Loading...
HomeMy WebLinkAbout97-00669 Ji- '1,' '!o- t. " " Ii,. " ,'" " ,f. " " !f" ,I' " ",- .-- , ,.' ~ , , " '" -f' " . ~ if ."., " /, ,. - l; , _,-I' 0_1,. " , " ,'/ ~," , " " , , " " " , , " ,,' '" " , }, " .. 1',,"-' 1'_-'-- :," ,J'. ,'/_1, "II " " IJ,I'" " If" ',1\ " ,,' .. I,., " ,j, 'f .' ,,'" " ," ,,' I" 'I" I" 1'/< ",j " "~,"~ ..;,J PETITION .'OR PROBAn~ And GRANT OF Llnn:RS J!.,/III, oj' I/lWIN Bl CII^BIN No. ll-liCU:::..lJ...vtl I/ISII knoll'II I/S TlII Rosl~l~r or Will. forlho i . 1)~.J:elt\'fId. County or ..f:lunooE..JmL- In tho SllOlal S,Qllrll)' Nil. 259 .. -:fU-.. 2.QillL COl11l1lonwonllh of I'ouulylvaula Tho poUllon of Iho undor81snod rOlpootfully ropruHonl1 Ihllll Your potlllollor ,who II, 18 yoarl of IIS0 or oldor IIn tllP oxoo\1I dx In tho lall will of the above dooodonl, datod Pecel11ooL_.!J____ and oodloll(l) dlltod None '_ Ilaj110d \ 19.,lL\L- ~- (lInlo rolovnnl CIIClllllllnnco.. 0'8' ronllnulnllnl1, ~o"lh lIr 011,,,,",,0,",) , Reoendenl Was domlollod aidllath In ..9!nberland:-. , _ Counly, pennsrlvanla, with h slaNt family or prlnolpal rONldonoe at 3344 Ches tnu.t ~tmot. Can~ Uil . (Borough ai' CflI1l,\) Ill] I ) Penn"'y1v,qni", 17011. _ , .. (1111'11001, I1l1l11hor nn~ IIInncl~"IIIY) ., Ceoendont, then -iL Joars of nso, dlod ~U~B~ ' S' , 19 97 ' , al bis residence looate in t-he Rnrnllg BlJIP Bill, Pr-mn"'ylv,qni'L . Exoelll as follows, deoodonl dldnolmarry, wasnol dlvoroed and did nol hllve a ohlldborn or adoplod after exeoutlon of Iho will offorod for probatol wns nol tho vlollm of a killing and was nover adJudloaled . Inoompotonll .....~!1e, . . . Dooondenlllt doalh ownod proporty whh os II mated valUoN aN followsl (If domlollod In pa,) , All personlll properly (If not domlolled In Pa.) Personal proporty In Pennsylvanln (If not domlollod In I'll;) Porsona,l property In Comity . Value of real ostnlo In PennNYlvanla ' sUualtd as follows I ~_ '~.OO $ . . $- WHEREFORE, petitioner, rOIPoctfullY1roq~oslC8l ttho probate of tho last will and codloll(l) presontod herowllh and the grant of 101l0rN 'es aniet) -al)' , ,. , . (lollnn,onln'YI n~IIIII1I'lrnllon c.l.n., n~lnlnlllr"lIo11 d.h'.n.c.t.n,) Ihoron,, " II I~ ) .~ ~ ~~,~~~ " . JLfltIlH~n; v~ 22039 OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH Qf PENNSYLVANIA } liS COUNT\' OF ClMBERLllND , Tho pOlllluller( ) "bovo-namod swoar(s) or afflrm(l) th"llho statemenlN In tho forogolng petition aro trllo ftndOllrreol to Iho bOGt of Iho knowlodso nnd belief of potltloner( ) nnd thaI as porsonal represon. tatlvo(,) of the nbovo dooe~elll potltloner( ) will wollnnd truly admlnlslor tho estate ncoordlng to law. sworn, 10 or, ar'f1rr,lod and Nubsorlbod { L j..{ UlI1//YlI Ii a.ww · /~, I boforo 1110 IhlN . Uti day of ~lGn l'ilJn....ila~ :=}l. ~al~ . mfl:r lit, 9114 Wood l'ointe Way r~i.lt..UI i:?NIfJIIJ';JJlftl . --Ea.iJ:.f(lX Rt'Rtinn. VA nmq MillY C. J,EWIB' R gNar ol!: 'I . " " " " " ", , ',0 , , , " " ;/ " , , " , , , I , " I ", . " " ,j " , , I I; " I I '~ ,9 LAST WILL AND TESTAMENT or uWIli S. CIU\SXN I, IRWIN S. OHASIN, of cumberlandOounty, Pennsylvania, make" publish and deola,l:'o this as and 1!or l)\Y Last will, and. Testal1\fI!nt, herIJbY"revoldng all other wills and codioils her.tofo!:'. made'by me. .IRBTI I direot that all inheritanoe, estate, transfer, succe~s1on and death talCes, of Llny kinctWhlltSoever, Whicih\1l~y !;I. payablebyrel!'son of my death,wh.ther or not with respect 'to property plllilsinIjJ under this Will, shall b. Paid out of tlili'prinoipalof my residuary estate. BIICONDI, I ~evise anr;\ bequeath all the rest, residue and remaindel:' 01! my estate of whatevernatu!:,e and wherever situate; inoluding an~ pl:'opertyover Whioh I,hold power of appointment and together ,with any insuranoepo1ioies thereon, in equal share., to my ohildren, KA~EN ANN KATZ and AMY JENNIFER OIU\SIN, provided that should ,any of, my ohildl:'eri predeoeas~ l1\e'; J: give and bequeath Iluoh ohild ',s shaX:lil unto' her issue per Iltirpes by representation, Il,nq if there be a failU):'eof .ame, then I give , -' .. 'I . ,. . .1'. ., aM, bequeath' suoh deoeased ohild ',s share to my, surviving ohild a. provided herein. THIRD, "Should any of my g;rari~ohildren not have ". ; attdned,the 'aqe oetwenty-()ne (21) ,years at the t;imefor d18... tribution to him or her, I qive, devise and bequeath the ,share of eaoh suoq grandohild ,to myhereinafte):' named TI:'Ustee 01:' Trustees, IN SI!lPARATE TRUSTS, to qold, manaqe, ,invest and reinvest the ,. " shares so reoeived,and to use and applyfrol1l timlil to time suoh portion of ino,ome and prinoipal for the ,_aid ,9ranclohild' s' eduoa~ion (inolUdinq oollege, trade,sohool or other simila):' training ,or eduoation)" .upport ahd welfare ,as my, Trustee or Trustees, in their soledisoretion, deem ac\v1sable. My Trustee v cr'11l:'ueteee may make the payments for the .IIUppc;lli'tandmaintllnande of my 9raridohi~dren direotlY to said granaohilaren or to thaiI:' aUardian or Guardians. ,Any, payments made by my Trustee or Trulteell purs~ant hereto shall be made without further I:'espon.. libility to the said qrandohildren, their GUardi,an Or .GUardians, 01:' to any pereon taking oare ~f my gl:'andohildren'. Th.TrulItee or Truete.e, in exeroiling their disoretionary authority with rei.peot. to ,the payment of inoome or prinoipal ,of the within ,'11.ru.t to my grandohildren, shall take into oonsidera.tion any i'noom. or othllr r'GouroesavaUab~e to my grarldohildl:'~n from ,souroes outside this Truet. I,n additlon, my here,inafternamed Trustee or Truste.s IIha.ll have the right, in their sole discretion, to puro~ase and pay for out of the prinoipal, as well as inoome, liIuoh insuranoe polioies as will provide for the grandQhild1s , , medioal 'care. ' Any income 'or prinoipal not so applied shall be dilil- tributed to eaoh grandchild when he or she attains the age of twenty-one (;ill) years. In tilleevent any of ply grAndchi~dren . predeoeases me or dies prior to ,the termination of this 'l'rust, the,irltel:'elilt of said grandohild in said Trulilt shall cease with any inoome and principal being divided ~venly between or among my other grandchildren or t~e separate trusts established he~eunder for their benefit. If, however, said grandchild is survived, by filly ohildren, my Trustee or Tr\lstees shall pay net income of the ~ TrUst to or apply the same for the, bensf,h, Of. such"children of my deoeaaedgrandohild,'in suoh amount or amounts as my Trusteeol:' Truste.., in their sole disoretioo, deem advisable ,for the support,. welfare and maintenanCJe of said ohildren. Anyinoome or , prinoipal not so applied shall be, distributed when suoh ohildren of my deoeased grandohild attain, the age of twerlty-one (21) , years. I'OURT~, In addition to all powers qranted to them' by 'law and ,/Jy o,ther provisions of this Will, I qive .the fiduoiaries aotinq hereunder th$ fOllowing powers, applioab~e to all 2 " stock ownership plan, or any other 'type of extent the plan or the law permits them to any other rights, which they mllY have under manner they consider advisable. np'1'HI I nominate and app~int my'daughter, AMY JENNIFER CHASIN, of 466~-C South 28th Road, Arlington, Virginia, " , as Trustee of the hereinabove,described trust, who shall serve without bond and shall reoeive fair and reasonable Qompensation. 8%X'HI I,nominate and appoint my daughter, KAREN ANN KATZ Executrix of thi~, my Last Will and TeAtament. In the event of thed.ath, resignation or inability to serve for any reason whatsoever of the eaid KAREN ANN KATZ, I nominate and appoint my daughter, AMY JENNIFER CHASIN, Executrix of this" my Last Will. and Testament. I direct that my, Executrix, and their successors, shall not be required to post security or a bond for the performanoe of their duties in any jurisdiction. IN WITNESS WHEREOF, I. have hereunto set my hand,and I' " . .- , eeal to this, my Last Will and Teetament, this II day cf ' DEC.; , 1996. . , ~~~~~~rs1:~A-~ qualified plan) to the do so, and to exercise the plan, in whatever (SEAL) Signed, sealed, pUblished and declared by the above- ,. -, . named Testator as and for his Last IHll and Testament in our presence, whc, at his request, in his presence and in the pre.ence of eaoh other, have hereunto suqscribed our names as atte.ting witnesses. Address '~1l\~ C && Address ('~Ttdr', ,Ur 9, A~,!M ( 4 ~:':I"""I". .^"\ ~ AMO A : ,HHSVlVANIA , W'AR1MRNT OF I\,VnNUE . " DSPT,l~1 I II! - REV.1500 INHERITANCE TAX RETURN RESIDENT DECEDENT CHASIN \1M. hM9tt WOfdt I RW INS ,,', <?. 15- lf1u - 10 FlI.e NUMIMlR 2 '1 Sf 7 0 0 6 6 9 21l9~36~2000 0.8/0,11/"997 II o 2/" 2/" 9 3 0 I" I " , o HAS 1 N, J A NI lilt Oi1glnol Relum o 4, Limited Bllftte 11Q 0, Decedent Died Teslete l""h"",~w..1 o 0, LlilQotkln PrOCIleds ReceIVed , , R R. 0 8 9 ~3 40 . 0 6 9 9 o 2, Supplemenlel Retum o 40, Puture IntereSt Compromise I~"~"''''''~' \1,\1,111 o 7. Decedent Malnlelnod e LlYlng TNStll\l>:h "", ~ ""Q o 10, BpoUlll1 poverty Cred1114* ~dO",_n \1,11,1'101 1>1.111 o 3, Remainder Return 14* ~ "'''' priof ~ \1,'1111 o &. Peqerel SIlele Tox Re\Ulfl Required _ 8, Tolftl Number of sofe ~poaK Boxes o 11. 81ec11on 10 Iftx under See, 0113(A ,^""hll<hO, I Andrew C. She.ly, I.q~ire P.O. Box 95 127 S. Mar~~ Me hanicllbUt" 697-7050 1, Reol Ellftle (Scl1Sdule A) (1) 2, ,St0Ck6 and Bondi (Schedule B) (2) 3, CklIGIy Held COrpllrallori,Portnershlp or Sole.Proprietorshlp (3) 4, Mortgogao & Notel ReceIVable (Schedule D) (4) 8, Cllh, Bonk Oepoll~& Mlscellaneoul PellOnol Property (8) ! (Schedule S) ; 0, Jolnliy twined Property (Schedule PI \0) 7, Inler,ylVoa Tranlfers & MllcollMOQUI Non'Probale Property (7) (Schlldule G or L), ' 8, Total Gran A..ttt (tOIftI Llntll.7) ~ 9, Puneral expenses & AdmlnlfttratlYe Coale (Schedule H) (9) ~ 10, DeblS of Decedtnt, Mortgege Llebllltlel, & Llenl (Schedule I) (10) 11, Totti Dtduollonl (total Llnol9& 101 fI,< , " .<:@ <;I :1'i -.. i! (~ !at ,'\ 7 9,8 2 0 . 9 8 T '6 II 4 II 8 T (8) 1 3 ,4 3 6 ,9 4 8 (11) ~ 12, NIl Vlluuf S'tell (Line 8 mlnUI Llnll1) 13, Cherilftble end Govlmmenlftl BequIIIllSeo 0113 TNllllor which en el~n to Iftx hel nol been madl (Bchedule JI 14. Hit Valul 8ub)lel 10 Tax (Line 12!nlnUI Line 13) 8, Amount 0 line 14 taxable at Iheapoulallex rale T' X ,0 See Inltructlonl on reveree IIOe fer appllCllble percenlftge 18, Amountelllne\4texable 1 2 3 1 3 1 8 1 018% rete I' X ,06 17, Amount 01 line 14IAxable 8116% rale X ,18 18, nM Pue 10. 112) 113) . 7 4 ,1 45 .;1, 7 9 .3 1 .0 0 1 .4 ~ 8 4 ,1 3 0 ~ 9 II .3 1 .4 1 .7 2 (14) 11&) ,1 3 0 8 9 5 .4 (18) (171 (18) 7 3 II 7 9. 1 T , ~ II 7 I . V 1 PLBASB ANSWI!R THe FOLLOWING QUBSTIONS BV pL.AOINa AN "X" IN THB APPROPRIATB BLOOKS 1, Dlddaoadent make a tranaler and: Vaa 1'''fe'lln the use or Inoome ollhe property transferred: ."",,,,,.,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, ~ -,PI tetaln tha right 10deslAnate who 8hall use the property tranafarred pr Italncomu: .""""."",, 0" retal"' rever.lonery Intereet: or""",.,.""""",.."""",.,.""""!"""",,"",""""'"'''''''''''''''''''''''' ' d, receive the promlae lor IIle of either payments, benema or carll? ,,,,,,,,,,,,,,,.,,,,,,,,,,,,,,,,,,,,,,,,, 2, If death ooourred on or before December 12, 1982, did decedent within two y"rs preoedlng dealh transfar property wllhout receiving edequale consideration? If death occurred after December 12,1982, did decedenl tranefer prcperty within one year of death wltho,ut , r~oelvlng adequate con.I,d,ratlon? ",,,. it "'" """""""""""'" " """ t' il.".,,, t" "'1/", It', httt" Ii"'''''; "',',,,-0 3, Old decedent own an "In truat lor' or payable upon death bank account or aecurlty , 4, ~tl;l:e~e~:~~~~~:~' i~di~id~~'I';~;I;~'~~'~'; '~'~~~~~t:' ~~~~ity :.~; '~i;;~;'~~~~p~~b'~'i~"p';~p~~y?:::: ~ I IF THB ANSWI!R TO ANY OF THB ABOVI! QUI!STIONS IS YBS, VOU MUST OOMPLBTB SOHBDULB a AND FILB IT AS PART OF THB RI!'TURH 72 P,8. 091 "(a) (1.1) (I) provl e or t e reductlqn of t e laK rate Impoaed on the net value of transfera to or for, t euae II the aurvlvlngspouae from 8% to ,3% for dates of,death on'or after July 1, 1994 and be,fore January 1, 1998, 72 p,e, 09118 ,(a) (1,1)(11) provided forthe reductlcn of thuate Imposed on Ihe net value 01 transfers to or for the use of theaurvlvlng spouse ,Ircm 3% to 0% for datea of death on or after January 1, 1998. Tha slatute doea not e~emot a transfer, to a aurvlvlng apouae from t,aK, end the atatulory requlremenls for dlaclcaure of a88els and flllng e taK relurn are etlll applloable even If t~e surviving ePOuse Is the only beneflclary. .', F,OR DATBS ,OF DBATH ON OR AFTBR JANUARY 1,1998. Pleese anawerthe 101l0Wlng question by placing an 'x' In the approprlatellpaoe, Dld.the dacedent create a truat or 11m liar arrangement which II eo1ely for the lurvlvlng IPllUle'1 benefit for hll or her,lntlre lifetime? Yle p No &1, , If you anawered yea to the llbove question, the tax 00 the trust or IIlmller ,arrangement la poatponed until the dealh 01 the ..cond apouse, at which time It 1'111I be lully taxable at the rate(s) eppllcable to the remainder beneflclary(leB); Entlrthe v41.ue 0.1 the truBt on Schadule J, Part II, In order, to remove It from Ihe calculetlon of the taK'due In this Istatl. You may wish to flIe Schldule 0 In or,der to make thlelectlon available under 8ectlon 9113. If the election Is made, the truet or almllar arrangement 18 taxed In the eatate of the flrBt decedent spouse, Ihe portion of the trust or similar arrengement Which beneflls the surviVing spouse IB taKed at the ~ero taK rate, and the remainder IB taxed at the rate(a) applicable to the remainder beneflclary(les). If you chOCBe to make the electloo, you muat attach Schedule 0 tc a timely-flied tex return, along wllh Schedule(s) K and/or M In order to show the epportlonment 01 the trust or similar errangement between the Burvlvlng epOUBe and the remainder beneflclery(lea). Decedent's Complete Address, I'~:" ':'~' 44 n,u,.., "'."'''' ......11I11I'1' C8\HP HXLL - I AI!jII\ I liP Till Plym.nt. Ind Cr!ldlts: 1, Tax Ous (Page 1 Line 18) 2, OrBdltl!Paymenta , . 0 . II. SPClllG1 Poverty OrBdIl p. Prlcr Psymenlt , 7 , I va . 6 8 d;OI8COllnl HlI, 60 (1) " Tctel OrBdll1 (II + B + 0) (2) 3, InlorelVPenelly If applicable O.lnlllreal "E,penelly .OM " , .' . TollllnlerlaUPenally ( 0 + E I (3) 4. 1/ line 21s greeler than II~e 1 + line 3, enler IhB dlllerlnee, This Is Ihl OVBRM VMIlNT, . Olltok box on Pagl1 Linin to requII' ~ ,refund (4) 8, II line, 1 + line 31s greete~ Ihln line 2, enter thedlllerlnee. This Illhe TAX DUB, (8) II, Enler Ihe Inlerlll on'lhe IIIlC due. (811) I . - , Il. enler the lotsl cf ~Ine 8 + M,Thlllalhe BAL.ANOI! DUll, (8B) MBks Ohsok Pa abls to: REGISTER OF WILI.S AGeNT -0- ""tl, 7 ,387,'U 7 I a a7 ,as ;,""0- lSll.u -0. -0- leo dJ3 I lCJ ~, MY,'......I;". , COMJ,IOIfflII, ALTH Of' ,PlNN8VLVANIA li'oI'lURtlANCe TAX RUTURN I 8 IRWIN S. OHASIN iI' SCHEDULE e OASH, BANK DEPOSITS,& MISC, PERSONAL PROPERTY PIL II tll1-97-0Gli9 Indude tilo proeeedl olli1lOatlOn '00 the dale Iho prooaodl WOfll reeolved by the 0I1s1e, All proptrly jOlnl~..wntd wtth the rlghl of evrvtvorthlpmvetlM dlloloetd on h~tdv" p, ~ V~M~ NUMSER OESCRIPTION OF DeATH 1, a. Whllt 'ir.t .uoh.r ',Iinv.r . Aoot.'WN04-alV8~al0B UBa ..377 Ihard . .. illS per .h.re " o..h .nd Honef ,Hlrket' Hll10n B.nk . Aoat.,17a.ll0.aBBB (ohlaking Aaat.) Blllnoe . 84,70B.fl plU. lntere.t 81.7B 810,188.18 1. 8 ",707,16 3, , Oare Itltel .enk, N.A.- Aaat. .a0013BV10B6a88Va (OertUiolte of alpo.lt) 41 .utnlm Inve.tmente Aooount No. 10a.la8g36aOOOIIUQ ~ Va3iOB3 . al.BS NA~ .er Ih.r~'. 8aO,111.V4 .nd Aooount No. AOI.1a8V36aOOO.18A 118V.0~1 .hlre. . 8V.la NAV .~~ Ihlre - 810,Bf..a. 831,101.86 " ,lnll looll~ .eouritf Oheok . JUly ~efund Ohlak -1111 Atllntlo " 8aa,Oaa,1B 8 1,000;.OQ 8 160.0Q . no.oQ 8 " 1. 4a 8 143.00 . a1.U 8. 6. I' 7, B. g. ,10 : 1987 'ontlle orand Am loaNV14uBHOB413V' per'.pprll.al dltld Slptlmber ae, 1"7 perlonll oontent. of deoedent', re.idenol plr Ipprai..l dlt,d 'septem~er 2e, 1,g7 R.imbur.ement of, prorat,d rent from ~andlord Refund' from PP . ~ " TOTAL (Also enler on line 6, Reoepltvlollon)' 7 V , B a 0 . 'B III more Ipaco Is needed, Insert eddlllonolsheels ollhe sarno slzo) t~ilruBIIlI(l~ IId'!~ !'L'\, I'll n", 10 III IIIHllUlolr~lllIl 1',\ I \1 ~ ~1I. 70 1 R ' I'; " Soptombor'11 I 1997 . coreSt.tea B.nk' " Androw C: Shool)' AUQrno)' Rt LAW l'D 130x 95 ~oohllnlllSbur!llPA 17055 " 1~1ll EHIRio of: Irwin S, Chllsln URto of DORth: AUllUSI 5, 11)1)7 j)oar Androw ShoolYI In rORponsotoYollrlottor, ploRso bll Rdvlsed lhllt IIIIl ~Ileodont hllld the followlnll Reeollnt(Q) wllh our blln~ liS ol'tho d"fo of dOllthl ' ACC()llN~r # ACCOUNT 'rt'rLE DATB DATB DATB 011 DEATII ACCR. OPENED CLOSED IlALANCn lliL 05/06/96 ,31,107,56 ,00 CerunllRle of DOpORl1 DI'. Irwin S, ChRsln 2001369705626592 . Inlero,st I'Rld JanuRry 1 tii AU!lUSI 5,1997:$1,982,54 nrust Ihlll WO hllve boon of nsalsllInco to you It) Ihlsl)ll1ttor, SlnQoroly, . CORIlSTATnS /lANK; N,A, f'l '4, 'J ;. .; .c;.;J , ~,.rt:4'-' " lllleon 0, Cn lera 80C/oll1/225 " IN REPLY REFERrO: REPORTING SERViCeS' Fe 6-90.3.235 ' PO 130X11 02 ' R~ADING, PA 19603 G 'I (J'05!;.3ril5~ PUTNAM INYESTMEN'fS I..' ; 11""'ln'111 Il1vlI.lnr "0" Ii",. 1"M,I!tfl,,'/lII,I'1/U1l'I " J.(llti/l/ClIl'fl, 111"",,, /-tlt//lil 11~"'UJ;I;:I/J /oI/(xl.~~,H~11I ' Account No.: A02.1259362000BI3CQ Account No,.,: AOB.12S9362000BBBA I~ellllllrn\lon: .1rwlnSChas!n ' '; ~ortJl'ellce No.: 017SS25250.0C7 " Seplember 16, 1997 Andrllw C, Sheoly A\tqrnel' al LIIW 127 Soulh MlIrkol Street PiO.Boll 95 Mechant~sburs, PA' 17055 DcaI' MI'. Sh\l~ly: Thank,youfprrospOlldlnglo 0;'1' prevlpusletler rosardln~ Ihe above-refercnoed aooounts, Aooollnl A02-BBCQ Wl\S, olienod 011 JnnuarY 23, 1995 a\ld aooounl AOB-BBBA was opened on Janllary 30, 1995. 'fhe lablethatfolluws provides the Information you have I'equesled as of AIIgust 5, 1~97. , Net APsct Vallie Agm ~ reI' Share MJ1tl<et Value A02.BBCQ 923.053 $21.86 $20,177,94 AOa.BBBA 1,189,061 $9,12 $10,844,24 Should you hav\l,addltlllnal questions 01' require OUI' asslstanco, pleasc 01111 Ustoll.tree at \.800.225-\581. 01113 l1f ~urlclephohe reprllSllllll1t1vcs wlllbe plellscdlo assist YOII. " (I n n II T (I N I I, n N 11 0 N . T n K Y n 01""""'01'''1'. , COMMO/fM!ALTH OF PPNNaVLV~NI~ ItlllURITANCQ TAX RBTURN , SOHEDULE G INTER.VIVOS TRANSFERS & MISC, NON.PROBATE PRopeRTY IRWIN fl.' OH'8-1Y' PILNU IIRR 21~91~0669 TATIOf Th~ ldledult mUll btIoompltied nnd flied If Ihe BnlWBI to'MY of qlloltlonl' 1 throlillh 4 on Iha rOIO,.o lido ollho R8V.1600 COVSR BHSeTl1 YOI, PSB RI T OF, P RTV. , OF 'iIIO\~ iI<tjIJ!! '" nOlIW<''l'/l.n",,,,,,iOIIlilP toOl""'"' ...11< "'101 ,,,,,,,,, PATS OF OSA'TH 0.CO'9 exe' UBION AtI~IlAtOffQf!l'COUO'Mflf.lintAlt; , ~ if TAXABLB VALUe .~ '~U4."tl~. j~auW1t1te - Aaat,'oRP-R37alO - 1al 8k~r'e oitiaarp,Dtp. Adj, ,rfd e la8' , 31a8.00 '0' 8k~r'eLi..y ..~ . 00,1 1118 11/11 _ ,10,411,98 ,lion'" M~rk.t Oath If 1. 00 " a. "~rrh Iluin'n BlInk Aoat. ',Ol-93-Ia3938 (~.A) pr1naip~l ~~l~no' 111,ta'.37 " xnt~r'et 18,08 3. Ptllphi'n D'poeit, B,tnk . '1'rlletaal1lp~ny (X~A't) , I~ Aoot. '~00~3aaeooa 1'380.10 Accrued xnt. ,all,a3 14,0'7,88 100\ 14,017 .88 11,937,37 ,100\ 11/137,43 b. Aoot. 'ooa32al006 ,al41.61 Aaorlled xnt. UU.11 a. Aaot. ,OU134700a $Bn',60 Aoorll'd tnt. ,318." , d~ Aoot. '0211347001 $8784~U Aoorll'cl Int. 113"te 1,631,73 100\ 1,631.73 a,71l.aa 100\ a ,711" aa 6,a16.88 100\ I 6,a16,88 6,904,,08 100\ 6,904.08 4'1800,47 100\ ',800.47 I,3U.I8 100\ I,3U.IB "i Aoot, 'oU13'7007 ,,,80.0B Aooruricl xnt. 11ao.I' 'f. Aoot, UlIHoB417 'IU3&.U Aaoru,cl ~~t,'l~I.I' Northbraak Lif' xnlurlnOI oOl1lp~ny 81ngle (l\dm1rlq 1)' ,remiu'" D,flrr,cl Annuity 7,763.10 100\ 7,713.10 " TOTAL (AlSO anlar on IIna 7, RllOapllulallon) . (II more space Is. needed, Insert eddlllomll Bheels 0: Ihe Beme size) U,UB,74 )w'1 , I>cccdcnt Cunl'lrntutllln Nnme SoelalSeo\l rltyNn Dnto of 1>Cllth - I"lI'ln S, Ct\llllln - 2,~1l-3(i-;WU(l - AIl/,\Ullt ,~, I (Ill? I>ONe 1'1 pllnn Aeon"n! Allllollnt 002.12~500fl Il\A 01/19/110 Acoount AuUOUl1t Nu, AUUUll n I 'I' (10 Dille Opened ur 1IIIllled Dille Closed or Mlllu red Dulu of Deuth Illllllnllu 1'1,1ll1 Dille of Dcllth Accruedl nl, Joint Owners U'uny) Dute of Joint ownerllhlp 002.1n5002 (m I .147002 1 H A OH/I,I/U4 II( A 0.1/ 14/U.1 NQno~ $lC1!J,CiI Nllno~ $5,H9'1.(\() PI.US $~ f(I,lJ~ 'NorllJ* $5,380.50 PLUIl. $2,545.61 PLUS $2~'J I.:!~ J>OHllrlp!lon Aouo""! AQoa"nt Aooount Aucounl Nil. 02~134700Ci 0251347007 6167;)OH417 Auuount'l'ypu lirA, 1 \( A 1 \( A Dnle opened ur tRRued 0207/111) 01/19/90 01l/;J4/% Illlle Closed or Mllturud Illlte uf l)elllh 1,I11111noe $6,7<>4,12 $4,680.08 $5,2.15,\)<) PI.tJS" Pl.tJS l'l,LJIl !'I"llli Dllto of noath Aoorued 1 Ill.. $131),96 $120,59 $155.S!I ,Iillnt ownerll (11'1In ) NlHIU* Nllnu* NoIIU* 111110 of JulnlllWnurllhlp Speolal COmmfJntHI *Jll'nllfloln rJell1 Kilton Ann Katz & Amy J. Chasin Illllu 1'1'011/11'0111 Hoplol1lbfll'l2, 1\197 "repllred by: Cheryl A, Bl1\Yul'i\ (110\' ~/1('/Q11 Pagel 2 "'''"''''''"'. COI,lt,lOtlWEALTII or PENNSYLVANIA , INHERJTANClITA~ Rf,TURN e TATe OP SCHEDULE H FUNERAL eXPENSES & . ADMINISTRATIVE COSTS IRWXN S. CHASIN Debit of decedlnt mUlt be reporttcl on Sohldulll. ITaM NUMBeR fI, FUNeRA~ e~p Nses: 1, DeSCRIPTION 1. H.Lll 'un.r.l Ham. - ,uner.l s.p.n.. wrLght Monum.nt.l Nark. - Memorlnl "..d.ton. 2. B, ADMINISTRATive COSTS: Pellonel Reprellnlallva'l Comm~llonl Name of Pemnel Repraaenlallve(l) KIIRIN II. KII'1'I, IXI0U'1'R,U flD (-wa-"ua... Bodo! Security Numbe~l) I elN Number .01 Pel10nal Rapr..enlatlvt(l) BUllIlAddrOll 0114 wooo PO!N!!!. WAY 'l\IIIFIIK 8'1'1I'1'IOH 1. " City elale VII Zip azon H/II 2. 3. Yee~l) Commission Paid: Al10meYPIII IINbRIN o. INlIl,Y, IIQUIRI; PlR 1I0RIIMIN'1' , Pamlly exempllon: (II decedenrl addrelS II nolthll.lme .. clalmanrl, atlac:h ..planallon) Claimant O~I Add,... CIIy Ralallonlhlp of Clalmenllo Decedenl Slale Zip 4, Probtle Pili and .hort a.rtl(Loat.. 6. Aoooun!anh Pili Tax~~rW'rf,ll~h~&\'laf D.o.d.nt'. ln7 Inaome TIM and,1duohry Inoom. taM r.turn (8110~+ 8170.) 6. 7, U.I. '01'1'111, IIRVIOI OIR'1'I,IIO MlIll, 001'1'1 e. Ohuak IrLak.r, lIuatLon..r IIppr.l..1 ,... g, l,odgLnv .Mp.n... for non-r..ld.nt IM.autrL. r..ultLnv from LnabUHy to rel1d. .t d.a.dent:. r".Ld.na. due to the nature of d..th, 10, R...rv.. to aonalud. .dmlni.tr.tion of I.t.t., lnaludLnv fl1Lnv of '" Inh.rLt.na. '1'.. R.turn, Inv.ntory, ,ir.t .nd ,Lnal lIaaountLnv, pr.p.r.tlon/mliling of n.a....ry ,LduoL.ry R.tUrn. AMOUNT 8 7,201.00 8 ua.oo 8 -0- 8 3,'U.OI 8 U7.00 " 8 320,00 8 a ,77" 8 80.00 8 a08... 8 100,00 TOTA~ (A180 enlar on line 9, Recepllulatlon) . 813,43 8,31 (II moro .peeo ,. needod, In.art oddlllonal.heel. of tho ..me Ille) WRIGHT MONUMENTAL WORKS No, 4589 OlrlCI & UlmAY ~ , , ' . _ I' ?"'.;: ,< 'iI' .("<J,' ~~e ES:1'17i:~i(lfW:"N S. Ct7'''/.r/'~' BOI,O ~ jl1~', K,q~tN K.<j/:t '- c..., 11'1 Wrk'.l,2.) tflllol rlr W'<jo' TO .."(-~ I" I.~i.'~; /W",\ ),"'''/1,,/(,1,,; ~. ':1:1.,,1..:,'1 ThPiJhnvu hlrlhY.l\onlllll!U "If nl111 "u;ou, W IH"'ll!ll,pllnfH \Vllulll Mnll\lllllltlllli WIII.-I, 11ll! 1lIlIIIItI1IUlilijl Will II 1llll1li/ljlllUI Iln'CHIIIIHlllmlllrlHlIl'Uf lllllllllJ!IIIU 10 II1IY t').t), (I,'" IUI tRillO, U"Ulllhd f\ijl1lpllllllln 1111111101, lhu '"111 (II $_. /.,,' I'^ Y ^II LL il' 1lllltlW'l _- 2121', MAIN SlIlI:U . PIIONI' 3!JH,61136 . IlIlAl)WIlD, prNNSYIVANIA 16101 I ...... .. PATB_G.: ./"1 ',f 'I.. '/~/;J .:.,~ I (", I AMOUNT op RALB, ~II' " liARS BIZB I' /:ll( (;. ,. >. .',," (, _d.:.!::.li.L ." ;.,'" ) Ilf'IOIPIIlATIONR flNIBH '(Ii < . 2,.I'$(<f ',''(11., ,'~" i",r;'1 "f- ' II MONUMBNT V" MATBRIAL V(>/')I.'i./ ,;",'/ O.lunNo, ri'. th';"!.!'l MARKBR MATBRIAL ell''',',!1 tr' OellulINo. ~'r~I',\'/f\ 1/, \' 'I',., IN Tn II' ""1011 nn \'0\ No, In '1~ r;,'\ IJI'., ".... '''\ Ii, . '~/'" I't \,) c..t.t.,\ I~hn'" 1\ < S~(I,) n liJ~ t}(t- '~'c , ' ~ \, ( . I . 10~, or.. loon lhlltonllnr "'I'ottlhlo, 'lfl~o" It(lcl!!f;lllU or 011"" CAllsel of dul4V, '1r1l1hullnQ '"0" of ,"ntJ1ClfU\ldh blvonC1 our nunltol, IIICGJH'd', )"~ V ... ,~! ^1(1 'I H,/("', II" , PUlIllllaUon\ot'l.h"nhllfulIIY ,', _(1,1'-11 ( I" r._ f 8KSTOH OP MONUMPNT MA~K B R 11l1I1l1l(Hllimc!t wit" oilu af IIUII:1I111Ulupr', INBCR IPTION8 IWllh .,.f'll 1IIIId6vlltliUflt, "'t\I,'IOfUl Of ,,_Iurltlonl QI tn_V ho CUUlmut'V' , J . .~' :lt~1 If I tv 't ,(}i ~,:',';J "ttP1 .' lrviJt/Y; /A,;!1,v I /' . /,,f' 'It II . ",^I eJ,.' 6.~1Cill rljA, ~/,j,t.., vOl -P1J i J' t0~ r1'" " "d) ; -' ()# - 1,... .. ';t..I/ \. )1;), ,,1.1 (;itMI, ' , I\Y () , ~ tVl, . BKSTOH OP MARKBR ,," ...,. I-T~~"'- ;:I')~ I \ ~V\:/jN $, I l..., .ft!; /.\ ::)III~MLI ".4... b~_~_ : lj i ;1 \ \l I .- '~' " ____~i.:........;..;....._........~.._..; -~,j.~,,-.,-,---; ,,-r"':"i~:1'r:'''-'. '.. .,f:.. "_,_-"",+!,,_'~""_'",I,,,,";f,--t. ''Ii,''''!',!''''. Thl Imount ","olflld In Ihl. oontf'CI1 dOllnol lnoludl Inv 1I\lI/Inu whl.h mlvhu ,.qul'..1 In thl IUIU,I, ' ' CONDITIONS, Thll IU'lIm..t II m.dl !Ubl"t t.. thl 'lUplonel WII..I If' W,lghl Mlnlm..t.1 Willi Th. mlm.".1 .',h., " h".ln pre,Id.d III, .h.II" remlln tho pre""lr II W,lght M,nlm.n,.1 Wllk. ..lIlt.m. h p.ld '" 1.1,11 ..d IP..I,II'" ,. ..mpllt. \Old p'rm..", W,lUhl Mlnum..t.1 WOIkt .holl har. t~. Iloht III 1",,.,,/ .,rm ond ,.,,.,, IIpon 'h, Ii,.mlt.t wh.,. tam. h locot.d tf 'fI'pOI"" tam. _llh any chllm fO, ddmoo.t .ho"..nt., If b.lng ,llIlth., IInd"ilood thdl the pl"eha..r 110,,1110 Ihlt controct ,.lhu,"lth.,all clolm t, ul4 WOlk Of 10 on, ,nan.y h. ., th. ma, hoyt paid prnloll' to tlich tlm., '~, I"t.,..t will b. add,d On amou"" pOll dll', In dtlQlIlI of paym."r 201;1 ~IlOln.'t f.,l, .11I b. Qdd.d I. Ihe omoun' " the cantldcl ~hu Ulllt utll ud Int.,,,, 110m thv 11111' .f the co",pl,llon ., th, COIII,ae" ' Pllttha'''. h.rthr- 1I111nOllu an, 0"01"" 01 flu,d to conI." IlIdO"""' fo, the Inm., .-Ilh I...nly p" unt QIIOlnl',', ((wlml"lon, wlll,lnQ lnquhlllon, ..,mplloll a"rt Iluy 01 IIIC1U.tlOIt {:nnullntlon of Inll co"IHlf! rOil only ho moil. .-Uh th. conurlt of Wrlllht Monllm,nllll WOlkt qn4 on IIIml lhol '11'111 Irlll~,,,..,lr lIololn1l loti. lhh IIIUlllm..U tunhUlI1 lh. .nllll untlQcl lal...n th. POIII,'. ::IOHT.~~NdMPN,T,~L W~,~~~ I; '. 1,_,'" I' ~" ';'. ltilli!.U_.. /(;'1' ~ lU!~:l!.L_. ~-I.;' 1'/ ." JH~'i!!L._, 9iijrlU/I --....:!:f.un l' I"'J I'" j " _~.L.L.1. ,-, I , , " " , ,1,101 MARKB1' HTIUlIl'l' SiAMI' HIl.L, "^ 17011 , (7/7) 7n'H726 ", W<1I1N 1\ I'ICKIlH,Pl/, RlJrU'tvI~l'/~ I August 8,,1997 Kl\renKatz 9114 Wood Polnte Wny 11alrfux Station, VA ,22039 o " .' Services fur: i,.wln" ('I/n,\'/" Vlsltl\tlon Immedlatel3urlal Cemetery Dlll\th CortlOontos 25 @~,oo oa, Rn~blWelnor Other Transpl1rt 150 1I11@ 2.00 on. JM Qoldon Onyx. /8 lln/volvot Vault ~.Llnor Totalllunernl Charges PnYll1ent Received . aalance ()\10 on Account. (Duo dnte: 09/05/1997) COnltllol No.: lU()Ul2,11 Coso No.1 1493 3,OIIJI!I\i(\' HTRIlI!T UAII~IHIIIJIW.I'A 17111 (71" I~M,2633 Hl1i1'ItUN), WII,NIIAl'II. I'll, liilPuftVINOR $ 400.00 2,205.00 700.00, 50.00. 250,00 300.00 2,650.00 ___, CiSO.QP_ $ 7.205.00 $ ( 1,300,00) $ 5,905.00 " I I ~ I, , r'; , , (: I, t' , t:-;, ",' . I,: I: E~' hI; , , I . d I" 1 . I , , ,-, , (,I II 1:'1 I'" " ., " " .... .. tir:." 1.,1 1,f:J .. I '.: (. jill, t1' , ....1 : j;f Ll l~ -t:t , ' ". (- (Ii ~tl 4.." k~ ~i ~-'1 "n f' i I 1,'\ !. i..:1" I,', r' 't. J,:: , to) r t1! (1,; ...;" . ,J " ~J "I. ~ VI " 1(' W . ~~ . \ t:.< I :1.'" f'j )p: :;;1 r.1) ,It; I 1;'1 -I, [J 'I' .. -:I " et: " .-. U' .-, (" 0;;' I..~ }! " ~,' P h' I" , r 1.1,1 i ,I " I' " :. , , , " '" 'J; ..-.... ~lIl1'(.III'I'~L ,'~ COMMONWllALTH Of' PUNN8YLVANIA INH8RIlANOI .TN! 'R&TVRH SCHEDULE I . DEBTS OF DECEDENT, MORTGAGE LIABILITIES & lENS mATeo IRWIN S,' OHAf'!:N Inqludl un~'mbur..d mldlolll~p~nl", IT6M NUMBeR 1.. 1, .', UMBRA 21-97;'OUP DESCRIPTION AMOUNT ual Hn.l bUl and"ah\lt /Iff oh.'~v. "'\l11n~ a~p.pla, D8vld R. ~ankar, II, to rimel,s IlIlted puaon.'1 prop.rty and oontsntl daatroy.d by, m.nnar 0' d'oedsnt/a , 71... duth , , aU.OO !' 3 f Vlrt\lslly .potlaa. ole.rtln, bl11 ~o pl.oa .p.rtmant In oondltlon to raturn to Landlord dua to natura 0' d.o.d.nt'. d.ath. , u,OO . . PUL InarllY - Und bUS , 'O,U , I. rlnd lIant "aymant - JaoK aau,hen 1I..1tor . no.oo " . . .prll1t - rlnd Lonv ,1l1'lh1lO. 8111 . 13," 7 ~'! ..U IIthnUo - ,hd "lephon,; 8111 . 18.37 q {, ! j TOTAL (AIIO enler on line 10, Recaplluletlon) , ' (II more IP~ II needed,lneen addltlonellheetl of the lime Ilze) "8,00 ii, ...'!ili! ('/!,H\ i' f',II',J I "f"I(L ",I,,(\..,Hu,j.ln 11'.'111 . I' I, I , ' I,,j '111,' llPOlllht rollQwlll"tf"'. W ,IlQpdltlo"l '" ,will, " , 215' 00 ' 'hi" (b) l~lt.nIlUqr"'llAIU!"'lM~'lIlf)q I..,W!, mhl. . '..... (QIJ "'.rmtnl'l~ IllVI"", t11t,"tl/lllh4',!;:l .n '''' , " , IlIlh"nloU~'"(I",~9,,~ .1, , , .. ",," (dl.~,,~I~,~r o~AAklP1P/l1IU\'I"nYl,}~I, I.~ll b11f,,~ I ' , , "',~' ",: , ,\I,d I,,(~lll \I~".J~I,~~~\:~ttq)'~~~.IrI~ol.lr.clt~l~'!r','~(~,~t.~~ to lW31/9~1:,' , ',', ,',' ,',','" '1I11'In, lflll"lItf"rt,~,~'R'~'lL'rM"r,,1Il '~",~""..I I", 1 , , " ,"" I 1\1 Ii'" ,,('h,..!"" Al1!Ir.. , , t:1MI'tiNt de or .ach ,.J.t" 'U'""'''''I'''!, ,0 "',>" ,,(~) n" P"t.Mlfl(yC ~t,~~ fl'~ ..... In. . ,'I , ' ell ""rtrm p(~Ut~lMith ' . . "", 1"," ,"il1l, ' U) 'I" qqm'lWN~llW,~I~IP ,. "hm-mTl " t',\ lilli' (~ltl!#,Il'P,I,(\II~I\~'\t.1\I M.1ft!1\ , ", . ,I""', , lI) ',l\~~~~'t\I,(illi~~I~'\V'!fI!l\ln"~ 'hili""" I ,,,'I', II.. lm)",. \l,~\f~II'I:i11 WJf>, !,!\\q"lpd ~r, F!IMr mliii " " ,,,,,'" (n) L..,,, wll...u r prtmlltl i)NLv II Khl"'" ,(.uI,~..~I~'llVlI"!:lI ,W~1,f(.llMlIMnl~~ ,r,Jh!' ~I~, "'. It' . " , , , , WIi.., ",I,.\'I!,lI",~II' n,lfln, m'fl'~,,'r,j, du.1 ;11 'ul,"hII'YO('h,unh'dsl''':1~(~ "";1 I,."" "tldJI~ I ~ ~ ' <'"'''' "d.", a_ It~t(tl", \'",,!, , .., 1~ICtll ',IY"[~'i' II,WIWJ,,4,\\1I0,llIb'h' ''I Iii., ", .. ' :... h ... '" III ; ~"j.~J,i.> 1" :, 0111'" II!Wrl'~ ,'Nilid(Ylh '~~,,'r.4~r\ (II . III ~~!'" '... all, ~ 011, ... ',d C, '" ~"wo ....., (I ,,' r'I"" ,'," I lorlf",ICi, P y..rlv,nllburn'r.l"nllla, I:J ''''ruulllfrllocl..n,lnl, . 'i..f _ - ..-1\ _" \ il1t' I ' ."t, , j\ I I', 'IHf or dill" I ',:'''ll\l'':'I'~I' ~rlHP6"I~, "C0L4:Jlllr':1 '1I1,oiw~le;. 'rJ~l, lIh"', n lb'I.ClrI.... ,lhc"lwnQlrt,' , j' ~4'" m L' N I ,1Y.g,,1't IliTl ",'J C 0 I r ~" lit I . I 0 wlI'f In 'Hcm Il( yoarlt,.nlllllnlUnl ch"8~.,. 0 rur'1 011 bU!I1t! c~lnln., "'}l" 0"'" "e:J'~I:ko~~Pt\l.V~~lrll~I,;; ,',,, ,II, '!III, 1"'" lI.....2Glt......l!U.!!JlI!!im!""""ur.'''',,,, I, ",',",",',;':,';,' 'I. "(.iI,I~tl';r:ii>:lf~VHW.l~"NI~Ir"IH~,ln !.I~ Qnll;r;I)I;'I~'I,II~ ~ill 'r'1 0011 nr '01 III aU IIralll o(lnY ~(n~'~h",j..ver,l, ",,"fQ,u/[lrw.rl'Pf f,~m~~f1<:~!1'q~',rl'hlf I.." w~,,~ ihe,lnJI~I~U'IOUII III ,*,h "r.lr IIIIIlIh;n I,,~o'o, ; '0" , ,_i\d'i:\I, Ik,:Il,lf !Iht, ,.tl\:f' ; I' \t",. _ ' "j'/'-'I ',' W(Il",~";. , ~O~ ,11'111.11', ~{i"I,II~~ r~ r.f wlillln ,h. h,rtlll dilcrlbe,nl~~l~I;~~~or:I,~~,;; ',HIi;,'~', I-':'f >/,.';,_.',_--__',1, L" .' __ 'h\Lflj~;!i .....-- . II; 1/',)11,' . Mrn!1 dW IH1\1~t..~jH'\I'.J\Il,j,.,f;\n~(\!i\". '!i'I\.,,,,) ,'l. ,,,' I., '"'' a ,dll! rH'_;';l~~'{L,b,\',"1\'trl.l)~)fPVt'r lh(' '_:i'. 'P.-)1\1 Ii . . ;;,1iu',H' 101 /ltI\ t1HIUIII!O,y'Il' i!\;,lilill; 'II ,lnil jLdrii'!-'_'\iI:iptHliilIIJil)lH' Ii\, II iilL II ;'fltj 'II , flit! dVHftl;;lirH)tJflllt' l'i~'\j 'V"d HI Li\:-,fNC' ltH," 'I, ~,; ::!~!~;_~'fM"(Wf4~4't'I~\HI'~I"i" , There Ire 4 corHOt of Ihll "''',fllOnl. I Whlll __ 1"",,, ~ Velll,w _ ^,.1I1 1I'Iok _ 1"'1ft 481, '" ~,'~" ..;l~':1 I' ::: :~I' ,"~'" l,t- I -'tl~"~'-" i ';'IUIIIII''I\ t-l Nli L.C';'I"i I.. \~. IlW'H'! I, , PlLQftMllV '~I.,:bf&~~..', 1,'. i~ , ll,litl",' tl~'1 -jj I; , "!,\H 1'1:\,1" ; I '1\' ~" I , I ~ \\Ii JIi "', '~~+ "1\'*1' { '<"i/l\' In ,;" " It 'Ir~~lA,I!."I" , Rl1'~.8~", I', " 11i1!1i Ih,o Ill"! !l lh l'l.Jtt! b i\S~,i l '!iljfMAi.r ~ ~ ~lt, \ )i/I 'i!t'lft{ ,~~ \ 'I!' h r" 'Iii.; lAX I linn/II, I_',~ff' tnU-t It" LEASE <FO.R. REAL EST A TE I .,PART,QNE pF. A,~~,P "~R~_~_G~:f:ME ~ i Jaclc I'f'OIHIrty ~In~ r ,'.' ,'~Li' ,.', I ,,,",, 1',,~_1 "u",. ,'T011 , , i " i, Ill' d;i Ii Ii! 1\ \\-11;\'1';: 1//1 ",,--,:,"~.fll t,l; I -.--..---........... ,,1")'01 I Ij,.,,,,,,I,,,L~,,\'I.h "!:''''', 'I, "I', "'.'-'1'\\ ,',I W,~\ "::~,,. .""mt,i ,~~~e}hl( :,1", ~,'.'~ BO',,"II' "tI ; , \ ., Ii dlY or Dee Iii j I '''A.DI19!4 -'If,! " "" f\ \ f'~ . j i .,' I ,I i "Ill.. , -- hmlnl,.e,' 91 ; i i-II II! f ! - ,!~r~ .-he,~I"." L,tMlO prem,", "c~I,I'~\~_e.:' , 'n, kn~WII II ,~ ii/ ';;.il , 1\\ t'll\:'- .1:' w~v,,~~~t';,~,9,'~~I' 'It' 1 ~Y or CUlllbtrland ~~(~I,I.',,~ ',' curtains nUl In tho' , , S'lle or Pennl, \;<.\!;\ <i '.., .'1' q nlill!'i!!, j d I;" ill- ki ;';' I ,,_I d ,j Iii Ilh;d , " ~-"_,, .." 0'""1 -I't,..q,. I lI" '"-; hll tth,; "1;11\1 ;,jdi "'Ilfl, WIIl:1I .tll~ ; iil'-.HIIIII ~,~.flj" I.A~ ll"\()f. '1;"", IH [\1 '; d Hi j',-" , Iillli .', jj;O ;; .,11 !.II'); i I i' ; I. h hill !',{A~I:\ -j;'! ~-""lJ:"_'L'(_ljlllllltl,b!l.p 1'1" _.....-..__............~ \, .....'" upon I~ 'oIlQwlnl l.n"R ..... ..oPllltlon. tq ,Wltl ' !5 '''S' 00 ", .' (b) T~I ,.nltl,r~r''''~'L!'"IlfY'_J, IQ \A"or , , ,~ . 'l\. ('I)'P.Ymtnllln"'Vft.,"!~'hlf"l;l,,,,, " ,.' ..lnlhunlUunl"rl:".~Q;~ ,:' 'I' . "" (d) ~,,~4'b 9r "~fAk,,"PmIJ.""If",,,,,,\~I, 1.~"bY I.,,~., $~, ,,,;;~;,\:,I ~~~III.~~~~~:'~!:~;i" nl'~~~.~rl:"AA~,?~~~(~~ to 1~/31/~~1,:~: hHI,', {~",.~\4~~, ~, tll4t tint 'day or ..chllO~t" <I'P""'''I' " ",~~': "1Il~:"T'~~Q!Jb~I';~Iffi' .'l~ and ~,d,' '", '_,. I..".,.,' ,,', 1" ""1111 . OJ !;..C~f\\'lM~~~~I~,'P ,~lflo.' .h~,~ ~r D=:=~ .. ,,:;^.f,l.;a;l ' ft. lhlj, \~I')i>,.~.pl,!'\I~1\1nl"", 1tf.'I\'"I1l"\ """ '. I'! '. i......~.Y "r ''"'7't, l....tl--r^J'''''19 " ..k' tU ',' R~~~m~Ir~IfJlll~tKW,/fI11\I"'I('~I' I',~ "'iO~, :~~~f"iO~;u.:'=~ae. 1'''''- .,\', ,It,., l:,).... r:,~:~Ilr\~rr~?~'!'!ll~.flJ~r:~P~:'''( ~liiillil""'Ulll1'" .'7r;""'" 'l"III'lK ,'",,<1 "",' I '''\II.' '. ~l r' One rn-- - klil'\,',' ,.((~I'II!i~'~'IW~II\D~r.p(,llffl'\lltnlt,~ ,r,IN!'~~"I""" "',~ ,.',f " , " ,'.., , , ~<:",' 1,,'I"l'~'I,' nllln mt,~tfo Y ',d,~'I"~,,, ulI110n.Y.or'h'U~It'dSI.I~!O~~I,."I",i' "',' ''''''1 "-"" ntldl"~ /111\1 VIm ' I~" fd (oln~~':""',"', .." " ," 'alllp~f:"j"" (, H,', ' ..' ~':llt "'I ,Ii III" ,~,,,,,\I,,) 'J.,i '1"11" \H", ',' , "'1"'" ..,...,.... hi" '" r ,"",H I\',"~,"'"JI~ i.,~ P; IYih '~~ "~,"!,.r~,ir II,U,in,," ,'1',..,",."',, ',0,... t;J h'AI, C'If,rl."", "~I'W,7tC,.re,' ' " i", <11;1.1 1{ I " I~~ ltIIW,". ~r,"!W"nl,I<~~~,n~r ~!I..nln., 0 ''''P"ull..plI''I.~\n.\~f'()r 0111 I..", 'I ,c,,1I ,.,01 ''''''l'~'~II''ll/.~'", r'~~~.Ir. 'P"IW"I~r': "!tholw_ll}~"II,,,, IIhool, lb.loo,rl,;""lhthlwn'co..," ,.. " ('"', I:l'~ I>'W' S',~Vil'\' ~U: ',01\'." I" . '''or '4ri minimum ch"8" 0 yurly 011 bu'nt"l..nln , ,,"I~:I,I,:' ,,'''' "",,\Ill "b'~I~&o~~"'~W~,J'l~"i\"'''h.'' [",'!~U<, liI.r",,~, ~,bl.. releDbciM' I'" 11I01 ,,,,,,d," '" i , ,,,'" "\iJ\.I::,':tJ.Q:i~~%m~~~..i;"~~lri.I~~!h~i~' v~~ir,nii'!"'I,i.~,~III\i'Y'''I,,,r .ny<u .11 r,p.11l o("t\Yklt\iI'~hl/,j"'VlI," " ".,Ilf~.urtlp.t,r/'P,p,Vm'll~~'~'~.'?',P!.,~II, ,.m ~~~,~ l"",lndl~~u'l '''',1 IIf 'M,h "p"lr II 1'"lht" 'I~~~ ,:,; '" " ,i\lll_,;:u ~1I1';':t [II \It I ('\'1 }WI,It! i' ,;1' \ 'It".,. _ _ """",d,--'. ." r !,mt~'I'~'7~ V", ,wlll,","I(1'lm~ r~,r,r, Wllhln Ih. heroin d,.~r''1',1,fr~J"f~::~~,c,'rl',~~,:; '-'_IIII<!'-'!' (--i_____J__; I_I' _ i;i, ,.'Ui1j(q;,j-,,;' ';\1"_" jl~'di',p:,(!, ,Onl'"1 di\" ulid~r~~t"'t!\\I\)\',d,~'i!ih\I' III 1''' 1 ".." I" ,I,d' f" I" !H(I,:,Wcl,hYllllWf<LlI)h'''''r,'IIl~ ,"H. I\,'.jl\\"" Ii' Ii ",.\Q-III:\IJJl' fIll llll\ dlHUltwt, 1_!Ijj' "Il'illl_i,ji ill ddiii\! 'i I !,d rill~llt IfY pprtion 01..011' 1111-1 \d!, q~. il,. nllH i\;!\ !- , riil' dC'lfl(l,lir1l1M Ilk I"V,"'l ", ''''.1 !1I1 ,\;,iN(! TII\) I ". ~u\~:!;.-. .;~ff;~I;;\~l,tft_M-,-'4'r(Hnl'nl J', Thor. .re ~ 'Dpl.. "f !hl' "''',,,,,nl, I Whll. _ lOllo, ~ V.II".. _ A,.nl I Pink ~ I...... ~ D\ I III I.,' fOr j II' "'_, ~J11 ,~ ~,~!' '::I~,:; , ,. i , "'lHHHI' II . INI. '__-4.""'" I ,,\ (}WIH-i P'-ONlf\J\V \lhQ~;,,' ,~, p jili'tl't,'&K" 'i'ill "1\1 I ',f:-' /; ~\tJl I', ; ;,'t'(~' '''\~,' ",l~ln ! :' Ij"B"~~",,, Sh"~,I'~" 1 <I iH1I1I th~ IIn,/' ii, , ItttfM! h I'S~, l j,~~l,.~' I\,i(~!' , .' 'nttU""d [I, h fnh\ll," 1\' , 11\1'1, ,\ 'I {(norlh, I ; H~B1~,(i,]; 01 ,;!!)iW;(IL'j ,,"jj; ;":'.:44U;I,h;,." '.11.' 11\1Iilllll1ll., I",,, lIiIlIJtL:< d l i, INSI', AUQtWWlN " 'I Ill, l.l'h,~('~' (Iltl4ffi~l.:S""" " ! l'~o.;i 1l,1bl~, 'I' f!" ~ , l \; , II '\llIllidj 'I'll " ;1 H); ,.( iIi' r ''';;..1>1'19.9.4 I 'I,' ,','- ,'I I;A .nt 'or L.nor.lo, ; 1 '.Dee ,d~r or f"d'f"I'''' L!; iii, !. ''Ill "c'.lJ.~ Loi....;' known I' .:~qv,\~~t,,',~.q,~-l~\ 1,,,-1\ ;'i .........-jl' I -"'"Ii' ;'ll In'th., " " . .=r of OUlllberland ~~~(~'\\,',,~,"'ollrt,.1na _ _. St.l. or P.nn.. , !';';Li \d I !,: [ n 1l1l~iilO;:1 lh'll'i I'j" d 11! I i ;"11-" ., "II' ilL I'" 'I' 'II, ,.1;'_ ,:.I;iH I " ,;!;"d il\ hi, 'diil! d ' I l,i \\illlilid"i fld '\i'~, Ii n I ,\ \ I' V:i UIII I 1\'" '1.1 UI" !!',111 iiJ'.;'i' '/\(tU~" I' , I "Sprint. IRW1W1ll:HA8IN 3344 CHB8TNUT ST APT 4 CAMP HILL., PA 17011.4413 PI1\la: 1 Blllln\l Period Ending: 8/26/97 Involoe Pate: 8/28/97 Customer Number: 183430876 " Summary of Cha,rges $.71 ClIrrlrl Tala 11.21 Payable Upon Rlcel I m.IY Salanel Account Por.ward AdJullmllntl ".67 1.00 SPRINT Chargas $7060 Taxus Import.nt Informal/on from sprint: .. SSRVICS ALBRT! Q,UR RBPORDS 8H,OW A PAST DUB 81L.1.. ~. A,O~':;~tf' 8001ll'888 Gilt sprint Sllnse Toll Free lor $3 a month and pay Just ten oents per minute for Inoomlng c10mestlp oallll from 7 p.m. to 7 a.I11. weekdaya snd all weekend long, Call 1-800.877-4846 and press "2" lor more details. O,'F '.Crulsethe Internl'lt with Sprint Inter'n,l'lt PassporqSM). . ~~, '"g", " You,'ll get simple, direct aopeSS alpngwlth lrra e sOftVJSr,1l ., andaupport 24 hpurs a, day, seven days a week, To \let your ,,~ ' ' flrat month FREE, oall 1-800.396-2600. Get oonneoted nowl .9NTERNET . II,You h~ve ~ny'queetlonNboul your, Involoe, ple~$e 0011 CUllomer sorvloo ~t 1'800'~7N846. or 1""1 us 01 t.up:/lwww.lprlnl;r.om. ,.-, .... ',' "UUl-~lllJl"!fn~ l:I"'WlV','''' .,-., u.:.\n~"I'CJ""""U"l~'I~'u"-"";t.""-""....,,, "..',.",.....",......".,,,....j;..jj......,....... THANK YoU. for ualna and alaylng wllh SPRINTI " Itemization of Calls ORIGINATING NUMBeRI 717 730.0221 , Call.d Nbr Mlnut.a Chorg.. , Nbr D.I. Tim. . C.II.d 1.00.llon '", ' 1 0/00/87 liOHM 0 ~ORTON VA 703 600.a080 14,0 $3.50 2 6/05/87 alGa PM 0 ~ORTON VA '103 000.2068 1,0 ,~6 0 0/05/97 ,2137 PM 0 ~ORTON VA 703 600,2050 1.0 ,ao 4 8/05/81 ai40 PM 0 ~ORTON VA 103 000.a096 1,0 ,ao 0 0/00/97 ' 2100 PM 0 I.ORTON VA 103 ooo,aooo 0,0 ,75 0 0/05/01 2i07 PM 0 ~('lRTON VA 703 000.2000 M ,00 7 8112/87 ' 0117 pM 0 eNQ~EeIOE VA 703440'0103 8,0 a.oo TOTAl. POR 717 730.0221 30.0 ' $1,00 If you hRV' Rny qUOIt/anI, plea" oull CI"tomor S,rVIOO .t Jo600.677'4040, or VI.II us ot hf/p:llwww..prlnl.coln. ), .'.\ " '-0 . j ~ .::l ,0..: (, LAST WILL AND TESTAMENT or IRWXN S .QHAs:tN " I, IRWIN. S. OHASIN I of O.umberlalic1 county, Penrllllylyania, m~k8, p.ublieh and deolare this as ana for my Last Will anc1 Teetament, herebyrevokinq all e~hGr Wills and Ceelioils heretetore maae by me. rXRSTj I direot that all inheritanoe, estate, transfer" suecessien and aeath, talCes, ".of any kilielwhatsQever, whJohmay be paya'ble by reason .of my death, whether .or net w:j.tll respeot to preperty passin~ under this Will, shall be paid ,out .of I the prinoipalefmy resi,eluary, estats. " SIIlCOND' :1;" elevisa' ana bequeath all the rest, residue and remainder .of my esta~e .of whatever nature and wherever situate, inol\1dinq an'y preperty ever wh'ioh I helel power .of appointment and, teqether with any insuranoe polioies thereen, in equal s,hares/, to' myohildreh'i JQ.REN A,NN KATZ and AM'i JENNI,FI!lR CHASIN, prevideel that should any .of my ohildren predeoease me, I qive and bequeath suohohild IS share unto her is.,ueper IItirpes by rspresehtatien,anel if there be a failure .of same. then I qivs and bequeath s,uoh eleceaseel ohllel's IiIhare to my survivinq ohild as .pl:'evieled herein. ~HXRDI SheUlel any of my qrandohildren not have attained the aqe of twehty-ene' (21) years at the time for dis'" tl:'ibutien to him or he~, I qive, devise and beqUeath the'.haFe .of' eaoh suoh,gl:'andohild te my herainafter nam61el Trustee'er Trustees, 'IN SEPARATE TRUSTS, te held, manage, invest and reinvest the sharE!s so rE!ceived, and te use and apply from time ,to time suoh pertien' .of income and principal fer the said9randchildllil eduoat~en (inClUding oelleqe, trade sohoel .or ether liIimilal:' trdnin9 e,r eduo~t'ien), support ahd welfare as my Trustee or Trust.eEls, in their, sele' disdretipn I deem advisable. MY Trustee . ~. , " I, i , ., . .{ ~ ~' or TrUste.. may ma~e the payments for the ~uppcirt'an<1 maintenance o!! my c;/ranc,\chil<1ren <1ireQtly to saicl'9rlmdchildren or to their Guardian or Guardianll. Any, payments made by my Trustee or Trustees pursuant hereto shall be made without fUrther respon- dbility to the said 91:'andchildretl, their OU,ardian or t;iuardians, or to any person takinq oare of my qrandchilclren, The Trustee or Truste'" in e)(8I:'cisin9 their discretionary authOl:'ity with , respeot to the payment of inoome ot' pl:'inolpal of ,the within Trust ,to my 9randChilqren, sh'all take into 'oonsideration any inoome or' other reSouroes available to my qranelohildr~n from sou roes , outaids" this Trust. In adeli tion"my hereinafter named Trustfle or Trustees ,shall have the l:'iqht, inthGir"soie dil;loretion, t;o purchase and pay for, out of the prinoipai, as well ~Il inoome, suoh insuranoepolio!es as will provide for the 9rando!,\ild's ,me<1ioal oare. Any income or pl:'incipd not so applied shall be dim-' tribute<1 to each 9randohilcl when he or she attains the age of tw~nty-one (21) years. In the event any of my 9randqhilQren pre<1eoeuee me or dies prior, to the terminati,on of ,this Tr'umt, the ,interest of hid 9randchild in said Trust shall cease with, , any inoome and pl:'inoipal beil19 divided evenly between or amonq my" otherc;/ral1qo!,\i~dren or the separate trul;lts established hereunder for their benefit. I~, howeyer, said 9randchilel issUl;'vived by any ~~ildren, ~y Trustee or Trustees 'shall pay net inoome of the Tru.~ tp or apply the SI.\11\~ for the ,bene tit of such ohilcl,ren of my, , deoeased. grandohild I in such ,amount or amounts as my Trustee or Trustee81 in ~heir sole disdreti~n, deema~visabls for the 1- ,- .' support, welta!:,e and maint,enanoe of said children. Any inoome or prinoipal not so" applied shall be diEltributiacl whim such ohildrliln of my deoeased 9randohild attain the a~e of twenty-qne (21) ysars. J'OUR'l'HI In addition to all powersqranted to them bY law and by other prcvisionsofthis Will, I qive the ficluciarieS aoti~q hereunder the folloW,+.nq poWerS" applioable to all ,. 2 - " 'u . " property, 8x8rcisaple,wit,\lout oourt approval and sUsctivll until actual., diStribution ot aU property I " j; , (A) TO"U at pUblic Or pl;'ivate eale, or 'to' lease, toranypsdcd,ot time, any real or personal property and to 9'ive oPtions tor salel, exchanqes or leasel, for suoh pric.s and upon luoh tem8 (inoluding, ondit,. with or without lilBoudty) or conditiOi'll 118 an deemed proper. Thi~ inoludes the power toqive leqally luttioi.nt instruments tor transter at the Property and tio ,reodve the Proo.eels ot any aisp61i1ition of it, (B) To paJ1t:ition, sUbdivias', or improve real eltate, and to enter into aqreements con6erninq the partition,subdivi- sion, improvement, zoninq or manaqement of "real estate an,d to i~pose orextinquish restrictions on real estate. (0), To oompromiseanY oldm or oontroversy and to abandon any property which is of l~ttle or no value. (0) To inve~t in all formlofpropeli'ty I iholuc:linq . stooks, common trust funds ana mortCj/ar,/e investment funas,without r.striction to investmentsauthorizec;\ for Pennsylvania fiduci- ar~e., as a,r. deemed proper, withouf. re,qara to any principl" of div.rsif~oation, risk or productivity. t - ~ (E) To exeroise any option, riqht or privileqe granted in insurancetpcli'cies c~ incther investments. (F) To, e~erdfse any eleotion ,or pr'ivileq8 given by the' , , and cther tax ll\ws, inoluQinq, but notnecessadly beinq , to, pljlrsonal' inccme, Cj/1ft anti estate or inheri tI1ncetax' , Federal limit.a '~ laW.. ii " , (0) To make distributions to ,I11Y her,sin named benefici- aries in cash or in kind ot;"partly in eaoh, (H) Wo borrow mon~y ft'omt~emselves 01:' othet's!n oreler to pay debts, taxes, ot' estate or trust administra~iQrt ~xpense8, to"pr~teot. <<;lr improve any property hela under my Will, and for !hvestment p~rposes. . (I) To select ~etirsmen~'plan (pension '" " .~ $ a mQc\s of pl\ymG.ntuncler any qualitied plan, pt'~fit sharih~ plan, empl~yee ".- , t' 3 '" " - . . . stock ownership plan, or' any othel;' type of qualified plan) to the extent the plan or the law permits them to do sc, and tc exeroise ' any other rights which they may have under the plan, in whatever manner they consider advisable. JtrTHI . I nominate and appoint my daughter, AMV JENNIFER OIt'SIN, of 1\5lS2-C South 28th Road, Arlington, virginia! as'l'rustee'of,the hereinabove desoribed trust, who shall serve without bond and shall receive fair and reasonable oompens~tion. StXTHI I nominate and appoint my daughterJ KAREN ANN Kl\TZ Exe~ut't'ix of this, my Last \'Ii 11 and Testament. In the event of the d.ath~ resignation or inability to servs for any reaeon whatsoever of the said l<AR~N ANN I<ATZ, I nominate anclappoint my daughter, AMY JENNIFER CHASIN, Exeoutrix of thiS, my Last Will and 'l'estamllmt. I dir':l.ct ,that my Exeoutrix, and thei;, eucc;leElSors, shall not be required to post security or a bond for ,the ~erformance ,ot: their duties in any juriSdiction. IN WITNESS WHEREOF, I have hereunto set my hand and seal to this, my Last will and Testament, this II day of DEC, ,1996, , . () t' .. . "":v .J.C,' ,~..<f.n-,-",) ~S.'CHASIN (SEAL) signed, sealed, published and declared by the above- named Testator as and for his ~ast ~il1 and Testament in our presenc;l$, who, at his request, in his p1;'esence ,and in lThe presence of eaoh, other, have hereunto subs~ribed our names as attesting witnesses. At\dre.. l~J~~ c st~ At\drlass "1 (""~, " 'r'~ ,?7'1r:" , ,tI (~) ,..:' "' .: "'d I ~C!.., 1\ 07-15-1998 CHASI N 08-05-1997 21 97-0669 CUMBl!RlAND 101 L A.lt\lI1t AMIHed .1 MAKI OHIOK PAVAIlI AND RIHIT,PAYHINT Tal REGISTBR OF WILlS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17015 OUT ALONO THII LINI ... DITAIN LOWIR PORTION FOR YOUR'ftIOORDI ... itW: IIW.lr.~~ll'.r~':":r.Nlii"'al~~cS~.Wil, liifflllcSl.Y~xl.';ili~itAYillli r..~t1:cl'''~llcl'I.'b1f.....-...... ..... , DIIA!;I;OWANOI OF DlliUOTloNI AND AIBlII I~T OF TAl(' .. ISTATI all CHASIN IRWIN S FILl NO. 21 97.0669 AON101 DATI 07-15-1998 , TAX RBTURH HAS I I X I ACCBPTBD AS flLBD () CHANGBD RISIRVATION OONOIRNINO FUTURI INTIRIIT .111 REVIRII AflPRA%IID VALUI Oil RITURN IAsID ONI ORIGINAl RETURN I. R..l B,t.t. (80h.d~I.AI B, Stooke ~d 8ond. (80h.d~l. 81 8, Clo,.I~ ~ld st~k/P.~t""r'hlp Int."..t (S.lIIdul. 01 A, Nort...../Hot.. R.o.lvabl. (Soh.dUI. PI J,Ca.h/8.nk Dlpo.lt./H.'o, p.r.on.I Prop.rt~ (80h.duI. BI 6. JolntI~ OW""d'Prop.rt~ (Soh.dul. fl 7, Tr~.f'r' CSoh.dul. 01 ' 8. T~t.l A...t. APPROVID DIDUOTION8 AND IXIHflTION81 15,456.51 9. fun-r.l BXpen.../Ad.. to,t./HI.., Bxp.n... (Soh.dul. HI (91 ' 10... Debte/Hort.... LlabIUU../Li.n. (Soh.dul. II (10) 948,00 11. T.tel Dlduotlon. (111 16.lIR4:lIl la, ~t V.lut IIf Tex R.turn 'uBI 130 ,898,41 18, Ch.rltabl./Oov.r"""nt.I 8.qullt.) N."..II.t,d 9118 Tru.te C8.h.dUl.Jl (111 ';' 00 lA, Net V'Iueof"lItet. Bubj.ot to T.x (1Al 150,895.41 NOTlI If.n '.'''.llIllnt W'" :l.I1l.lld prlv:LOl.l.:LY, Un.. 1,41 18 end/or 16d,' 1'1 end 18 w:LU rif:L.ot, figur.. t~.t :Lno:Lud. t~. tot.:L of ~ r'~l.lrn",'""""' to det.. A88188HINT OF TAXI 18. A.ount of Lln. IA .t Bpou..l rete (181 16. A.ount of Line 14 t'XabI. .t Lln..I/CI....A r.t. (161 17. A.ount of,Li"" 14 t.x.bI. .t CoU.ter.l/tl... 8 r.t. 1171_ 18. prinoip.l 'Tax CUI TAX ORIlliTS, PAYHENT DATI 15=-11\~ -;b 8URBAU Of INDIVIDUAL TAXE8 l,*lI!RITANCE TAK bJVl811l1l D1!PT. U060l IIARRUIIJIlO, PA I7IU'0601 OOHHONN.ALTH OF P.NN8YLVANIA IlIPARTH.NT OF RIVINUI NOTICE Of INHERITANCE TAK APPRAISBHENT, ALLOWANCE OR DI8ALLDWANCE Of DEDUCTION8 AND A8DE88HENT Of TAK ANDRBW C SHEELY BSQ 127 S MARKET ST PO Bll.X 98 MBCHANICSPURG DATI IITATI OF DATI OF DIATH FILl NUHIIR CCUNTY AON PA 17058 III cal III (Al (11 <<61 171 ,DO' .'00 .00 ,,00 79,820j98 iOO ~B,4S8.74 (81 7,763,60 X ,00_ 125 ,1510 81 X .06_ .00 X ,15. US) RHCurT NUH8dR D%8COUNT C+ I INTERH8T/PEN PAID (-) AHDUNT PAID TOTAL TAX ORIDIT .ALANOIO" TAlC DUI INTIRI8T AN FIN. TOTAL DUI c.,. ". m.lfn II m lIt.m lRWIN S 'NOTE I T~ in.ur. prop.r .r.dit to ~bur.ooount, .Ub.it till upp.r portion of thi. for. with YoUr ~e~ p.~,",nt~ 148,279,72 ,00 7 ,587 ,91 ,09 7,387,91 , ;. 7,586.28 198,54CR .00 198.34CR . If PAID AfTEADATE INDICATED, SBE REVBRSB fOR CALCULATION Of ADDITIONAL INTBRH8T, C 'If TOTAL DUE f8 LE8S THAN U, NO PAYHENT 18 REqUIRED. If TOTAL DUE IS REfLECTEO AS A "CREDIT" (CRl, YOU HAY 8E DUE A REfUND. SEE REVER8E SIDE Of THIS fDRH fOR INSTRUCTIONS. I AotllH I8TAATI\'l!' cORRacilONlI P..tUlI .rror.,dl.oov.r.d on thl. ........ot .hould b. .ddr....d 10 wrlllng tol PA Dop.rt..ot of o.v.nut, aure.. of Indlvl~.1 T'~'" ATTH'po.t.A.......ot R.vloll Uolt, P.pt. 2&0601, Horrhbur~,PA' 17116-0601 ~ (17) 76?-.6I01, ... P'~ S of tho ,bookl.t "Io.truolloo. for lllhlrlt",o. T.. R.turo for. o..l",ot Po_t" (IlIIY-ISOIl for OIl '~PI",.II.o of _lol.tr.llv.1Y o.rr.ot.bl' .rroro. ," DIICPUHTk If ."'v I'~ dUO 10 P.I. wUhlo thr.. (Sl o.lood.r oooth' .ft.r tho d...d.nt'. d.ot", . flv...r.",t n~) dh,,","t .f tho t'~p.ld I.. .lloMld, ~~ II~t'~ -.oo.tv ooo-p.rtl.lp.tlon p.o.ltv I' oooout.. on'th. tot'l .I.th. t.. ind Int.r..t.......ldlOlld oot p.l. bOfor. JonUlrv la, 1996, tho Ilr.t dOV Olt.r tho .od ol'th. t.~ ""..tv p.rlOd, Thl. oon.p.rtlolp.tloo p,,",Uv I. OPM.loblo 10 tho '.... """"" .od 10 tho th..... II.. pori.. II YoU ~oUI. OOP..1 tho to. .od IM"..t thltlll' bOon .......d .. lodlo.t.d 00 thl. ootlo.. Inltr..t 10 .hlrPd bI~ll1Illo~ with llrot d.V 01 .olloqu.n.v, or 01'" (91 .onth. ood 00' (l) .ov Iro tho dot. of ...thl t.,tho d.t. 01 poV..ot, T.... whloh bou'" "'lIoq",ol b.for' Jonuorv I, 1911 bOor 101O'OII.t tho r.l. .1 "~ (6~1 poroont P'I' _110 ool.ulolO. ot 0 dollY roto .f ,00016" All I.... IIhl.h b..... d.lloouool on 0Ild .ftor JlII1Uorv.11 1911 wIll b..r 10lorOlt .t . r.to Whl.h will vorv froo ooloo..r v..r t. ..Iood.r v"r IIlth thot rol. _,lOCI bv tho PA Dop.rt..ot of oov._. Tho ,"pll.obl. 10torOlt rot.. for 1911 throuoh 1991 oro'" oBBloYATlPfU P\JIlPDIE Pf' NOTlCBI PAT"'HT, IlIII'UHD IQlll DIJ&QTlDH6' PllHALTT' IHTBIlII", N l~ !iI'. '+t' ~I U .~g '~tl_ ' ,- ,,', ,;': a: ') ,", , " \0 .... l,1 L! .~1 ~ (I) @~l ~ B~ a: B.totOl of ...",,"10 dvlng 00 or b.for. D....b.r IIi 1911 .. If onv futuro 10t.rOlI 10 tho ..101.10 tr....forrld 10 po.....'oo 'r ,ol.vooot .t. DI... I (..II.t.r.l) blo.fl.l.rl.. of tho ...Odoot .It.r tho ..plr.tlon .f onY ..tot. for l1f. or farv..r" t~ o~onWl.lth htrlbv.IMpr...lv r...rv.. thl rl,Ht to Ipprll.o and ...... tran.flr Inhlrltenol TIW.I .t tho lowful CI... I (o.ll.t.r.ll r.t..o .ov .u.h f"lur~'lotor..t; To fUlfill tho roqulr...ot. .f ~..IIOh 'I~O of tho loh.rlton.. .nd B.t.l. T" Aot, Aot '1 01 199.. (7' P,B. B.QUOO 91~Dl, '" ' Pot.." tho topp.rtloo ofthl. H.tl.. .od .ubllt wIth YOUr P.yo.ot to tho R.gI.t.r '1 Will. prlot.d.oo t~ roVor" 'Ido, u"",. """k or ooo.v .rdor p.Vobl. tOl RBGISTBR OF MULS, AGB,NT ' A'refund of . tlM arMllt, Whioh "., not raqu'Il~'d'on the TIM R.tdr""..~ b. r.qu..t.d bV ooltPl.Ung ,., "Appl1CiIUon f.r R.fund .f Pono.~IT'ol. Inhorltot40 ond B.t.t. T.." (REY-IS1S), Appll..tl.n. .ro ,Y'llobl. .t tho Offl.o .f tho ooslolor .f Will., onv ..f tho IS oovon". PI.trl.t Dill....' or bv ..llIo~ tho .p.ol.1 '~.hour on....rlou..rvl.. ouobor. f.r loro. ord.rloa, In Poon.vlvonl. l-aoo-161-IDI0, .ul.ld. Pono.vlvool.1od wltnlo 10..I'H.rrl.bUra .r'~,11171 117-a09~, TPPI (717) 771-..al (H..rlol'lopolr.d ~llv), ' MV p.rtv 10 lotor..t 'oot .,U'flld IIlth tho .Ppr.l...."I, .1I.wooo. or .10.11........ of doduoUon., .r .....""'t of t.~ (lo.I~lou dl..ount Or lol.r..t) .. .n.wn.o thl. H.tl.. lUot obl'.I.wlthlo .llItv (60) d.v. of r...lpt.f thll Hotl.. bYl ' -'wrltton pr.t..t .to tho PA Dop.rt.."t of R.vo"u.,lo.rd 'f App..lo, P.pt, UIDlI, Horrlobur,. PA 17ua-IOU, ...llotlon to hi..,. thl' ..U.r d.teridn.d It ludH of thl IClOOunt of thl p.r.onal r,pr..entlU"I, OR nllpp..l 'ta tht Orphln.' court, OR ~ lnt.r.it Rat. DIllv 1nttrl.t F.atar XIIr tnter"tfl.t, bath Int.rllt Flatar 1917 191'-1991 199. 1995-199~ 1991-199' ,Yo IlYo 9X 7~ 9~ ,0001,7 ,000SOI ,ODDI~7 ,oooua ,000117 19a. 'O~ .0011,1 1965 16~ ,ODO~Sa 19a. II~ .000SOI 19a1 II~ ,000116 19a6 10~ ,000'7, --Intoro.t I. ool.ul.t.d .. fOil....' INTBRaBT 0 SALANOB OF TAH UNPAID X' NUKBBR OF DAYB DBL~NqU~HT ". DAILY IHTBRBlTFADTOR ..Aov Hotl.. 1I.lIOd .ftor tn. t.. b.o_o dolloou.ot will "IIo.t "" Inlor..t ..Ioul.tloo t. flltoon IIBI d.V' bI~opdtht d.'. l!l'f thl ........nt,,1f pI".'"' 11 ..d. aft'r the lnt.r..t OOltPutlUon dlt, ,hoNn on thl Hotto., additional lnt.t..t IUlt b. a.laul.tad, " t?~ ~ ~J :n '1'- ~-,j --) f( Ii 'I (, , Cf t-.l ,t.;1i PAI'ltBHT , . Pot.... tho top portloo of thh NoUoo 0Ild ......It with your p.y_t .Ido p.yobl. t. tho ..... 0Ild odd..... prlotod 00 tho r...roo, .Ido, ' I ".I . --J : ,~! ',~, r . ,)- ,,~ ~,I If IlIIIIIM!IfT PBCBDBHT ..... .- .r .....y .rd.r p.yobl. to! RIGIITIR OP IfILLI, AGINT, If HOH"IlIIIIPBHT PBCBDBHT ..... _ or .....y .rdor p.yobl. to, CotlHOlllflALTH Of flNtl8VLVANXA, jh ~t. IIIII'UItD (C01, ~ r._ of . tl' Irldlt, ""Ioh "" oot roquo.t.d 00 tho T" .otum, IOY Ill' r.quo.tld by .....I.U'" on "NlPIIOIUoo for .._ of P_.ylVOllI. lohor!t1ll1UO 0Ild ".t.tl T.." (ReY-IIIS), APPlI..Uoo..ro .v.Uobl. ,t tho Dill.. of tho ...ht.r .f HIlIo, onYof tho IS ."1hUO olotrl.t Dill... .r frlll thl Poo.rt_t'. 1~-ho\Ir ,"_ring IOMllo. _re for f.r.. o...rlng, 10 P""".yl.Ohl. l-aoO-S6I-IOJO, ouhlcl.Pono'vlvOhII ond lI!thlo 1...1 Horrhbur~ Iroo C7171 7a7.1094, TDO' (7171 771-1111 IIto.rlng 100.lr.d onlVl. IIllPLV TOI ~u..Uoo' r_rdlng orr.ro oootolnod on thh I1OUO. .ho\Ild bo oddrould to, PA Dep.rt_t .f R......., lur... of lodlvldUOl T...., ATTHI po.t ~....._t Rovlow Unit, Dept. 110601, It.rrlobur~, PA 17I11-0601,.p/wloo (717) 7a7.6101. . OlllCllUlfT. If lilY t.. dUo h pold wlthlo thr.. (a) ooloodor _th. .ft.r tll. do.......t'. do.th, . fl.... porOOllt (Ill) dloo_t of tho t.~ pold I. .110\I0d, , , _LTV, Tl10 Ill( 1Il<.....\1I,hOh-p.rtl.lp.Uoo _Ity I. ......tod 00 tho l.t.1 .f tho t.. 0Ild lot.root ......10, 0Ild hOt p.ld blforl """",rv II. 1996. tho flrot doy Iltlr tho ond of tho t.. .....ty I'orlod. ItmlRlllTl lotlr..t ,'o,Ohtreod bogll1lllllll with flrot doy .f d.llf1<l\lOl10Y, or 01... (9) _Ih' 0Ild .... III doV frOl thod.t. .f do.tn, to tho dot. .f p.y"",t, T.~oo ""I.h bl...o dolloO\lOot boforo JOIl\l.ry I, 1"1 ,...r lotorut .t, tho rot. 'of 11M 16~,1 porOOllt por...... OIloul.tld .t . d.IIY r.t. .f .09016<\, All to... Whloh bo.... doll_t on 0Ild .ft.r _rv I, 1911 will bI.r lotor..t .t . r.to "hloh wUI ..ry froo o.l.odor yoor t. ..Iond.r voor IIlth thot r.to ~ by tho P~ Ilop.rt_t .f R......., Tho OPpll.obl. lot.r..t r.t.. f.r lOa, 'thr.ugh 199a or., VOIr Iht.root'R.t. D.II~ ,Jnt,r..t faotor V..r Int.r"t A.t. O.lly lot.r..t Footor - I". lOX .00DlI4a 1917 9~ '.DOOl~7 1911 1611 .OODOII 1911-1991 IU .000501 1914 IIX ,000501 1991 9X. .000107 I_ Ill( ,IDOl" I99S-I994 7ll .00019. " 19M 101 . 000.7~ I99S-I99a 9. .0001.7 '-lotor..t h OIloul.tld .. foll..1I JHTBRI8T . IALANCE OP T~U"~AJD Ie "U"III OPDAVS DSLJ"qUSHT Ie DAJLV JHTBRBST PACTOR '-Any NotlOl I.ouod .ft.r tho t.. bo..... dllloouont will rlfl..1 on lot.r.ot ..1~I.tloo t. flft~,(j&) d.y. bevond the date of thl ..H...."t. If ply""t II ,Ide Ift.r thl Inter..t oOIlPU~.t1otl dl'. lhown on the. Notl.., addltlontl Int.r..t .u.t be o,IOU1tttd.