooount_ ;1I'.bUthld Jol~Uv h"WI'" hUlband and wlfl .or. thin em. y''';- prior tfJ d..th ~r. not \lMlbl"
6, Aooountl hlldbV .'dlnd,n' "In tru.t !or" ~,noth..r or o,h.,. .,. h"lbl' fullY,
REPORTING INSTRUCTIONS . PART 1 . TAXPAVER RESPONSE
I. aLOCK ~ . If thl Inforllll,'ton IndaOt,Hltttleu' '~-th. notlCII Ir. oorrlO\ Rnd dtdulltlon,.rt not b.ln,Ql.1.id, phot ftn "X"
In blo~k "A" 0' P.rt , af thl "t'IIP'~1r R"floM'I<< 'lothIM,- 'l,n two oopl.. Inti '\lb." thl. w"h your Qhluk for thl ..OUI'''of
tlM to thl R..I.tlr Qf WUlIa' th. OQ\mtv ,lndlut,d. thl PA Olpart.'tH af Rlv.n\l. wUl itiu. In aftlcl.l ",u,,"n\
IFo,. RIV.ml 1M) ,""n ,.,.lpl '~, Ih. ,.\U,n I'.. Ih. Regl.I., ,f Wlllo,
I, ILOCK I . II th. ...., ,p..IIl.d ,n Ihl. noli.. bO.b.,n or will b. ,.po,l.d ond II' p,ld with Ih. P.nn.yIY.nl. Inh.,llon,.
TIM MI~urn fUld by thl dlc,d,ntl. rllprl,lnhUy., pllol 8n ")('. In-blook III" of Partl_nf th, "TeMPIYIr A..ponn" 'Iotlon, Ihln on.
oop~ IItt1d return to the p~ Piplrt.tot of Rlvlnul, Burlnu of lndlvhlull T.ntll, 01'" 280601, Ihllrrhbur" PA 11UI.0601 III t"1
InYllap. provld.dj ,
s. noel( C . If thl nCJ'-'u Infor.aUon I, Incorr.ot end/ur dlduothm.:arl b.lng ol.lt,d, CJhlok blook tIe" Ind oOlllpl," Pftrt' , IndS
ICGordlng to thl ,,".truOUc'"'~11ow._ Ilun t..o__clipl.. Ind lun.1t the. with your ahlllk fnr thl IMunt at t.M PIlI.hll to t"_-M.glttlr
of Wllh af the oou~ty 1nd'oltldl Thl PA O.pert.lnt of A.vlnu. will lllu. Iln offloll1 .....IIII.nt (For. RftY-U~. EM) upon r.utp,t
.f Ih. ,.Iu,n Iro, Ih. R.gl.I., 'I Will.,
TAX RETURN . PART 2 . TAX COMPUTATION
nc
"
~IHI
1. Entlr thl d.t. thl l4loount orlglnaUv w., "tlblllhed or \ltlid ln -the ..nn.r IHltUng It dtlh-tH dtathl
HOTI. Po" do..d.nl dying .11., 11/1,/111 A..,unU whl'h Ih. d.,.d.nl pUI In l'lnl n.... within .,n, (I) ..., 'f "..Ih .,.
"Mlble full~ .. tr.ntf.rt, llow.Yerj th.r. h In IHelutton nelt to I~a..d 1,000 p.r tran,f.r.. rl'llrdl...of thl YIlue of
the ,.0ClOU":tar th, nuabll' af looount. h.ld. '! ' ': ,:i '
If 1_~oUbl~ ..tlrl.k ("") ,pp..r. b.far. your fir.' nl.. In thl Iddr." portion of tHII ~Q'lo', thl .~,ooo .~olutlon
..lr.id~- hi' bltn dlduot,d froa the .aoount blllllnOl II r,portld b~th' flnlno III In.tt tuUon, ._,
I, Int.r the tot."1 b.l.l\c.... of thl -lOco"nt tn.o1u.dlng Inttr"I,c;loru,d to tHi d.tl Qf d."'hi '
S. Th. pwrcln\ of the 100Qunt thll h tIlltlble for lIoh .urY yor it dater.lnad .. follow,'. '
A. Thi Plrc.nt \lM.bll forJo nt .....t, a'\Ilblhh'td .01'1 tha" one y~,r pdal' to tha d.o.dtl~~j. dll\hl
1 'DIVIDED IV ,TOULNUHIERDF OIVIOIO IV Tom HUHIER OF X 100 . PIRCEWT TAXAIlE
~OIWT OWWERI IURVIVIHO ~OIHT OWHIRI ' '
1,.I.pl.1 "Joint ....t r.,lt1.r.d In thl n'" of thl d.Oifldtlnt and two oth.r P."onl.
I, DIVIOIOIV I (JOINT OWHIRII OIVIOIO IV I (IURVIYORII . .16/ X 100 . 16,IX lTAXABLE FOR IACIlIURV1YORI
\Ji
I. The pertlnt UHIbII far I..th ar..t.d within on, val,.. of the dle.d.nt'l dllth or ,aoounh ownld bv thl dludtnt but hlld
In I,u. 10' on,lh.,' Indlvldu.lltl II,u.1 b.n.f 1,lft,IIII.
I DIVIOED IY TOTAL HUHIIR OP IURVIVINO JOINT
OWHERIOR TRUI' .~HIFICIAR1E6
K 1'0 . PERCIHT TAXAILI
EM.apl., Joint noount r.ghtlrld In 1h, n.a. of the dlo.d.ntllnd two eith.r p.r,on. Ind "hll1hhld w"I1I,,-onl V,'-r of dllth by
th' dlc.d.nt. ,- .. - ,
10lVI,OEO IV 1 (IURV1VORI) . ,10 X 100 . lOX ITAkABLE FOR EACH IURYIVORI
. . . . i.
~, T~ .""unUubl..I, 10,'" (I In' ~)l. doll,.ln.d b. ,ulllplYlno Iho ,..ounl b'I.,n,. IlIn. I) b. Ih. P.,o"."' 'I...hl. (lIn.1," '
I. Inhr thll '"l.. Q~ ttlt dltlt. t.lld t,I.du" HUfl. 1 hhl~ 1'1 P., ~ 3. ..-. . " . - -. .
6,' Tit. ..ounl I...bl. 11 nO 6) II d,l."I"," b. '~bl,.,lIng"lh. dob\l .nd dodu,II,n. (IIn. I) 1'.0 ,Ih, .oounl .ub'j.OI Itl I.. (IIn. ~) i
I, Inl., Ih. .pp'op,I.I' '" r.l. (lIn. 7) .. dll"oln.d b.I.W, '
Al f'CJr dlt.. of de.th ooourrlno -""II' '/I0I9~" -the t.M rite, for tranlf." to ,POUIII arl .. follow.1
I, 0.1" of'd..lh On 'r .mr 111/9. .nd b,lo,. 1/1/91 Ih. ,.1. I. IX,
I, D'\I. ofd..lh on',o, ,"" 1/1191 ".nlf." I' .p'un. will b. loud .1 OX I.' ,.,.,
H.'.' P., dOl.' 01 d'.lhp,lor 1'111/9. I'.nll.'. \0 .puu... .rs I",bl. .1 6X.
I. .Tr..,lf.r,1 to 1,lnll' dil4lnd.n~,; nOludl"Ii"Uher,.othlr, 10", dluaht.r, gr'"dOhl1dl'ln, .0n-I"-llw,
d,,"onl.'.ln~I"( ,.I'P'hlld on, Ih,I, h,u, .'0 I.,.bl. .1 .1. "",.nl 16X), '
CI TrIM" II" to.1 othtrli _",IUIH!i. brathll', .I,tll', unQ'JI, aunt, ""phlw_ Ind nl.o. ar. \aMlbl. at flftun PlrOlnt OIH).
0, If lI'OU Ohan'l tht '~M rt'l, pi.... ,pl01h your ,rll.Uonlhlp\o thl dlc.dlOt In the ,rea provld.d,
6, Th. ..ounl,ol 'I.. dUo IIlnll) Is d,I.,olnld b. ,ulllpl.lnl Ih. '.bunl 1I'.bl. llln. 6) b. Ih. '" ,.1' (IIn. 110
CLAIME~ DEDUCTIONS r, PART S
DEBTS AND DEDUCTIONS CLAIMED
AlIoliobl. d.b\. ,ond d.Q~,'II.np,. d.I.,.ln.d .. loll'."
Ai YoU 11..1I~.r. rcliIPO"llbl' for ply.,"t, or _thl ..tete 'IWJlllot to .d11lnhtrIUon b~ , p.r,o~ll "IPrI,tI"htlYI " IR.UfU.l,"-t
to PIli' th. dl~uctlb1. tl",
I, VO~ lotUIlh Plld thl dibtt IHI,. dllth of thl dlOld.nt at1d OIn fur"llh proof of pIya."t.
0, D.bt. bllna all lid au.t b' H'.lnd_ fuUV In P.rt I, If IddIUo",1 _.pao. " ""dad, Uti phlln p"per . 1/1" )( un. Proof Of
PI~"nt "'V b. "qU,U'd by the PA D.p.rt.,"t of AIYlnue.
ilGXVS~UI!~EN:llt\TsH,I!Rpl*fX{T~~~Xo~~AA~ljiNTICDEI'STCROINJTACOTpFAfJs" .', .,
HARRXg~u~aLkTT~~1'~R~~~.g~2~~DX~~g~A~7I~~E~72!~~~~V~nE1~~~&R1H~~I~E~NONLV)
~AvtlIlO'l
Del..., tho tOfl po.U"" of tM. Hollo. IlIld .\lIlI1I willi VOIlr piVl!tf\I ..... pov...l. 10 1111 """ ,1lIld ~ro..
p.lnlod '"' 1111 rov.... lido,
-'If 1lIl8lillitl Ill_Ill...... ??1OO\< or """,V V,do. p.V"'lo lo( RllllfTSR 0' 1I1~~a, AliItO',
__ 111401l-lImflllHl 1H!I;IlIIHl, ,......_k or _v oNlo. p.v...l. 101 cOl1ltOHWIA~ TH 0' ~1HH8V~YA"IA,
IlIlI'IIIGl(Cllll A rol~ ,~f!' I....odll, whloll ." nol ,...,...I,od "" lho 1.. 1I.lu,n, ..v b. 'lIqIIt!.lod bV _1.Unt III
"Afoto\looUon f., R.fundbf P<ir<I'Vlv,"l~ 1,.....'11..... 1lIld,~..I.I. 10." IIlllY-ISIS) , AfotoIl""llon. ",o,voIIOl.I. .t
t/)o.Offl.' ./tllt IIl1hl.t ,of Nllh, IIIV 01, I'" .. lI.v,"", Phi, lot Offlo.. ''', fr", tlio Ptporl_I" '4-ho\l,
IIl.wo.11ll ,.,vlo, nuibt.. f., f..o. O'dO,lnil In P,""'VIVIIII. 1-100-S6",DID, GUI.ldO ponn'Vlvon"
Ind .llhln 10..1 Ho"I.bu" or" 17171 717-ID94, 100' 17171 77....1. lHoo,lnt l..ol,od ""Iv),
IlIlPLV 101 Quo.Uon,,"..dlnfl or'o" o""lolnod on Ihh nol'o, ,hOllld 1M tddro...d 101 PA Oop.d..1II %lloyOfl\IO, IUroiIU
of 1""',vldU~1 1....' AlllI' po.1 A.......nl II.Yloo Unll, Oopl, ..D6DI, tI...lobU'., PA 1711I1-0601', P......
17171 7'7-6101,
PIlCOWl, ' 1f IIIV to. !Iuo I. p.ld wllhln th,.. III 0'1''''''' ..nlh' oftor lho dooodlnl'. dOolh, 0 fly. por.onl lilXl dh....,'
o,f \hi to. pold h oll~,
P8f1AL1\" TI1I IIX to. ..nutv non-porUolp.llon ponollv'l. .oopulod on ,Iho tolol of tho I.. ond InloroO\ .....IIOd, IlIldnot
p.ld IMfo.. Jonuorv II, 1996, lilt 11,.1 dov .lIor tilt ond of 1111 t.. -OIlY po,l.d,
11I1,,",'1l 'Inl.,..1 h ohirtod IM.I,,"lnt IIlIh 11"1 d'V./ ~,Ulnquon.Y, .r nino (91 oonlh. ond ant (I) dOY froolho dot.,.f
doIlh' to lho d.lo .f p,v,,"I, 1.... whl.h 1M.... d.llnquenl IMfor. J~.rV I, 191' lM,r Inl.,..t 01 tho r.t. of
.10 (6~1 p".onl Por """"" ..10111.I.d 01 . d'UV .ol',.f ,00011q, ,AU I....whl.h ,_dollnqu.nl on Ind.ft..
Jonu.rv I, 19U,I,IIIM., Int.,OII .1 . ,.1. whlnh .11I, vi'V /roo 0.1.""" VOl. I. oollfl\l!l' voo. ,lIh thill rol'
ohi1ouno.d bV tho PA P.port_1 .fll.v....., 1111 ""pll....I. Inl....t "1.* f.' I.,. Ih,O\IIIh 1991 orll ,',"
;;,j " "
VI.r Intor..1 R'I' O,IIY Inl"OOI P'.lo, V..r Inl"OII R.to pollV Int.,..1 roolo,
- . -
10..' lOX 1000141 1917 ' 9X ,"01141
1.11 16X ,OOO~" 1.II.ml II~ ,OOOSOI
19M' lIJ ,ODOIOl 199. 'X ' 00OR~7
1911 lJX ,OODlI6 1990-1'94 7X ,000191
1916 lOX , 000l7~ 199IJI991 .X ,0101147
..lnt,...1 I. ..IOIlI.11d o. f~IIOW.t
IHTIR"T~,IAL4"C8 O~ TAX UHPAIO X HUKISR OF OA~B OB~l"QUBHT X OAI~Y I~BRqaT FACTOR
"'AnV Noll.. lGOUld .ftor lho I" 1M."" d.lln"",nl,1I1 rlfl..1 on Inl.r..t o.l.uhll"" I. Ufh.. 'lIl) doV'
bollOfld IhI d." .f thl ........nl, If p.ioonl h ..d.' .f1..,tho Inl....1 ~oopulOllon dol. ohot<n .nlt.. .
HoU." """IU...l Inl....1 01/11 1M o.l.ul.lad,
;;
I'UII'OR iii'
HOTlc:t:, To fUlfIll tho .....1'_1. .f Ioollon .141 I~) .f tho Inho'lI.... WlCI a.t." T.' A.t, Aol II of 1991,
(11 p,', Ioollon "41), '
PAVIlIlfT' Dotool1tho lop po,lIon of \!III ~II.. ond _II wllh ~OIl' p.v-t to lho RIII.t., ~f Willi p,lntlll on tho
rever.. .1.. .'
.. HoI<.,"'"'* .', _v......, povllll. 1., RBOI8TIIR or MII.LI, AllIlIT.
OI..-CTIIIIIII
_ (ClU' A ro_ .f . 'tllll orllllt ..~ bo '.....111I bv _1.11.. on "ApflIlOltlon for R.fund .f fIInn.vlv..l.
InIlo.ltorioo ond I.t.t. Tllll", (11I\I.11111, AppIlOlllon. or. ...IIIl1I. .1 tho Dfll.. .f tho RIlIIII.' ., Wlllo,
..v.f tho Q IhI_ DI.I,I.t Olfl... or f'OIlho OoIHI'I_I'. 14-I1O\l, .....'1.. IIrvl.. ..-.. fo, f.... ordo,lM'
In fIInn.~I~I.I."O'I6I.,.aO, .ul.ldo Ptnn.vlv..,l. WlCI wllhln 1...1 Ha"IIbu'. .,.. (111) 1'1-'094,
TIll. (111) 'I1..',U, (1tH,1.. 1....I'1d DnIVI,
M'i po,tv In ,nl....1 nol ..tI.llld wltl1lho ....._1 of I.. .._ on Ihll noli.. ..v oIlJ..I within
.IMIlI III) doll. .f ,".Ipl .f Ihll Nollo. bVI
..wrl,"n p,.I..1 I. lho PI Doporl,,",,1 .f RtV._, 100rd .f ......10, Dopl, 111111, H.rrl~rg, PI 1111'-1011, OR
~..IIIII.. 10 _ tho ..tt.r dol.rolntd.1 .u,Ut,of tho po'lOIlIl '1Il,.""I.llv., OR '
.._.1 I. tho Ortohon.' COIl,I, ' '
AOHIM.
IITIlATlYI
~CT10ltl1
FHI\III .rr/lro dhooyorlll on'lhh ....._1 .hoUld bo odd'....d In M,III.. 101 PI DIp.,I_, .f R.y"""",
IU,... of IndlvldYIl T...., ATlN, Pa.t.'......nl R,YI.. unll, loP I , "0601, ""r,lobo'., PA 111"'0001,
,_, (111) 111...... .... P'" I .f lho booMl.1 "In.t'IIOII.,,, for lnho'It.... T.. Rttu'n for . R,"dlnl
_I" (1IIY.IIOU fo' .. .""Ionollon of, ....lnhl'.lIv.h .0rr'.IIIlI. .rro.., '
IlnIllUT 1
, ,
Tho I'X I.. .....Iv non-p.,II.lp.tl.n p"""ltv I. .DlPUIIII 'On tho 1.1.1 .f lho I.. -.d Inl.,..t .....OId, WlCI nol
,pold bofo'. _'v II, I"', lho f1,.1 dov .fl.r tho ond .f tho t.. ......tv pO,locI. Thl.non-porU.lp.Uon
.....It~' I. _I.bl. In lho ._ .,..,.r WlCI In tho tho ._ U.. po,lod .. ~0Il MOUld _I lho I.. Ind 'nlor..1
thol ho. ...... .....IId.. Indl..I.d on Ihl. noli... '
F.. dll.. .f doIth on 0' .ft., 10-a.OI, penn.vlyonl. n.l.t. T.. b...d on lho Fodor.1 a.til. T..
,.Ium ~. doll_1 .1 tho ..pl,.I.lon .f I1II1t (10) .onth. f,.. lho dol. .f dI.,h.
, ,., dol.. of do.lh ,'10' I. lo.a-Ol, P.nn.~lv..l. ..1.1. T"b.1Id on lho FOd.,.1 .'I.t. T.' ,.Iu,n
boo_. doll_t .1 tho ..pl,.lIon .f .llIht..n C111 _tho f,.. lho dol. of do.th,
T.... ohloll bHOII doll_t blf... JlIlUlIrv I, IOU ""., 'nt.,ool .t tho rol. .f .1. (OXI PlrI",1 po, .....
OIIOIlI.tlll II . doll~ rol. ./' .000164. All I.... .hloh blo_ doll"",,"nl on or .ftor _'v I, I'U Will bo.'
lnt.,..1 .1 . ,.1. ohloll will v.'v f,.. ..1.....' v..r I. ..Iondor Vlor with thll ,.1. onnounolll bv lho PA
OoPI,lIIIlt .f R.y....., Tho oppllolbl. Intor..t r.loo for lOll th'OIlIIh 1999 .,., '
PlMAL'lY1
i,1
VII' Inl.,..1 R.I. O.lIv Int.,..1 F..t., V..r Inll...1 R.I. O.II~ Inl.r..1 FIII.r
- -
101. lOX .000114' 198.-1991 IIXi ,000101
I.n 16lI ,OOOU' ' 1991 9X .nOl41
1014 lIX .000101 1".-1904 1X ,000101
I'" IIll ,00DII6 1991-199. 9X ,000141
1016 lUX .000114 1099 'IX .1..101
101' 'X , DOOl41
..Intorlll 10 OIloul.lld.. follOll..
IHTaRIRT . I'LAH~ or TA" UHPAIO " HU"III or DAYS DBLIHqu~ " DAXLY ItrrIlR8IIT PAllTOR
,
"
'.AnV Noll.. IlIlIod '11.. tho I.. bI..... dolin_I will rofllll on Inl.,ut OIIIUI.llon 10, flftlO!l (1I1.dovI
blv"'" tho dol. .f tho .....-.1. If p._1 10 ..... Iftor tho lnl.,..t ._I.llondol. _ on tho
NollOll, od,Ullonol 'lntorl" ...t' bI..I.ul.tld,
"
P~Vl!IlIlI
1It1"" \111 lop ,",rUon qi Ihll HnU.. ...., _II ~lIh ~O\Ir ..._1 .odt p.~obl.lo lho I1IIN and addr...
prlnl~ on IflO I'IYIr" .111I. '
.. Ii llIIll1llIfT,llI~.. 0IlI<Ik or _~ord.r p.~l. lo,.ftI01IT8" Dp ,"Z~~I, AOINT,
._ Ii I<<iIhRttlDl1/T III_lIT ..... 0llI<lI< or _~ ordor p.~I. 10" COHIIONIfIA~TH 'OP pl"",V~VAHZA,
~,'IC!lllAr.~'of. I" or.,III, 1Ih1~' "", nol r_.lld on Ii" To. A.lum. ..~ bI r_.lad b~ ClOIpI.U". on
, "~lI..llon for, ~."""' oi'Pann.lIlvonl.ll\hlIrll--.'I,ld 111.1. TIIIC",IIllY-IlII). ~lIo.'lon' .r. ,1V.llobl. II
It\O Pffll!I of, u.:; Ratl.l.r of ""I.' on~ 0' lho U R.V....... Ololrlo' om... or fr.. \111 """"r\HII" I~'''''''r
on~rl", ..rYI..~ri' for f.~' orlllrl"., In Ponno~lvonl.'I'IOO'S6a.aOIO. O\II.ldo Ponno~IVlnI.
. and ~lIhln I_I ItIrrllllUro.r... (711) 717'1094. TObO (71n 77a.aua (ltI.rln'I'I....lrad onl~',
RlPLY TO' llUI.Uon. r_rdll1O .rron oonlllnod on'thlo noli.. _Id bI addr...ad 10' PA """.rllOllt of R.v....., aur""'l
of Indlvl~l. T..... ATTN, po.t i.........1 Alvllll Unll, 1lI!>1. a10601, ItIrrloburR, PA 1711'-0601, phono
1717'-7,7'6111,
DIICIQIT, If on~ 11M '...... 10 plld ~lIhln Ihr.. II' ..Iandar _Ihl, .fl.r tho dooodonl......lh, . f1vo po....,dm dl~1
of 1M Ip~ plld 10 .11-,
PlNALTV. ThI lax IIIIC _.llInon'Plr\loIP.Uon._lt~ I~ .",.pulad on tho 101.1 of Ill. I.M ond lnt....1 ......ad. ond nol
...Id blfor"Jonuor~: II, 1996, 'I~ flnt d.~ 1,I.r 1111 .... of lho IIIIC _.I~ porlld.
INT11IllIT. Inl,r.OI I. ~hlrllldlloolnnl"" .llh Ur.l dI~ ,Of dllInqUono~., or nlrie '(., .onlh. onclOl1l (II dI~ f... lho dolo of
dIIth, 10 IflO dill, of p._Ii T.... III110h lIfo_ dOllfl'lUII11 blfo.. JonuIr~ I. I'll bI.r, Inllro'l .1 IflO rol. of
,I.' IIXI Plr_1 'Plr onnuo Olloul.lad ., . dollll r.I' 0' '.OOOl".~I\ I.... IIhloll - dollnquonl,on ond Ifl.r
'JonlMor~,I, 1... .m bI.r lnl.root "' Ir.l. 1II110h .111. v.rll fr"" ..londOr ~ur 10 o.l_~~..r Wllh \hI1 r.l.
~ b~ lho PA""".r_1 of R.vonuo.",TIII.....1l0...1. lnl.rool rol..for 1911 IhrO\lll1,j999ar"
V.ar In,"r..1 RII. Pollv Inl....1 p,otor V..'r' inl.r..1 A.,. O.Uv Intor"l ...I.r
- -
,
I'll lOX .mMt 1.1...991 IIX ,000101
I'" 16X ,OOOiN 1.91 9X .oom1
,. 1tt4 IU , ,1001" 1,,5.1.... ''/11 1I00lOa
I'" IlIll .010516 199'.1991 9X .0001i1
1906 lOX, .om7. 1999 "" ,IOOI.a
1.17 9X .0101i7
~'I 100.hulAlad II follOll.'
I T I,'ALAHCB OF TAN UHPAID' lC HUHIIR OF DAYS DILIHQUBHT lC DAILY XHTIlUIlT, FAcrraa
._~~ HOII" loouoq .fll. lho I.. 1II0....dlllpquonl will rofl.ol on loloro.1 ooloulollon 10 flfl... (II) dlVO
blV!'!ldlhl do'. of IhI 11.....,1. If p._1 10 .1Ido .ftor lho lnlor"l o......lOlIon dill. - on IhI ..
NOlI", IMldlllc.n.1 Inlor..1 "".1 III oll...i.lod.
,.
"
PA-rl
Dtl.... Ih' lOP po,IIOn of WI.'"""" 1II1Cl..~II' wl\h'~OII' p."",,1 0JWlt PtVobl. 10 lho - III1Cl ockI'tt'
p,lnltd on'~ ,IVI'" .I~.
.. If ....11Im ...~ ..... otltok 0' ..nov o,do' p.vobl. 101 RlallTlR Of \fl~~" AalNT,
.. IfHOil'!lU11lIM1" IIIW1lfT..... ~., .....V o,llt, p.volli. ,101 cOHtiOllllIA~T" Of PI"",V~\IA"JA.
~ I~II A rofWl!l of . IIlI o,odll, !!hI"" W" !WII ,_.locI on lho TIM R.lu,n. ..~ bo ,.qu..I'" bV _1.11111 .. ,
"1I'l'1".,,,on for ,,"fUnd of fl<MIV,ly..l. l......rlltnpO III1Cl R,I.I. T.W" U!R'i'lm1, 1I'l'1I..lIon,..' 1V.1I0111. .1
~ '011I" of ~ R..I.I.. o,f WlIlt. on~ of lho ~ R'YII"" 0101,1.1 OW.., or f,'" 1'1'11)"'''-1'', WhoUr
OI,,,,,rln. oo,YI" nuollIr. fo' fo~. ..cIorIM. In pom.VIyonl, I'ROO'16"'''O, OIIUlcIoPom,VIY!lIlI.
ond ~Ithln lnoo~ Hor,ltbUr, "'11 (717) 717'1094, 1001 (711) 711.1111 ("",1111 lop.lrtd .nl~).
_LY TO' Quo'llon. r",r~111I "'.r' oonl.lned on thlt noli.' lhould bo ock\ro..ocl 101 PA Pop..I_1 of.R.yltOlO. lurOOU
of IncUYI....I T....' ATT"' pool A.......nt R.vlow unll. PlPI. 110001, Hi.,h""". pA 17111'060\, ~
(11717".om.
PlleouMTt If ..v'tiIM .... I, p.ld wllhln IhrH (II ..Iondor ...,Ih. .ftor tho do._I" dl.lh, · fly. po,oonl el~) dl..~1
.f ~ t.. pold 10.11-.1"
_LT'l1 rho 11l( IIlI .....111 ~'p,,".IP."on,ponllltV 10 '-'ltld'on tho tolll .f tho I.~ ond Int....1 .......,s, ond nol
pold bofO', _'V III, 1996, \hi fir. I dotl/,.flor lhO ond .f thO t.. .....tv po,locI,
IImllIITI Inl.ro~1 1.~ohI,ttd botlMl11I wllh flrol dI~ of d.lln_~' o,nln. 19I._lh. III1Cl 0l\I (l) d.~ f"'" tho dll..f,'
doith, to tllOdol. .f p."""I. T'~" whloh bo._ ~lInq\MlllI bOfo,. JlIfl\l"~ I. 1981 '1iN' Inlor..1 .llho rol' of
'olw 16Xl por\Ollll pO, .....,.~I.UI'locl .1 , dOlI~ rol, of .0001.-1, III t.... whl.h....... dollnqlMll11 on ond ,".'
_'V I, 191. will boor Inl"..1 .1 ."U ""l.h' will vor~ fr" ..I,",,"r V'" 10 ..I..-lor v.., with lhOl rot.
~,bVtl\l p, Poporl...l.f RIVonuo, lhO tppll.llbl. Inlor,,1 i.l.. f.' 1911 Ih,....,I'" or"
'j,
1M. llX .pOOI4,
191' 16X .OOOAM
1914 IIX .000101
1961 Ill( .000116
I,.. 'lOX .ooom
1917 9X ,000147
'iim-.r:.1 It oolOUlOlocI .. f.U.....
I , . 'ALAKCB OP 'AK,UHPAID
v..r Inl..I.1 R.I. 0.1I~ Inlor..1 '101.'
-
1'11'19'11' lIX .000.01
199. 'X .000l1?
1991-1"" 1X ' .000191
199IH99. 'X .000l1?
1'99 n ,000191
Voar Int...,1 R.t. b.lIV lnlor..1 ,lOt.,
.....
It, HUK8B11 OF DAYS DIL%HqUBHT It DAlLY Ilmllll8'\' PAO'I'OR
.-AnV ""tI.. ........ .flor lhO t'.~ "'9-' dtllnqLonl .111 "floal "" Inlorool oola.l.tlon to flIl-, CUI doV'
bOVond \hi dOt. of lhO ....._1. If p."",,1 It .oclI .ftor In. Inl....1 ._lOuan dOl. 11- "" lho
" ""U.., oddltlOl\lI Inl.,..1 ....11>0 ool..I.IId.
MAKI CHICK PAYAILI ANDRIMIT PAYHINT TCI
RI!IHSTER OF WILLS
CUMBERLAND CD COURT HOUSE
'CARLISLE, PA 17013
OUT ALoNCt,THn LXNI ... RITAIN LOWIR' PORTION POR YOUR RICOR!)8 ....
"'W;I.'4""i'l/'.~~lI'-r&1f;.,..nlllYf/lnWWAilfffAll6'I.Yt~';ili~~A"filllilJr..Att.CSQ7iIMi.bR'......-.-........
, ' D'i.A~~OWANOI"op DIDUcnoN8 AND A8'188HI~T olf TAlC '
ISTATIOP BURD DENTON B PILI NO. Z197-06sa ACN 101 DATI 12-28-1998
TAM RITURN WAil <<Xl ACCEPT_~ AI fILED <<) CHANGI~
RIlSlltvATION OO~O.R~INCt PUT~RI INTIRI8T . 811RIVIR81
APPRA181D VALUI OP RITURN IA81D ONI ORIGINAL RETURN
1, R..l E.t.t. <<Sah.dul. A)
a. etook. ~d pond, lla~dul. I)
I, Cla..1Y H.1detaak/P.rtn.r,hlp Int.r..t Cloh.dull C)
q. Hartg.g../Nat.. R.o.lv,",i. (loh.dul. Dl
S, C.ah/Sank D.p.,lt./Hl..; P.r..n.l Proplrty ISahldul1 I)
6, ~olntly OWnld ProPlrty laohldul. f)
7, Tran.f.r. leoh,dull 0)
B, t.tll A,,"t.
APPROVBD DIDUOTION8 AND IXIMPTION81
.. funar.l e~p"n,"./Ada, Co.ta/Hi'o, 'e~p'n'"' (Soh.dull H) /.)
10, Dlbh/Hortgl1ll Ll.blUU../Llln. llah.dullI) (101 4.1179.91
11. Totll Dlduot/.on. (11)" 111 . nl q 7~
12, Hat VI1III 01 TI~ Rlturn 112) 1.812,761.61\
la, Ch.rHllbl'/Govlr~'ntll IlquI.hl' Non-Illotld .111 Tru.t. (eohldul1 ~I ns) ,00
14. Hat V.1111 .fllt.t. sub4.ot to T'~ (14) ,1.812.761.61\
NOTal If.n "",,"lIIlnt wa, t..u.d prel/iou.1Y, Una,' 14/ 11 and/or 16, 17 .nd 18,WiU'
rlflaot ,f~gure. that inolud. the tot.l of akk r.turn. .......d to d.t..
ASSISSHINT OP TAXI' "
18, AM.unt 01 Llne 14 .t IpoUlll rlt. (18) ,00 M' 00_
16, AMount 01 Llnl 14 t"w.bl. .tLl.nlll/Cl... A r.t. (16)' 1 ,809 /8S6, 12 K. 06_
17, AMount 01 Lln.14 t.~.bll.t CoU.t.rMl/C1... a r.tl 117) 3,201\.92M'1'8,
la. Prinolp.1 T.w DUa" UB)"
TAX ORIDITSI
PAYHINT
DATe
!J: 19'5 "'/3
BUREAU Of INDIVIDUAL TAKe.
Il4ltfRI1AHCE TAM UIYIIllllt
Ul!PT, la0601
!lAHRla'"lf". I'A 11118"0001
COMHONWIALTH OP PINNSYLVANIA
DIPARTMINT OP RIVINUI
NOTICE Of INHERITANCE TAM
APPRAISeHENT, ALLOWANCE OR OISALLOWANCE
Of DEDUCTIONS AND ASSEDSHINT Of TAM
CHARLES E SHIELDS III,
6 CLOUSER RD
MECHANICSBURG, PA 17088
DATa
IBTATI OP
IIATI OF DIATH
PILi NUHIIR
COUNTY
AON
(1)
Ie)
(1)
14)
,Ill
16)
C7l
- -
01\-30-1998
09-01\-1998
REQUPT
NlINPIR
.
AA270022
AA296622
D18coUNY HI
INTERIDT/PIH PAID C-)
,
, DO
269,01\-
c/
12-28-1998
BURD
07-28.1997
l!1 97-0688
CUMBERLAND
101
AMount ~..IHfd
208,186.80
828,604,.73
.00
.00
128 I ~9_3 .B6
2B6,29B.39
802.800.92
(8)
106,,1\59 ,88
AHoUNT PAlD
, ,
75,717.80
8,889,1\4
TOTAL TAX oRIDn
IALANCI O~ TAX DUI
INTIRIST AND PIN,
TOTAL DUI
.
m-lI.,II'" I".tll
llENTON
B
, I
NOTII To In.ur. prop.r
or.dU to your ..oaunt,
tub.it th, upp.r portlon
01 thl. for. wlthyour
t.w p'YM.nt.
"
1.923,781,40
,00
108, 9n. 1\0
480.71\
109,0'81\,14
109,31\1. 90
287,76CR
,00
287.76CR
M If PAID AfTIR DAYE INDlCATED. SES RIVEHal
fOR CALCULATION Of ADDITIDNAL INTEREST,
I If TOTAL DUI IS LESS TNAN 'I, NO PAYHENT IS REqUIRED.
If TOTAL DUE IS REfLECTID AS " "CREDIT" lCRl, YOU HAY aE DUE
A REfUND, sle REVERSE SIDE OF TNIS fORN FOR INSTRUCTIONS. I