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LAST WILL AND TESTAMENT OF
Ci1RLOU. SHADE
I, CARLOS F.. SHAm~, 1I resident of Wormleysburg Borough,
Cumberland County, Pennsylvania, being of sound and disposing
mind, memory and understanding, do hereby make, pub lish and
declare this instrument to be my Last Will and Testament, hereby
revoking any and all wills by me at any time heretofore made,
ITEM I: I direct my. hend.nafter named Executor to pay
all my just debts, funeral expenses, administration expenses and
inheritance, estate, succession or excise taxes, which I owe or
may become due on account of my death, as soon as may be
convenient after my decease.
ITEM II, I give, devise and bequeath the sum of Five
Thousand Dollars ($5,000.00) to each my brother, Paul W. Shade,
of 24 Valley Road, Wyomissing Hills, Pennsylvania, and my sister,
G1adya Smeal, of 7 Marshall Drive, Camp Hill, Pennsylvania.
A. If my said brother or sister should predecease me
or die simultaneously with me, then said share shall lapse and be
included in the residue of my estate.
ITEM III: All the rest, residue and remainder of my
estate, be it real, personal or mixed, of whatever nature and
wheresoever situate which I may own or have the right to dispose
of at the time of my decease, I give, devise and bequeath to Ira
C. Mellinger, Jr., of 30 South Front Street, Wormleysburg,
Pennsylvania.
A. If the said Ira C. Mellinger, Jr. should predecease
me or die simultaneously with me, then I give, devise and
bequeath all the rest, residue and remainder of my estate to be
divided equally between my brother, Paul W. Shade, and my sister,
Gladys Smeal.
ITEM IV: I hereby nominate, constitute and appoint Ira
C. Mellinger, Jr., Executor of this my Last \<Jill and Testament,
r!~ld'rd1 6:. t~ ~~d.r
ar OB . a e
(SEAL)
, .
CCM!/f~~~tIiT~\(~s".fit.NI'Ill\~ aNla
Ha"",.i5~Q,~a '~b.06.1
',) '- / 'ie;. 'I
INHERITANCE TAX RETURN
RESIDENT DECEDENT
(TO BE filLED IN DUPLICATE
WITH REGISTER OF WILLS
Al!v.lSOOE)( . (7.\J"1
paR DArES o~ DEATH AFTER \2IJlIgl CHECK HERE
IFA'lI'OU!jAt. D
!ll.~~_
FILE NUMIER
C A I
H P L
E P 0
C R C
K 0 K
P S
VEAr' q '1
,/13
NUMBE"
B
C
,
OlW60ENT'S NAME (LA9T, FIRST, AND MIDOLE INITIALI
Shade Carl DS
COUNTYCOOe :.'1. \
OECEOENT'SCOMPlETE ADDRESS
3D S, Fr()l\t Streot
Worm1eyabur:g, PA 1701.3
E,
SOCIAL SECURITY NUMBER
181.03.6281
DATE of! DEATH
08/03/1997
DATE OP IJlfHH
06/11,/1905
X 1. Original Re~--oz.- Supplornontal Return
4. Limited Estate D 4.. Future Interest Compromise
(lor dates 01 de.th .Ilor 12-12-82)
[]] 6. Oecedont DI.d restate 0 7. Oecld.nt Mainfained a living Tru!it
(AUach copy 01 Willi (Anach a copy 01 Trust)
C P ALL CORRESPONDENCE AND CONFIDENTIAL TAM INFORMATION SHOULD IE DIRECTED .TO:
o 0 NAME COMPtET!:: M....llINO "DORE~S
= , Earl Richard Etzwel1er Etzwei1er and Associates
S TELEPHONE NUMBE" 105 North Front Street
717) 234-5600 Harrisbur PA 17101
1. Re.' Estato (Schodule AI 1 one
2. Stocks and Bond, (Schodule BI (2) None
3. Clo.ely Held Stock/Partnership Interest (Schodulo cl (3) None
4. MMgago. and NolOS Rocel.able (Schedule DI (4) None
I, Cash, Bank Doposlts & Miscellaneous Personal Property (Sch EI (5) 4,276.00
6. Jointly Ownod Property (Schedulo F) (6) 20,026.94
'I. Transf.rs (Schedule G) (Schedule L) (7) 69,666.48
ao Total Gross Assets (total Lines 1-7)
9. Funeral Expenses, Administrative Costs, Miscellaneous
Expenses (Schedule H)
10. Debts, Mortgago Liabilities, Lions (Schodule I)
11. To'al Doductlons (total Lines 9 & 10)
12, Net Value 01 Estate (line 8 minus line 111
13. Charitable and Governmental Bequlsts (Schedule J)
14. Nit Value Subject to Tal< (Line 12 minus Line 13)
15. Spousal Transfors (for dales 01 death after 6-30-94)
Se. Instructions for Applicable P'rcenhlg8 on page 2,
(Include values from Schedule K or Schedule M.)
1&. Amount cf Line 14 taxable at 6% rate
(Include values horn Schedule K or Schedule M,)
17. Amount of Line 14 ta)(abl, at 15% rale
(Include values from Schedule K or SChedule M.)
18. Principal tnK due (Add ta' from Line 15, 16 and 17.1
19. Credit$/Sp Poverty Prlur Payments Discount Inter.st
0.00+ 12,000.00 + 631.58 0.00
20. If Line 19 is groater than llno 18, entor Ihe dlfferonco on lino 20. This is tho OVERPAYMENT.
~ 0 IChock hero II you ora roquoollng a rolund 01 your overpaymon..!:l
~1, If Line 18 is grealer than Line 19, enter the difference orl line 21, This is the TAX DUE.
A. Enter the inter.st on the balance due on Line 21A.
B. Enter the total of line 21 and 21A on line 218. This Is the IALANCE DUE,
Mako Chock Pa obi. 10' Ro letor of Wille, A ant
. . IE SURE TO ANSWER ALL QUESTIONS ON PAGE 2 AND TO RECHECK MATH . .
Urw" p'r'llIlll.. of perjury, I dcctlle lhllll hive elillm!ned thIs r.turn, InclUdI"1ICComplnylno ,c:nedul.' and :tlltements, .nd 10 the besl of mf knowltd~'llnd blUel, It Itlrue,
conK-llnd complell. I dICII'. Ihtl.U 't.l eltltl 1'111 be.n r.polted II true mllk.t value. O.claf.tlon of prep.r.' olher lh.n thl persoflil ,.presentatlvel. b..,d on IlIlnformaUon of
whIch Pl'p.,.r hIS Iny knowlldglt,
._ County Cumburland
(IF APPLICABll:l) SURVIVtNG SPoU!lF.'S NAME (l.AST,FIRST AND MIODLE INITIAL) SOCIAL sECURITY NUMBER
05.
8.
R
E
C
A
p
I
T
U
L
A
T
I
o
N
(,)
7,677,93
(10)
201.00
(15)
0.00 X
AMOUNT RECEIVED (SEE INSTRUCTIONS)
0,00
Remainder Return
(for dates 01 de.th prior to 12-13-821
Federal Estate Tax Relurn Required
Tolal Number of Safe Depos,t: 80)(85
(8)
93,969.42
(11)
(12)
(13)
(14)
7,878.93
86,090.49
None
86,090.49
0.00
(16)
o . 00 X .06 '
0.00
I
X
C
o
C
T
A
T
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N
12,913.57
(17)__~90.49 X .15'
SIGNATURE OF PFlRSON RESPONSIBLE FOR FILING R~TUAN
? I. - , I
/ ,. ... ()....' 10-1'
30 S. Front Street
iI(;rmi;"y~b;"rg ~. 'PA" -i704"j -..
(18)
12,913 . 57
(1')
(20)
12,631.58
0.00
(21)
( 21A)
( 211)
281.99
0.00
281.99
DATE
I I' ~.J
VI) I i I ..'
DATE
I!P/'i'{'
Etzwei1er and ASSDciates
iris - North- -jiro';t' si::r~~;;"""'" -...... -.. -.....
Harrisburg, PA 17101
Copv,lght (e) ,
Form 1500 (Rev. 7.904)
.. -..,.. --
~ST WtL~ND TESTAHE~
QMLOS E. SIWlE
;'.'
I, CARLOS E. SHADE, a relid.nt of Worml.Ylbura Borouah,
Cumberland County, P.nnsylvanil, b.lng of lound and dilpoling
mind, mamory .nd und.rotending. do her.by m.ke, publilh .nd
daclara thia in.trument to be my Last W1l1 .nd Tut.ment, heraby
ravoking any and .11 will. by m. at .ny time her.cofora mad..
ITEM II I direct my her.inaft.r n.m.d !xocutor to pay
all my jUlt debto, funer.l expon.... .dmini.tr.tion .xp.n..1 and
inh.rit.nce, a.t.ce, aucce..ion or .xciae t.xe., which low. or
may b.co~. due on .ccount of my death, as .oon a. may be
conv.ni.nt aftor my daceaoe.
ITEM III t give, devi.e .nd bequ..th the oum of Fiv.
Thou..nd Doll.r. ($S,OOO.OO) to each my brother, P.ul W. Shad.,
of 24 Valley Road, Wyomi.aing Hill., Penn.ylvania, and my .i.ter,
Glady. Smeal, of 7 Marshall Drive, Camp Hill, Pennsylvania.
A. If my .aid brocher or .i.ter .hould pred.cea.. me
or db lilll\.lt.neouRly with m., th.n .aid .hare .hall lap.. and bl
included in tho ro.idue of my ..tate.
ITEM 1111 All the rest, r..idue .nd remainder of my
I
',:
..tat., b. it r..l, p.rsonal or mixed, of whatevlr nature and
wh.r..o.ver lituac. which t m.y own or have the right to di.poll
of at the tlme of my decease, I glve, devi.. and beque.th to Ira
C. Melllnger, Jr., of 30 South Front Street, Worml.ysburg,
P.nnoylv.nia. ..'
A. If Che ..id Ira C. Mellinger, Jr. should pr.dlce.s.
me or die aimult.noously with m., then I give, deviae .nd
bequ..th .11 thl root, re.idue .nd remainder of my ..tate to be
divided .qually bocw.en my brother, P.ul W. Sh.d., .nd my oister,
GladYI Smeal.
ITEM IV, I her.by nominata, con.titut. .nd appoint Ira
C. Halllna8r, Jr" Ex.cutor of this my La.t Will and T.ltament,
tP.nA~ Il e.~Afi.~
arLos . ha.
(SEAL)
; ,-'
-,
.~
BRENNER
. CADILLAC OLDSMOBILE, INC. I
. P.O. BOX 1955 2222 PAXTON STREET
HARRISBURG, PA 17105 HARRISBURG, PA 17111
('117) 238.2552
y~I'.-97
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-.-----.,-...
SALES. SERVICE 0 LEASING 0 PARTS · FLEET
BRENNER SERVING CENTRAL PENNSYLVANIA AREA SINCE 1921
"IV. tlonx + 112...1
COlOl1lm~~aM'>>"N"
I'TATIO
Carlos E, Shade SSil 181.03.6281
Joint tononri.),
08/03/1997
A.
NAMI
Ira C. Mellinger, Jr.
---
ADDRISS
30 S. Front Str.;;~
Wormleysburg, PA 17043
..
c.
Jointly-own'" prop.rty'
pili HUM.IR
RILATION'HIP TO DICID8HT
friend
ITIM LITTIR DATI TOTAL VALUE DECD'S DOLLAR VALUI OP
FOR MADE DISCRIPTION OF PROPIRTY
HUMIIR JOINT OF ASSET '.4 INT. ICEDINTINTIREST
TENANT JOINT
I A 6/14/91 Fulton Bank Cert If icate of lJ. ,956.09 50.00r. 5,978.05
Deposit No, 411.0583640.
000 value of $11,906.07,
plus accrued interest of
$50.02. Account owned
jointly with Ira C.
Mellinger since 6/14/91.
2 A 5/6/83 Dauphin Deposit Bank and 1,364.19 50.00r. 682,10
Trust Company . Checking
Account No. 76871746, Date
of death value of $1,363.70
plus accrued interest of
I $0.49. Account owned joint y
winh Ira C. Mellinger, Jr.,
since 5/6/8~.
I,
3 A 12/10/90 Dauphin Deposit Bank and 2,087.81 50.00r. 1,043.91
. Trust Compeny . Savings
Account No. 4913748785. DO
value of $2,083,10, plus
accrued interest of $4.71.
~ccount owned jointly with
Ira C. Mellinger, Jr., sine
12/10/90.
4 A 8/15/95 Harris Savings Bank . 11,088.82 50.00r, 5,544.41
Certificate of Deposit
Account No.
(see contn sched attached)
Total of Contn Schedule(s) 6 778.47
TOTAL (AI,o ontor on Uno 6, Roc.pitul.llon) 20,026.94
(If mort spacI Is n..d,d, insert additional shilts of same size.)
CopyrIght (e) 1114 form IOUwa,. only CPSysteml. Inc.
FOfm 1500 Sc:htdula F (A_\!, 12.88)
Estats ofl Catlos E, Shado SS# 181.0).6281 08/0)/1997
CONTINUATION SCHEllULE
Cant Inuat Ion of Sohedulo F
ITEM
II
LETTER
FOR
JOINT
TENANT
DESCRIPTION OF PPTY
. TotAL VAL
OF ASSET
DECO'S VALUE AT DATE
% INT OF OEATIl
DATE
MADE
JOINT
09.56.275214, 000 value of
$11,034.84, pl.us llCcrued
Interest of $53,98. Accollnt
owned jointly with Ira C.
Mellinger, .Ir., since
8/15/95,
554,97 .
5 A
12/13/94 Harris Savings Bank .
Savings Account No,
09-20.028236. 000 value of
$1,100,00, plus accrued
interest of $9.94. Account
owned jointly with Ira C.
Mellinger, .Ir., .since
12/13/94,
1,109,94
SO,OOr.
6 A
12/1V94 Harris Savings Bank .
Savings Account No,
09-20.028237, 000 value of
$1,100.00, plus accrued
Intorest of $9.94. Account
~NI\ed jointly with Ira C.
Mellinger, .Ir., since
12/13/94.
1,109,94
50:00%
554,97
7 A
:1./21/92 Lutheran 8rotherhood 11,337, OS
Securities Corp. . LB Income
Fund Acct. No. 7082372, 000
Interest of 1,322.876 shares
@$8,S7 per share -
$11.337,05, Accmmt ololned
jointly with Ira C'.
Me1-lingor, Jr, since
1/21/92 ,
SO,OOr.
5.668,53
..'.................. ..
'6.778,47'
Dauphin Deposit Bank and Trust Company
1*1
F.\H.,\Ii':lC\ [lANK' \'.\1 LI-,\'II.\SIo.:
n"S!.: lH PI',S;-'<'i\'L\'.\N1.\
HOI'I'!'.1t SI\LlIlt\Y & Co" I:-.:e.
EASTFllS MORHlM1E SI'.R\'ll:I','i, INC,
AUlust 29, 1997
Etzwetler and Auoclates
Allorneys at Law
105 Noreh F,'onl Slreat
Hanlsburl, PA 17101
,
. ---.-""'1
Re: ESlale of
SSN
DOD
Carlos E, Shade
\8\.03.628\
August 3, 1997
Dear Mr. Etiweiler:
Thank you for your request concerning date of death balance Information for all accounts held by Mr. Shade.
The enclosed Ilstiog is for any accounts which may have been held al Dauphin Doposil Bank, Farmers Bank,
Valleybank, and Bank of Pennsylvania.
We are happy 10 supply this Information to you. Also, If additional information, resoarch, or fIIo copios are
. needed, they can be provided for a service charge of 820.00 per hour (one hour minimum) and ,25 per copy.
If you have any fureher questions, please call mo at (717) 255.2054.
Sincorely,
Q~Q.~
Cheryl A. Bowers
Cuslomer Management Informalion
Department
~ab
P.o. lIox 2961' HARRISIlt:R<:, .P:\ 17105.2961
TEI.r.I'HONE 717 255.2121 . http://www,,,nytimcbank.colO
Dauphin Oeposlt Blink and Trust Oompany and Hopper Soliday & Co., Inc. are subsidiaries 01 Dauphin Deposll Corporation,
Bank (If Pennsylvania, flarm.u. Sink .nd Valleybank are divisions 01 D8uphln DlIpOSl1 Bank, Member FDIC. Eastern MOrlgage Services, Inc, Is II subsidlaty 01 Dauphin Deposit Bank
B~~~l~
Operations Center
635 North 12th Street
Lemoyne, Pennsylvsnia 17043
7171731-1440
AJ.1;p9t 15, 1'HI
~iler ard ABaXi.at:es
1a; N. Fro1t st:reet
HarriEbJrg, PA 17101
The.in!ormntion which ~ou requocten on the ~ccount(n)
~ 0;0a;Sed (lJocinl Sncurity Humb",r 181-03-6281
Heme of Joint
Owner, if o.ny
C9-2J-0282.."'6 C9-2J-02B2:-"7
Savir'gs Savir"gs
-
12-13-94 12-J.3-9Il
$l,lCO.CO $l,lCO.CO
9.94 9.94
1,1<:9.94 1,1<:9.94
Joint Jo.mt
[o\;turity rate:
N::m N::m
I1:a c. Mellirger:, Jr. Selre
Account llumber(lI)
ClaslI of Account
tlo. to Opence:!
Principal Uo.lance
Accr'Jed !ntcreGt
Dalance at
Dllte of Death
Account
Owner:lhip
Adc:!itiono.l !n!or-
mlltion Refll\nr.te~
12-13-94 12-13-'94 8-15-95
Year to rete interest:
$9.94 ~_ Ckt (.0'" CQ
P100se have the ro:vi.voc COTp1ete the erclcea:1 w-9 fcxm ard ret\JI:n it
to lfEl in the p:Mckl envelc.'f2. 'll"an'< p,l.
Dllte Owonrshir
'Wns tstnblinhod
~y,
.. (j.;::rzL.......~.~~
. G:'etd1en (,. cale
Sr. clep:5it Dx:urentaticn Services Pep.
FEE SIMPLE DEED
THIS INDENTURE, made the 7th day of April, in the year of our Lord
One Thousand Nine Hundred Eighty-Nine. '.
BETWEEN. CARLOS E. SHADE, single man, of the Borouglt of
Wormleysburg, Cumberland County, Pennsylvania, Grantor, Party of the First Part,.
A
N
D
.'
. IRA C. MELLINGER, JR., of the Borough ot Wormleysburg, Cumberland
County, Pennsylvania, Grantee, Party of the Second Pan,
WITNESSETH that the said Party of the First Part, for and in
consideration of the sum of One Dollar (S1.00), lawful money of the United States of
America, well and truly paid by the said Party of the Second Pan to the said Party of
the First Part, at and before the sealing and delivery of these presents, the receipt
whereof is hereby acknowledged, has granted, bargained, sold, aliened, enfeoffed,
released, conveyed and confirmed and by these presents does grant, bargain, sell, alien,
enfeoff, release, convey, and confirm unto the said Party of the Second Part, his heirs
and assigns, the remainder Interest In the premises as hereinafter described with Party
of the First Part reserving a life estate for himself in said premises.
ALL the following described lot of ground with the improvements thereon erected situate
in the Borough of Wormleysburg, County of Cumberland, Pennsylvania, being parr of Lot
No. 7 according to the Plan of Wormleysburg, the same being bounded and described
as follows:
BEGINNING at a point on Front Street and the dividing line of the houses; thence along
said line West one hundred fifry feet (150') to alley; thence aiong said alley South
twenty-three feet (23'), more or less, to Lot No.8; thence East one bundred fifty feet
(ISO') to Front Street; thence by the same North twenty-three feet (23'), more or less,
to the place of BEGINNlNG.
SAID PREMISES hereby conveyed are improved with half of a double frame dwelling
house known as 30 South Front Street.
BEING the same premises which Carl W. Geiger and Mary M. Geiger, his wife, by their
Deed dated Nvoember 18, 1969, and recorded in the Office for the Recording of Deeds
in and for Cumberland County in Deed Book "L23", Page 777, granted and conveyed
unto Carlos E. Shade, Grantor herein.
TOGETHER with all and singular, the tenements, hereditaments and
appurtenances to the same belonging or in anywise appertaining, and the reversion and
reversions, remainder and remainders, rents, issues, and profits thereof; Ai.'ID ALSO all
AlII.. lOll EX + (2.'7)
COM.nm~.MhY'NI'
ISTATIOF
SCHEDULE J
BENE ICIAFlIES
Carlos
-
ITEM
NUMBe.R
E. Sha~SII 181.03.6281
D8/03 1997
RELATIONSHIP
AMOUNT OR
SHARE OF ESTATE
NAME AND ADDRESS OF BENEFICIARY
--
A. T oxoblo BequosI"
No individual aeeete available for distribution
after payment of Estate debts.
ITEM
NUMBER
NAME AND ADDRESS OF BENEFICIARY
B. Chot~ablo and GOl/ommonlal Bequosls:
PILE NU"'IIR
AMOUNT OR
SHARE OF EST~
$
0.00
TOTAL CHARITABLE AND GOVERNMENTAL BEQUESTS (Also on,e, on lino 13. Roca lIulallon)
(If more space 15 needed. jnsen additional sheets of same size,)
Copyr1llht (c) 1994 for"' lloftw.reonlY cPSytt.ms, Inc,
form 1500 Sehedule J (R''', 2-81\
/5'-199 'i
BUREAU Of IHDIVIDUAL TAMEI
IHHE~ll.NCE TAM DIVISION
Dl:PT. 21"01
HARRIS'URa, P. 11121-0601
COMMONWIALTH OF PENNSYLVANIA
DI'ARTMIMT OF REVENUE
*'
l:_....
NOTICE OF IHHERITANCE TAX
Ar'RAIIEHENT. ALLOIlANCE DR DIIALLOIlANtE
Of OEDUCTIOKI AND 'IIEISKIHT OF TAX
~I'H'U II ." l"om
04-06-98
SHADE
08-03-97
21 97-0713
CUMBERLAND
101
EARL RICHARD ETZWEILER
ETZWEILER . ASSOCIATES
105 N FRONT ST
HBG PA 17101
DATI
ESTATI OF
DATI OF DEATH
FILE NUMlER
COUNTY
ACN
CARLOS
E
[~llOunt R..ltt_
MAKE CHICK PAYABLE AND REMIT PAYMENT TOI
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
CUT ALONG THIS LINE ... RETAIN LOWIR PORTION FOR YOUR RECORDS ~
ii'i'V= ifti'7- fi-APji - ili9':97Y"iioTi cr-o; "iMHiiiiTANci- Y AX .'APiiitAiiiMiiir; -m.-oMAMci -iii--.....---.-. - -- --
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ISTATE OF SHADE CARLOS E FILE NO. 21 97-0713 ACN 101 DATI 04-06-98
TAX RETURN WAI' (X I ACCErTED AS FILED
RESIRVATION CONCERNING FUTURE INTEREST . SEE REVERSE
APPRAISED VALUI OF RETURN BASED ONI ORIGINAL RETURN
1. x..l Eot.t. (Io~dulo AI
2. Stqoko _ Iondo ISoMdul. II
5. Cloo.ly tt.ld stooklr.rt..rohlp Int.r.ot lSohtHlul. CI
4. Kort_o/Hot.O RIlO.lvob1. I SOMdul. 0 I
5. C.oh/lonk Depoolto/Hloo. r.roon.l 'rop.rty (Soh.dulo II
6. Jointly O~_ rroporty ISoMdul. FI
7. Tr~oforo ISoh.dul.01
I. Tot.l Aoo.to
( I CHANllED
NOTE. To Inouro proper
arlMllt to your aooount.
o...lt tho upper portion
of thlo for. .lth your
t.. P.y_t.
.00
.00
.00
.00
4,Z!LJ1.
20J026.94
69.666.4L
III
111
121
III
141
III
161
171
93.969.42
7,671.93
APPROVID DEDUCTIONS AND EXEMPTIONS.
9. F~r.1 EMp.no.o/A~. Cooto/Hloo. E.p.nooO (SohtHlul. HI I"
10. Dobh/Hort_ LlobIUt1.o/LI~o ISohtHlul. 11 1101 201.00
11. Tot.l DtHIUotlono (111
12. ...t V.I.. of Tax R.tum (121
15. Ch.rltobl./Go..r...,t.l ....ohl Hon..l~ttHI '111 Truot. lSoMdul. JI (151
14. ...t V.l'" of Eot.t. SubjllOt to T.. 114 I
NOTE I If an ........nt W.I illu.d prlviou.1Y, lin.1 14, 15 .nd/or 16, 17 .nd 18 will
refl.ot figur.1 th.t inolud. the tot.l of ~ r.turn. .11..lld to d.t..
ASSIIIMINT 0' TAXI
15. AaoUnt of Ll~ 14 .t Spou..l r.t. (151
16. AaoUnt of Ll... 14 t....l. .t Llho.l/Cl.oo A r.t. 1161
17. AaoUnt of Ll~ 14 t..obl. .t Coll.t.r.l/Cl... I r.to (171
11. rrlnolp.l T.' 0...
TAX CREDITII
rAVHENT
DAlE
1 -30-97
01-13-98
7.A7A Q~
86.090.49
.00
86,090.49
.00 X .00.
.00 X .06.
86.090.49 M .1S.
1111
.00
,00
12,913.57
12,913.57
REcurT
IRJI\IER
AA242418
AA242659
DISC_T (' I
INTEREST/rEN rAID (-I
631. 58
.00
AIlOUHT rAID
12,000.00
281. 99
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST AND PEN.
TOTAL DUE
12,913.57
.00
.00
.00
. IF rAID AFTER DATE INDICATED. SEE REVERSE
FOR CALCULATION Of ADDITIONAL INTEREST.
( IF TOTAL DUE IS LESS THAN tl, MO rAVHENT IS REClUIRED.
IF TOTAL DUE IS REfLECTED AS A "CREDIT" (CRI, VDU HAV IE DUE
A REFUND. SEE REVERSE SIDE OF THIS FDRN FOR IKST~UCTIOHS.I
.1 :.Ii
C\
(~\)\':
REIlRY.TloM. Eololoo .f dtGodOnto dvl.. .. .r bof..o ooo....r lZ. 1"Z .. If any '"Iu.o Inlo..ol In lhe 0.1010 ,. I.an.forrad
1n po.....ton or ."jOYMn' to ch.. . (OOUlt,,.1) "",flctld,. of ,he _lIMn' ,ft.r tM Illpll'.Uon a. ."y .,t". for
11ft or far v..rl; the C~.lth hereby IKP,...lv ,...rv.. the ,ilht to .",,1,. tnd ...... ,ren.f.r Inhlrlttnal TIMI'
.t ,hie l_W. Cl... . (oouat.tlll r.t. on env .uch future Int.ntt.
~Of
NOTtCEI To '\lUlU ttMl requlr..-tltt of S.aUon Z14D of the Inherltenct end E,t.t. TIM Aot, Act 21 of 1"1. (12 P.S.
SHUon 9140).
p.YllEMT. DoI_ lhe lDO ....Uon .f Inll NoU.. .... ._It .ltn ,our ,0.-1 .. lhe ...,.1.. .f Millo .rlnlad on lhe r...." .ldO.
~...... ~ or 110M>>' or.r PIy.lt tOI REGIlTEI OF MXLLI, AGEMT
REfUMII (CR). . .of_ .f . 10M .rldlt. ....'.n .oo nol r_.tld on lhe 'OM '.Iurn. .., bo ro_'11d b, ._l.U.... an "",II.oU"
for R.fund of ~.vlY.n..lnhlrltenc. ~ E.t.t. rill" (~V-ll1S). Applications ar. Ivallebll .t the OffiCI
of t~ ~..l.t.r of WI. 11, InY of t~ZS Revenue 01.trlot Of~lo.., or by oll.lnt the ,pacla. Z4.hoUr
.",..,Int ..rviol ~r. for for.. order'nll In penn.vly~l. .-IOD~S'2~2DSO, out.lde pann.>>l~lni' .nd
wlthin .0CI.1 ..rrhbUr. .r.. (7.') 761-'094, TODI (111) 112-22SZ (Head", 11IP.lred On1>>),
OIJECTlOMSI any p.rt>> in Intlra.t not ..u.flad wUh the ...ral...."t, aUololano' or dh.Uowanc. of dlducltlfln', or ...........,
of t.. (Inc.udl~ di.count or Int.r..t) " .hoMn on thl. NotIel .u.t object within .IMty (60) dlY' of raoel,t of
thit MoUoa bYI
-~wdttan prot..t to tha P. _art.."t of Ae,,"""', loard of ~a1t, Dept. 211021, .-rrltbur., PA 17UI-IDII, Oil
~"e.Mtlon to haY' the ..ttar daterllnld .t ...It of the _oount of thll PlrlonIll r."Hnt,U"I, O.
-~.....1 to the OrPhln" Court.
AllIUM
IIT.ATlW
~_CTIllM1l
PEMALTVI
'Mt.... .rrorl dlsoov.red on thit ..........t shOU.d bI Mdr."M In wrltlnt tOI PA Depart.."t of "a"MUI,
IUr.-Y of lndlvldua. TIM", ATTHI po.t ,......-nt ".~ieN Unit, DePt. 2'0'0., Harrl~r., PA 11.ZI~0'Ol
Phone (111) 11'-'101. Sea pili S of thl bOOkl.t "In.truetlon. for Inherltanc. '1M _.turn for' ..,Ident
Deoadant" (REV-liOl) for an a.,.enation of ~lnl.tr.tlv..Y corrlOtab.. .rror..
If WlY t.. due .. p.ld within thr.. (S) e.l....' Mnth. .fter thll deo...,tl. ...th, I fly. ,.roent (IX) clllO....t of
th41 'a. ,ald I. .Uowed.
Ttw Ule tlM ..,.aty non-partlclpatlon penalty .. o~ted on the to". of the t.. ... Int~r..t ......ed, ... not
p.ld blfor. J.-.a'y .', I"" thl flr.t day .fter thl! .... of thl tlM ....ty ,.dod. Tha. non~partlolp.tlon
,.wlty It ......... In the ... .-mer and In thl thl ._ UM pIIr hid .. you ..uld .....1 thl tu and lnt.r..t
tMt he' Men ........ .. lnilowtld on tl\l. noUOI.
In'.r..t I. oMr.... bellmiN with flret day of dall".,.ncy, or nlM (.) "",th. .... one 0) day fr_ the da" 0"
elMth, '0 thl dIIt. of p.YIIIft'. TI... lIIhlch bIcI_ daU~t ...for' Jerulr, ., 191' balr Int.r..t .t thl rat. of
.1. ('~) ,.rcant per ~ c..cul.ted .t . 0.11, r.t. Df .0001'_. ... taMO' Which beo_ dlli~t on tnd .ft.r
J~rV ., 1'" will ....r Int.r..t .t . r.t. Mhloh will v.rw frDl oa.endar velr to c.landlr w..r with thlt r."
announced by thl P. Depart....' of A.venue. 'lW ...110..... Inter'" r.t.. for 191' thrCM.llh I'" arll
'!!It lnt.r..t .at! DlI.w Int.r..t FlOtDr !J!r Int.r..t "" Dallw Int.rllt FMtor
I"Z ZOX .000141 1'" .~ .000241
1..5 ..~ .00001 ""~1"1 m .OOOSO.
I'" 1l~ ,000101 I'" n .0002.'"
1'" UX .0001" 1"'-1_ 7~ .0001'Z
I'" IO~ .000Z7~ .""-1'" .~ .0002'"
u lnt.rllt I. c..cu..t" .. foU.....
INTEIlUT . IALAllCE OF TAM UHrUD M NUHIER OF DAVI DELINQUENT M DAILY XNTEIlUT FACTOR
~-Anv Motle. hsued ,ft.r 'hi '.M blOOM' daU~lnt will r.flect lltl Int"..t o.loulatlon to flft..., US) da~"
ba.OfMI thI dat. Df the .....lMnt. If p."..,t It HdI .U.r Uti Inter..t ooaputatton at. thown on tM
Motlol, addltlona. In,.r..' ~., bI o..cu..ted.
DIICtlRfT I
IIfTtREITI
STATUS REPORT~ER RULE 6.12
Name of Decedent. (l ( I. 1('
Date of Death. (;; J , ~/
,
Will No. \' \ (\f (>C... I I )
, )
:,I\(lfL
Adm in. No.
Pursuant to Rule 6.12 of the Supreme Court Orphans'
Court Rules, I report the following with respect to completion of
the admInIstratiun of the above-captioned astate.
1.
State,phather administration ot the estate is complete;
Yes~ No
, 2. If the answer is No, state when the personal
repr.esentativo reasonably believes that the administration will be
complete:
3. If the answer to No.1 is Yes, state the following:
a. Did the personal representative file a final
account with the Court? Yes_____ No~_.
b. The separate Orphans' Cr)urt No. (if any) for
the parsonal representative's account iSI
c. Did the personal representative state an
account informally to the parties In interest? Yes X No
d. Copies of receipts, releases, joinders and
approvals of formal or informal accounts may be filed with the
Cerk of the Orphans' Court and may be attached to this report.
~ O~~. j.@-:" fl
Sign-a-ture "":: ~
Ear~ Richard Etzweiler, Esquire
Etzweiler and Associates
Name (Please type or print)
105 North Front Street
Harrisburg, PA 17101
Address
Date: S
c-
."
15
iS~
I"..""
1-
( lei
'f
~
~
liS' >,
Il>
'lil
II
(MAH I rnll,1 AM3)
C\ l.-'
( i
In
t'?
~~
,~) :'
'0
()
....
~
'1
Ai
( 717) 234-5600
Tel. No.
Capacity: _____Personal Representative
_~_ ,...Counsel for personal
representative
RW-Z7