HomeMy WebLinkAbout97-00800
.
-"""
"
. ,- [ ~
.
c2
,.
....
~ .
, i
WO
. ~I
0
1;;
Z
...
PETITION FOIt PIWIIATI': Illld (;RANT (W LETTERS
iiU- Iqq7~Q_iOt'___
Eslale of
also known as _,._.
No.
To:
___"..,,'.____c... lI.el',lsl<:l 01 Wills for Ihe
--'~-------''''-''''C'' '1 i /)eCl'(/,\wl. ('Ollllly of ",~\"'\".'LL!,IJ.l'l.. in lhe
Social Security No, ..';::(Jl.1":,-'}j~,~_"""i. ('omlllollweallh of !'ellnsylvania
The petition of the IIndersigned respeclflllly represellts that:
Your pelltioner(s). who is/ure 1M years of age or older alllhe exec'III'b'.t'..""...,.",. natted
In the last will of the ahove dc'cc'dellt, dated '____m_'_"~;":...:.m'.--.m'''---.,,-_____, 19~
and ('odlell(s) dated __.,__.__ ,.,__....__,_._,,_______
blare Iclcvullt drCllIllStarH.'C\, (',g. rt'lHIIU:lullon, death of c~w..'utor, ~tc.)
Deeendent was domiciled ut death in ", _G.""-'l<('lJ.~___,. "_._'" COUI,IIY, Pennwlvanla, with
.~-;'-~~t last ,farnHy 01 princ~I~/at ~y~jdcncc( (~.l "..\..').f).tJ.L~1~lll-iLJJ;1-IM~~-.JT _):__.!)' !.: ~) n If.! '~-L-:J' 1 Y!.1-
J.I 0 C r 1 n. U.:....Q.LU..!.lU_..;,~_.. ._.)_~~~i~.__-,--,-_ --.:}~~~___..___.,..;. !.~.l[_~~.l~ ...1~..L.~:_(]XL~lQ\:Ll!L~L:.i1~. .____,.~__~_
(Ii'it me"t, 1I11mbt'f and tIIuIldpal;tYI
C .. , l ]') -tfr;"
Deeendeht. then ..., ..1.IL___ yems of ag'" died ."....',i'1'._;.m'~'._L____m__...__,_,119 '~,
at -..--.J.Ctt1.1Uln._..\~:..1l1Ll_L:.il_:'...2~~;.- ,.",: ;,: ~J. J ._L'-~-_)_:.~____Ul'.L\~_~_!.,l____. '.':.).,qJ. I,L~.: -; J _~::..:'.:..:.,~. ~nL~j\ . l' ( / l , 1_, ,
Excepl a, follows, decedenl did not marry. was nol divorced nnd did nol have a child born or adopted
after execution of the will offered for probale; was nOllhe vlclim of a killing and was never adjudicated
Incompetent: _..._".,. ",'m_'m___m__m.. .. .., ..."",."..,,"'_,,____
Deeendenl at death owned property with eSlimated value, '" follows:
(If domiciled in Pa,) All perlOnnl properlY
(If not domiciled in Pol,) Personal property in !'ennsylvania
(If not domiciled In Pa.) Personal properly in County
Value of real estate in Pennsyll'ania
situated as follows; __'_______._.' ._._,'" '.. .... _... .'-____'____________.___~."'_m< In u
L_Lt:.~.,il!J).()~
L..
L_.
$...
WHEREFORE. petilioner(,) re'peClfully request(,) the probate of the last will and eodlell(s)
pt'",ented herewith and Ihe grant of leller',...___....1-'''-'_L'~),~~1.:d~t'.y_,,__, '
(tr.'ilamcntary; lldnlllli~trullOl1 c.l,a,; admllllslrlHlond.b,n.c.l,a,)
theron.
i
..,-
'~~
..g
"0,9
:is
-"
.0.
1i~
30
"
.
~
~'1 jj(J.)'1/,':i.':::?:':1'r""-'_""_,,,
-rr:rf~1RFL~~[lYJ~~f~g:nn(~'~'-:==.
l::.o-Olillllic.~huI~~J__l~l1il~.~___,_~_
-~~....'.._-_..~._'.._-~--_.
______M_.,,___~___~__.__._, ......_.., ~.......,,_... ...__._._.;___~__.._____m'___________~_
-------_..--"-_._.~---,----~._._---~~.'_.-.,~'"_._--,---~._-.... ....__..~-~._-,_._,_.
OATH OF PERSONAl, REPRESENTATIVE
COMMONWEALTII OF 11ENNSYLV ANIA t HS
COLJNTY OF J ..
The petitioner(s) above.nanwd swearr') or "ffirlll(s) thai tlte slatement' in the foregoing pelltion are
true and eorreel 10 the bc,;( ,1f the kilOwledge and 11elief of pClit;OIwr(s) and IIHtI a, personul represen.
tative(s) of the ahove dee..dr'l1t pClilioner(s) will wcllltrHi.,lrllly adrninbter the estate according to law,
,//, '.{,/~
s.worn 10 or affirmel! and S\lbScrJ(1('dY''<:{;'llLt'':r<'LJ.:'(ti..2:!:.~~"",,--__,,_. VI
before lI1e this ,_uul.'.L!,11 u_,.__ day fm'L/-/-_..-. .., "",,__ ~'
,'~r)!'jl;n;;',I\;j1"' r- 1~ ('i" . Cl
-:n~:~~~~VlIO!~:I\{(' ..-.-----~~~~~:.==,,::~~. !
/5 -,JD5 -1/
n'IJ'fllHl
~
'lflMAHIHl
II ACKIHK
~I
~
~
C~r
~~
.
I
~
I
lhi<;i~ IOll'rlilr Ikll IIll' illlllllilillllll\ hIT\' gi\'I'1l I'. \llIl\-'(th (11!licII1III[11 dlllll!rlll,d 1','llilil,lIC ill dr,nll IlId, liI\',1 \\dlh lilt' ~l\
l,()I,d Hq'.I"lt~lI', rhe nri!',lllid IVltilh.lll' ',\'lll hI' 1('!\','.lIl!I'd III till' \(.Ik VII.Ii IL'(llld, tlll!'-I' Illl pt'llllillli'llt 1iIJt1l'.'
WARNING: It Is 11101.101 10 clupltcolo tills copy by pholostlll or photograph,
1\'(' 1(11' llii, tnfiilLlh'.'~,~,{HI
,I ~
I
Y; 14.<; ;"<tA,/.' fIodw..~...
[Ill ,II (l'gi." 1.\1' 0 d
IliiiIlII/Ufhi"j",
";,,,'t ~\\~ OF pc~;.,.,.
"<,...... "".
,i~/' '-'TJ',.t:"';.:
(' "'"'.... ""'."~"
! $~'~""1"~
~i, ~_~
B! .j'l. ,;I':
I\: '( ~. ", 0' '.. ..J
\ <?~. ..' .' ~'t
\,.11p'..' . <..,,~,i~1
',.:'/MINl ~\ ~\""
ltt(q{t{!I!f;!!IJItI~I}~' ,
/,1
If'/I (.' , I'"~ I";"!
,,'~l -u,'4..J-L./.t.:-,(L..<, ..iII,!.t. ./.,
Il,ll('
4485747
N(I,
!tlli~ lUAli ~'1I1
COMMoNWEALTH 01' PENNSVlVANIA I OEPAflIMt::NT OFIIEAl'Il' VITAL RI!COAOS
CERTIFICATE OF DEATH
">If ."t ",,"~Ul
-- -----I~(,:c,~i.~[,:liiiiIY ;iuriUiM-~'---._.~.'----'-roAI~O;t.f;fii~M-';~T';-""J--~---
!Ill, _.]___ _ _ _~ _ _ .. 'l!l@!~... ~_.2.0i~:. ..~~..'::~~_._L~~'f;1~m6:rJQ,I'B
IJt40ERl (lAY OMl (J(lIInltl I lflllllll'lACI (I, ..-.1 ~\AC.O'o.'l/lt."'..."..,:.>f.:.... ."'~'" "'."'":'"''' ...., '. ..... '.' .. .
~-=rW~'" l ;~"1;'/1~~~? 1~~~I~l~~~~',"(~~ ;:~~~~;'I ~ ~~~"~~.~ .i.-- __'-~~_-:_1_=_~~1~~[0~- ~t~~~~~~-l-~- -~_-:~?,,:,.(~_~_' .
rffYlOIlIllwl'(JfOt4'" IrAClln~IjA"'~" I '~" " i' .~""'" '1'" I..... . ]~"DfCt.~",.OfII';"'.~'ii5001011H JfIA(;( A"'.'......".....A lIllo:" WNlI 01<:
"',Xl "",r-J"I"_'''<;c.WI1 ,'i;'I<',j
cumberland IDHOl Allen 'l'Wp. Bcttlimy V1l1uye 1oI1ut#<1 """,,,,fI.q,,.oW I White
-=-~!!if!lliifi~!!l~&:CiiP&~- u ~.lliQQf!!H!.'!~{~.:t!C!'i~!~! k -j""'ilJlLflUl'tIUllN!" - Qfn(JE~THOiJ<;Ail()~-..-.."" 1I"'-iiAA,lAlil,i.i'Ul-"';;;;;d-I- !!..~~Wi).Ty-----
1...,.,.~loI"".'l<>r4<loH'II""* lJl ,tjlIlHI'(}/\(.t:~1 ~H"!"~1Irltl[t!lI'<:!l~ "".1111",.1 ",.""'t<t 1I....".."""ltt,,.,.,"-I
<14""''''9'''''''''''''''''''''1 Fedora) GOVO':llIIlI.JIlt f 1 XI ilt"",'W,/lkoM." c'':':T: o-''''I,'*'vl
~lerli-1'YE!!t...__...~,. Ill,.... ___ !L ylt_ N" _ !l '~III!I. _ __~4':~_..._!~ey~.Marrled__ ___.___ ______
lI(CIOl"""IIl,I.Jtl!iQ"-lltlfln'I~" (~"\,,,.. ,1'" 1""--:',"1 -'1~1~~fNi;9-- III t,." ~~~~~~ylycl~,~~ I~l 11.KI .,..____,~"""'"._ ~r 11\!~!l.~! _._.~
325 WODley Dl'1v~ il:l;~,,~'~),~,~~';:.,. ::;':'~
!! MoC!~~.~.~.~~I~,(~.'. PA 17055 .__"""d';'H1 1I~~":,~~l~~~.:ra!'~I~ _ "'''~l'!;Il_ _~L):,.r:.:.:.-.:.~o'______________---=-_u
'AlII."'lINA"'~ If.. ....~>>. l'~1 l...n'''~A IiNA"'~ fl~ ",J<N 1,1.....\0.0'"'''''1
~~~~~Jlt~~l____ - - . 1~~~u;~!>;~~!~'1i~~~~i',~....i:f;;.-;;,;-~.ii'~.;~lu----- - -- .... - --- ~~
....T..t'ry.l!2Ulllall ___. ...1~1" UtalllLVl.ew Av",_~O"hUl.e. PA_l.1055___
i41iiiii'iirDliMii,~ If'~rf Of D,~Pu~llIC!h I't ~C( 01' OI~N~rlOk N....... olC_trr CI.".llolfy IOCAJK)H. ClftifiJn ~ l>llC<ldo
11<.I,.1'" C'."'.I"",I.l u"~"",,,,,\:;,.,.! ) .~.," 1"1 ~'~I ",'~"",PI"f
I-"J<I~~_I,_ ~1>i_'I\ _ ___ _ _ I) tl~ ~/1')/12~7 .Ui Hll~~IlUllC~O~_~~~~--=t~ __ 1e~t~CI_nover 2~P.________~
:~IIN(Jf'~ fW"V?~'U ml8<~.''''~lIH''''' b"~l";b#'{2 ( t::~~tm(Jf;~~~~:~Z~I~iafl ~~~_rA_l10~
~.'_n.c....., ,;,,(fi".-4'. I 1o""l>IlIuI",I"-'I~"'.Jt .....'1."',,".I04I~.'".. ,1.,..r.il+~."".,t<J ulfN'lfHU.....'1 OoCl'fiiJJitO
1trtM"".r<JI..I41..... oI...t".... '''''''''''fM,II'fl \. J ,/ (.1<<..,0.......,
,...."t,.,JIt01 cM'''' 11 'y-" t! { l I fv
1.....'.H~io,,;n.IlitI"'~ 'u~')'lJIiA1~ It 1_'\~{I'llllrifnll'"I1)I~i"~0l1l~Ij-'1 ~~"-"I ' ~S~A'lflltHAn(('IO".E1)i(AlTAAJ.i'-ii{fl.'C III ~---1-----~--
",_~ho~''''''''''''.lcM.1II ,(~ (}(\'1 ....r) ,.,(\;(
--." _ _ 1!~"'1'1 Li~JO' II ':"'\\_1&'(:( ll>, I.. _ "-- _.. __ __ _ _ ___ _______.
II."""",; ''''"I'''.IoIU''' ."....'''' '''''''''"-~'''''I~~.:""'&r.''IOl''JlI'" t.,,,,,r.:.o,,,r-.t""'."I"/-~ ....."..""~I<Q'If<l.'~')'" '''.'1 1'.d",t't.,II~"',' (AwlO'''.... 'Alii. OIl''''''''.Ac..-l'...._'''''''ilIU''''il.............
11ll..>If,>tI4<~"..~~f~'".'.. 1=0:,= ....1......~..IN~_""..."l'>IJn.
=~~I,~~~!.""". .~:;~"~.,)~(. i
'......"'."_'1. ...,l t
out: iOII~~!iAC'U;t,I!J1 :i '." .. { /,\ r I !
~=::~\I~ I ':' tMR)l'~;\\rl'\'(:?1;];},~L I,' I & rp<,~~'. I
t:~I.I~:'=~~~ t..M'.:.q"L- (~~.- \.'t I)...... I
~.::..:..~,;:,;t..1 OlllIUI'AI~~~'vi,;i{II'l'I't 1(1 I
,
~,./~;:~~~-i- =~'~;ft{~:tlfNii9" ';AmIiilCiuT~tI- - -- - -- - --- ~IJA~~:1,~~j~I~. ['lol( (;f'm0ii;-- --[/IJIlY AlVlOO~1 -- ii(5l;~iiM..i1OWiHNA'-OCClJi1iiiD----_.-
COlot'lllllY'(JfCA'/H ~/ I
Ol'OfAlIlI N'h"" ~ ,.....".. I () I)
A"",,,,~ t I ~., 1 '<I" '.., ',""" I I .... I...
,...IA" ...1) ...11 ~.".. I) ''''l......''.,.,,',..~ IlmU'lI"UJun'AII~""11'm~""'''lool'''''''~ t9'i IIOCArlOJil<;or:-t.ftii;;;,o,-siM.i
!!!" * :f - -.-,-.----.
CI~J:~l~~;:..~~~~~lN,.I,I"..,'".,,'",''I,.~..''',.,....''' .,.",. ""I'" ,..,.~ '."""1""."" .',",'I'" .,. _.",.":,,,,:~".\ij 1'< "'~~ -- - - KlN.<lUI~I' : Of "iHI~ Iti\r.-.~--"..'-'-.."'.'..'-~. ...-.t;--
'1..........I"',"...........4f"h""'~"....,..."'Ih...".fllI.""....."",.I",t-4 I lit. ~\.I' _.,_~ ..~-"
,oC~I;.u;"...~.l' .. . .I(;.f(tl{l~p~...'.'(l~.~
.'f11I/;1lUHC;~.I!Ul;."rlnINO'.."I(;IANI!I,"-,."t..,..',...,'t')''',.,-.,..""""."""",..".....,.", II ".. \,0 t \S. ~ L- ", '1 If 11
'......"'.ll'..,~...~.. iMtlh~.....'" ,llNl_. 4". ""'!Ill.... t,~I,,".lo 'hi ~.~..11I1'''' ."1'"'' U'II'I<I
NAIol( ~"tl'Ollllf~"I" r(~Of;"'''{Tl;(i'''rll TlOr.AIISl OIlilAIIl
'"''''1'1'''''''.''<1\1_ r'l . I "
1,~5~~::'~::::~.",";~~:'~~~:,"ln~':H~.I'~""nm10~UI'"".,j,"h"Wlllf<llll""h",.,<I,t,,'''<I~I~'~,I''<lMI..lh,~.~,fl.lIH~ ~_. ,. _._l) l;2 ~ .lX;~, 'l~;1 ~~,-,~~-'-~,-~~'-C ~!_,__!~,_,_
'-!i~~'-~l1ii-$Kii..j";UliI-~hlif"i"'lIj .' ,J ' JJ.I/LlJ{I.l.1 OAruIlCOI\!.."",....,
T\Lt4-<Jul.:<<.L, "",cJ."'~
ti.nrE.or-~(O~Hfif,w~-LUI-.._.---'--,._...-
~n
! camllp_lL,.. PQ
A(lrl(j~IkN.l.1 ~f<<)Ift,dAA
~'.b01o-
90 "I
L.___._.__:I_
CQU.tlVOl' Pl.(fll
3.
I give and bequeath the sum of Pive Hundred 1$500.00)
Dollars to SERVAN'rS OF MAHY of Barwyn, Illinois 60402-0712.
4 ,
I give and bequeath the sum of Pive Hundred ($500.00)
Dollars to the FRANCISCAN MISSION ASSOCIATES, 274-280 West
Lincoln Avenue, Post Office Box 598, Mount Vernon, New York
10551.
5,
I give and bequeath the sum of Five Hundred ($500,00)
Dollars to the ST, ANTHONY'S GUILD, Box 2948, Patterson, New
Jersey 07509-9952.
6 .
I give and bequeath the sum of Five Hundred ($500,00)
Dollars to the GRAYMOOR FHIARS, Graymoor, Garrison, New York.
10524,
7 .
I give and bequeath the sum of pive Hundred ($500,00)
Dollars to the CENTRAL ASSOCIATION OF THE MIRACULOUS MEDAL, 475
East Chelton Avenue, Philadelphia, pennsylvania 19144.
8.
I give and bequeath the sum of Pive Hundred ($500,00)
Dollars to my friend, J..AImY HOFFMAN, of 1516 Grandview Avenue,
Meohanicsburg, Pennsylvania 17055,
9.
I give and bequeath my mul'ti-colored "crazy" quilt, dated
- 2 -
1884, with the letter "F" in the oenter, to t.he MECH.l\NICSBURG
MUSEUM ASSOCIATION, of Meohanicsburg, Pennsylvania 17055.
10.
I give and bequeath the sum of Five Hundred ($500.00)
Dollars to my nephew, LEE MATHIS, JR" of 5559 Raleigh street,
pittsburgh, Pennsylvania 15217,
11.
I give and bequeath the sum of Five Hundred ($500.00)
Dollars to ST. JOSEPH'S INDIAN SCHOOL, % of Reverend Thomas
Westover, Charnberlan, South Dakota 57326.
12.
I give and bequeath the sum of Five Hundred ($500.00)
Dollars to VIRGINIA MATHIS, of 156 Jamestown Court, pittsburgh,
Pennsylvania 15216,
13.
I give and bequeath the sum of Five Hundred ($500,00)
Dollars to WILLIAM J. RATCHFORD, SR" of 650 Tunnelhill street,
Gallitzin, Pennsylvania 16441,
14.
I give and bequeath the SUIn of Five Hundred ($500.00)
Dollars to ST. JOSEPH'S CATHOLIC CHURCH, 400 East Simpson street,
Meohanicsburg, Pennsylvania 17055.
15.
I give and bequeath the sum of Five Hundred ($500.00)
Dollars to AMERICAN INDIAN HERITAGE FOUNDATION, 6051 Arlington
- 3 -
Boulevard, Falls Church, Virginia 22044,
16.
I give and bequeath the sum of Five Hundred ($500.00)
Dollars to CAPUCHIN FRANCISCAN FRIARS, of Post Office Box 986,
pittsburgh, Pennsylvania 15230-0986.
17.
I give and bequeath the sum of FIve Hundred ($500,00)
Dollars to ST. ANN'S SHRINE, 5384 Wilson Mills Road, Cleveland,
Ohio 44143-3092.
18.
I give and bequeath the sum of Five Hundred ($500,00)
Dollars to the RED CLOUD INDIAN SCHOOL, Holy Rosary Mission,
HC49, Box 100, PIne Ridge, South Dakota 57770-9710,
19.
I give and bequeath the sum of Five Hundred ($500,00)
Dollars to my niece, JEANNINE KRISTAN, Manor Road, Delmont,
Pennsylvania 15626,
I give, devise and bequeath all the rest, residue and
remainder of my estate, of whatsoever nature and wheresoever the
same may be situate, to my nephew, LEE MATHIS, JR., and to his
wife, DIANA MATHIS, share and share alike, or to the survivor of
said two, absolutely, should either of them predecease me,
LAS/rL'i, I nominate, constitute and appoint my good friend,
- 4 ~
I;
l,';!
.,' ,~
f:1 ~ ,~
~ 0
~. IJ.l '0 f'-.
"' w.. ~- I
w.. .
(~ ~, :::J~g;E I
[., b
[H ~, .,; ~ '
B . ~~~~
"., I'; H t.: ~~ ~ i
<t, 0
~
t:'] ~.~~
f:1 o ,
~ ,~ ~ ~ 0 t
~~ ...;., 1;:1
Ei 0 ..
(/1
~i
,,;'
.
"
':
,.
-
'f
INHERITANCE TAX RETURN
RESIDENT DECEDENT
WMMOHW'AlIIIIJf 1'IIIII~m^,IIA (TO BE FILED IN DUPLICATE
I>f.PAR1MWI or 'HVrt~Uf
II^,RI!Il!f,U~"i91".o60' WITH REGISTER OF WILLS) COUNlV CODE l (In VEAR Olloo '~UM8E'
~=~~~limffft.lfm.rM{fi~ ~f';;li'1;f '~ijf/Mlmti(tnmAir~~-'-:--:::--''--~-.:'-;o,- B" on_;' iif(f(irH!'rr(~MrltH'~-toirr~n ()'T 11'" t -j'::;''''vrrlii 'i ;'(.;' ~
1'(111)1;1 Tit :j~\-,lIll,'11\ I'll ,'~,;\:; 'lo:I'ICl,'/ ]ll'1.V(l
'i)(.:i.'U.~.'.(..UR'lYijlJ~iA~ii ---.. ..IOAI""..".lEA.hi '. l'Ij,,'.'..il.' ".liiii' liooltnnton1Jl11'{>;, r^ l'(U:,:~.;
:'(lII~o.\-'\'111 "/10/')'( (,ll'I/!)'( (' I 1 1
Clllllllr .)\1\11)(1}' _nth
,"i .,.r"."" ''''.'''''''' """,;':.>';"' ;,,,,,,," ""'"",',,' ''''''''', I'''''''' 5it""" ""M'" ^"U"H' ,,,,,y,io 15" ii,,,iiiCiIOiiiiH ,-..~-
iii!. Original Rolurn [ I 2. Suppl8monlnl RftlUrn I I 3. Rtlmoinder Return
llor doltlt 01 death prior to 12.13.87
[I 4. L1mlltld E'IClle I I 4(1, fulure Intere,1 Comproml'fI r-] 5, Federal e.tale Talr Relurn Required
If or cl"I,U of deulh after 12.12.92)
~16, Dflc"derll Died fe'lnto [ ) 7, Dl'Icodltf11 MolnlCllnfld (l tI\llnQ Trull ~,_ 8. Total Number of Safe Depolll Soxel
. IAllmh copy of Willi 1^"ClCh copy of Tru,')
..-.---..... '~lL CORRESPONDINCI ANO-CON;jDENTlAL TAX INFORMATioiHHOULD SI DIRIC:Ull.TO. ;t
13m l'ilMC----.--.-n--.-.-M----.-.-..- __________________.__._._.__...~_.n__....____ (OMi'i1TEl.i^Tcm01iiliRf~r--''''-"'"'-'~~-'''''''''''-'--~~-
gsa il, 1:()hOI'1; ;-d:'IIIJ'J'(l1', !\L\;,V. j'iar\;'oL :;qU.Ul'O L\.l_tlC;'
a~ filffoi1clrir-NHM8fR IIouhnnlcnhurg, 1'/\ l'iO~.;~;
....._n__...." _~. '(1 :JJ",,,:l ('f' :::(2()'(J.,..,,~. ". '... ,..',".c.. .==.=.=.....=._=,,",,_ ~=====_=... , ..__.,..,~,
If'
t<tffh .
RE'V.I:\oo fKt P,q,tl
".J ,I
1 .
"
l!!
ill
I. Reol EsIClle (Schedule Al
2, Slock, and Bond, (Schedule BI
3. Cloiely Held SlockfPartnershlp Inlerelt ISchedulo C)
4, Mortgage, and NoI" Recei\lable ISchedulfl 01
5, ((Hh, Bank Oflpo,il' & Miscellon~aus Perlonol Properly
IS,h.dul. EI
6. Joinlly Owned Property ISdlfldulo f)
7. Trnntferl ISdledule GIISchodule l)
8. Tolol Grou Auel'llotol Ulle~ 1.71
9. funorul hpensos, Adrnlnlstruti\lo Co,l" Ml,cellonoous
Expenses ISchedule HI
10. Debh, Morlgoge lIahllltllll, liens (Schedule !)
11. Tolol Oeducllon, llolollinos 9 & 10)
,,11.. Net Voluo 01 eslcte IlIne 8 mlnu, line 11)
13. CllClrltohle and GO\lernmftntcl1 8ef'luesh ISchedule Jl
14. ~!~. y~~~~ubl!.c.!...!~ T a~J!:~~~~in~~~!!.!.-'-3J__~_____..__.__
IS, Spou,al Transfers (for dales of death after 6.30.94)
See Ins'ructlon, for Ar,pllcoble Percenlage on Re\lflrse (151_.
SIt/o. {Include values rom Schedule K or Schedule M.I
16, AmCllrnl of line 14 toxable 01 6% role
(Indude values Irom Schfldule K or 'Schedule M,)
17. Am(lunt 0' line lt1laxoblu at 15% rale
Ilndude \laluD' from Schedule K or Schedule M,l
lB, P'l'1ripollox due IAcld talC, from lInos 15, 16 alld 17.1
19. Crfldil' Spousal PO\lerly (redit Prior Poyment, Dhcount Inlerosl
._.._D,Q(L + Q! 0.9. + ___i2,QQ ..___O.QQ_
20, If line 191, 9reot" than line 18, enler the cllfference MlIne 20. ThI, is the OVERPAYMENT,
Ill]
r')
,I(le). ,," 1/
C'
'ORDAIU 0' DIATH AmR I ~'3' 19' CHICK HIR
" A SPOUSAL
povun OIDIIII CLAIMID LI
f1UNUMliilU;'j ,-')'(~h::h().' .......
(II
121..
131 -
141
( 5)
0,00
... "._.li~6i).Q~ (1) ~
0.00
. ..-"-'--"""-'-o;Oi)~
u.IJ~ ;),1~9~;i~;~
_~2. 0.12_
... .,....__.._.y_...QiL
h'l.thg') !.:i'5..
'1~:J~~:9l\
'OA,SflJJH .
~
~
"
z
s
I
z
~
~
.
8
S
(61,
(71
I 91 _~____._J21.2.0_?!llL
(101 .......___.2, J,02 ~_~~_
(8) ,,___
Ill) ____-1,60.2 ,1~.l.
(121 __.__22'-02'( ,31L
(131 .._._..._...__.. (,,100, OQ.
(141 33,)27.A
(16) .
~_____..__._.Q. 00 ~,__" .._...._____~____'2...!.2~2
n,oo 0.00
_____. .._.__,.. "...._.___._ ~ ,06.. _. ._..........__.. ......., ...~~____.
3)1~;.21.J)L.15.. ..."....._..____2.1..o.29.lQ..
1171
(18In_.._._~_.2.!O~.'2.~_J",O'
.._-~~~----Q,()g
.._ _______O_,_12Q_
(191
(201
Check 111'1(' II you art:' tt'fjulJ\lIn{J n refund of your oVNpuynwllt
(211______ . ...;;~!)".').10
(21AI ... .... ___..____.9, (JCJ
1218) _____-..---.S..Q2D.1Q-
21. II Line 181, grealer than line 19, fUller Ihe difference onUne 21. This I, the TAX DUE.
A. Enter Ill" Inlerest on the balance due on line 21 A.
8, En'.' Ih. 101al of lIn. 21 and 21A an lIn. 218. Thl,I.lh. BALANCE DUE,
Mako Chock Para~!o !a,_Rogllt..,_~f,~,nl., "go,~.'. "u_..._ ...
~r'1('[l'C:)' ... ~)!-~.!. SUR_I_TO _~~~YlI~A.LL Q~S~Ic:lN.s_c:l!4..R.IYIRS!~I~~A.~.~ TC!.~~H.~l< MA!H <II( <II( .. __
Under penaltlet 01 pe,!ury, I declorfllholl hO\le ft)(omlnfld thit felurn, lncludinn Qccomponl.lng schedul"l and 'Iotemenls, and 10 the bell of my knowledge and belifll
1l1,lfufI, ('orr"r.! and (flmplete. I declare IIICII oil rflol eslClln ho, hMn rpportl!ld allruo /11mkei \lalutl. IJod(Hollon of preporer olher than the personal t&presenlC111\le h
baled ~fl.~ll . _~.~_I~_~~.__~_~I~c!!J)~~l~~~!r..~~~ '!!'_Lk.~C1_~I~_~_~~,< _ _ _ . ." __________'- .... ....--, ..____________,_.___... ..---
SIONAJI/ , SON~t~rm~SIIUIOll:fILlNORElllIl:N ^(lnl1fS~ '1.1;1/, (;1."\\1(1" 1.0\'1 Avo " J OA'~, 7. ?J
.;vv "o~ti~i.~.it~tP~:1~ ..'.'>"'."5 : i..~. \ ;.~.i.{.'.. ~.\~.I ~;~. ;;;:~.: ~.J 1\ ;....I.,j;,1...:.' 0; ~::- ioi,[-_1 . ....._~
. ~k!!t2'71 k"~() c.: I lUll jC:llnu'E JU,.l'/():'2 .._._._....._...._....Z-:~I..i:....2d-~-.
.'
Boulevard, Falls church, Virginia 22044i
16,
I give and baqueuth the sum of lrive Hundred ($500,00)
Dollars to CAPUCHIN F'IlANCISCAN I"JUAIW, of Post Office Box 986,
pittsburgh, pennsylvunia 15230-0986.
17.
I give and lJequeuth the sum of Five Hundred ($500.00)
Dollars to S'l'. ANN'S SIIIUNJ!1, 5384 WHeon Mills Road, Cleveland,
Ohio 44143-3092.
18.
I give and bequeuth the sum of F1 v,~ Hundred ($500,00)
Dollars to the RED CLOUD INDIAN SCHOOL, Holy Rosary Mission,
. HC49, Box 100, pine Ridge, South Dakota 57770-9710,
19.
I give and bequeath the sum of Five Hundred ($500,00)
Dollars to my niece, JEANNINJ~ KHIS'l'AN, Manor Hoad, Delmont,
Pennsylvania 15626.
I give, devise and bequeath all the rest, residue and
remainder of my estate, of whatsoever nature and wheresoever the
same may be situate, to my nephew, LEI~ MA'l'HIS, JH., and to his
wife, DIANA MA'l'Hla, share and share alike, or to the survivor of
said two, absolutely, should either of them predeoease me.
LASTLY, I nominate, constitute and appoint my good friend,
- 4,-
"'111\111_. t1nl
...a.~ SCHEDULE H
'DID FIUNERAL EXPENSES,
(OMMOPlWIA'"' 0' PfNNIVIVAH'A ADM NISTRATlVE COSTS AND
INIURllAPlCl lA, RflIl'" MISCELLANEOUS EXPENSES
'I'''''''' ""w"" PI.al. Print or Typ.
~~iAf~~.~- "l;~)~~.". ,I~:~-. ; ,,_u;'I~'~~:J:-~-'-~-~'-'-'-~~~"'-~]~lil~O:~ER_-_}\~:;~ ~~~_~_~~
ITEM
NUMBER
~_~.~. n"......~_..~.
A. Funoral hp.nllll
DESCRIPTION
AMOUNT
1.
l1alpozzl. Funo!'ul IJ0Il10, 0 Ilo.r'lcot Plaza Hay,
110ohunlonll\u'g, PA, l'EltmbU!'EJomont for.o08t of
olel'r;y, ol'gurd.lll; uncl 10 Death Gor'tHi(lates,
111-5.00
~p
B. Admlnlstratlv. COI'I!
2,
1.
Personal Ropresontotlvo Commissions [,IU'l'Y S. Hoffman, gxtv.
, ] 7? - I 2 - I, 337
Social Securoty Numb.r of Personal Representative, . ".u. :.._.__~-~_,__':t..____
Year Commissions paid ... 1, '1')Q_______,____
2,350.00
Attorney Feo. J. Hobel't Gtauf'for, Esq., attorney's fee.
2,350.00
3. Family Exemption
Claimant ____ _H/A_____..., ,._,...., Relationship
Address of Claimant at deceden", dea,h
S'treet Address
4,
C.
1.
2.
3,
4.
5,
6,
7,
0,
City.,
. ..u_,.__.___._~_State .____.. Zip Code
Probate Fee, C111l1borlnnd County Hegistev 0;[' Wills,
1,ettol'8 '.l'oEltf.\lIlentary.
Mllc.Uaneoul Exp.nltS'
Cumberland Law Journal, li:state Notlce.
Halleyt EJ Hes ttlul'nnt, 6005 Allen\;0\1II Blvd., Har;t'ls-
burg, PA, funeral luncheon.
Pealerts Flowel's, funeral flowers and spray.
115.00
60.00
103.70
131. 39
3-31
56.76
u. S. Post Offico Departmont, postnge,
The Sentinel, ~stBte Hotteo.
Register of Hills, filing Inventovy Bnd Pennsylvania
1nhorl tanco ',['ux Hoturn.
Registor of Wills, filing Account.
CordleI' Ant iques, 20111, Haricot St" Camp IH11, Pa,
appraising quilt.
25.00
110.00
50.00
TOTAL (AI.o enler on line 9, Rocopltulallon)
s
~) ,500.21~
(II mort .pac. II n..d.d, In..,t addltlonal Ih.... af 10m. 1111.1
I'
"",""'" 110,', ~.&
COMMOtlWfAlTll 0' rftltlHlVMll'+"
INtlUIIANl;IIA. Ull!~tl
U5ttlHlIO,C(OfNI
isTATE OF
ITEM
NUMBER
1.
2.
~:
;J.
6.
7.
8.
9.
10.
11.
12.
GANILLA L.
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES AND LIENS PI PI' T
lOll , n 0' VpI
~-'"="-"""'c="'~'==~==~J-~i[iNliM8IR ;?1 ~9'l ftonoo
PO\'lp:r.r, . ..... .. . .... ..._.._~1?2I,:,g2_eo~__
DESCRIPTION
AMOUNT
13J1:',l'HANY VILLI\GE 111':'['InErmll'p G,;:H'J'I;;H. 3?S \'Iosley Dri.vo,
HeohanJ.oslJul'g, 1'1\, sldlled nUl'sJ.ng care fl'om 0/31/
97 to 9/10/97,
AL1\HT rlTAJ1J.lACY, Bothany V:lllago, ,luo fUl' modications.
SUE CARn, ~UB for hair care on 8/12/97 and 0/26/97.
WHEn ALlj;m };ilS, Ulilbu1ance sel'v1co.
P1NJ.JAOLi': m:AUl'H HOSPITALS. mo~ica1 service charge.
HOLY S1'1111'1' lIOSl'J'PAL, Camp lIi11, Pa., balance due
on Hospital 13111.
VASCULAH AS;,;oOIA',rES, for consultation at Hospital on
7/n/97.
ClUj~S'l' DIAGllOS'J'IOS, IlIC., medical services of 6/19/97
and thrOUGh [1/25 n
COHLEY HED1CAL ASSOCIATES, P.O., modJ.cal services of
6/16/97, 6/23/97, 7/11/97. 7/16/97, 7/10/97 and
'7/21/97 .
COmmnS'l'Olm ADt1T In: SYS'l'EHS, ambul anee s el' v 1. 0 e of
7/U/97 .
COHL1\Y HEDIOAL Ml;iOCINP.Ii:S, P. C" moc1ioa1 sorvIces of
9/0/97 .
Hl'l'l11nnS'1'S ()lI CJi:Jl'l'ILI\L 1'/\, medical servIces of 5/27/97
and 6/2/97.
'I' 1,1.,26.00
ol
00.21
20.00
141.~. 00
~r' 00
c.;>.
16.Bo
10.00
7B.14
60.00
225.00
10.00
7.02
TOTAL (Also onl" on lino 10, R.copllulatlon)
(II mo,. 'poco I, nood.d, In,.r' additlorlol,h.." 0/ 'amo .Iz.,)
$ 2,102.17
lfYI\11Ut (I,HI
~"t'9.,
~>(~\ft:t
!:(JMM(lrlwIAllli or rt!lll~YIY^,UA
I"IIII""H(I '''I( U1UltH
"I\lOINT UICIIIINT
SCHEDULI J
BENEFICIARIES
ESTATE or
c..;;.'- ,~'~,__~.__,~_.,_.._.._,,___...~~~'m..,n~
_ , ,- .~, . ------ ,----- --- .--.c._,-,--------.....
._., L._._".__~~"'_,_~~,._.__~~HL.~~._
filE NUMBER
C^IH 1',I,A I,. l'()I,)J,:C,J I
ITEM
NUMBER
NAME AND ADDRESS or BENEfiCIARY
RELATIONSHIP
A'. Tult.oblo 8,Hluolh:
1. ),AHny lIOP]i'IIJ\N J)olle
1516 OllD_nll v to\'1 Avo.
Heehn,n1,ooll1.11'g, 1'1\ 'I 'I O"I~
" .J.,
') IIJ!:/i: 11J\'I'J LUl, ,In. Nephe\~
L.
r-r'I") Hnl" t[~:h St f t Sulto ;~13
),,1,1
1'1 t t;[J bUl'gh, PA 15217
3. DIANA. 111\'1\ J [[ [) Nieoo
r;(.;I; [) nnlolgh St f , nul.to 213
...'....
1'1 ttnbUl'CI1, 1'1\ 1':"17
", r_.
I ~ . VIHCHNI1\ lTI\'I'IIIil 1/100e
];;6 ,T!\lI\osl;Cl1-Tr\ Coupt
Plttnburgh, 1'A ';;216
r:;. W1LL11\11 ;J, HJ\'j'CIlPOI\]) , sn. J)olle
-
()~; 0 'J'1\tl1101hlll St,
GulUtzin, 1'1\ 1611111
6. JgAiIj.J1lJJ~ 1m IiJ'l'1\N Nieoe
lianeI' Hond
Delmont, 1'1\ 1;;626
7. IJEJi: rWl'IUo3, JH. Nephew
5559 111\1011'.11 Si/ , 811:1.te 213
l'itl;EllJurr,h, 1'1\ 1<)217
ITEM
NUM\lER
NAME AND ADDRESS OF BENEFICIARY
1.
B. Charilclble and Governmental Boquosh:
1'1111Fl~'1'1J1\r.. lm!',p CEH'!.'i,11
291+ 150th 31;.
Bronx, lJY 101,Sl-5195
o3EJWAll'l'S 01" llAHY
111.39 So. llRl'lem A VB.
l3or\1yn, lL (0).1.02- 0'{12
Fnl\.lW:UWf\N lIUJin ON 1\0330011\'1'83
P. O. Box ';90
]101111t Vernon, J1Y 1 O~;t)l
S'l'. ^11'I.'IIOllY' 3 GUILD
Do); 29hl1
l'att01'S0.\1, liON Jot'Eloy O?509-291~0
li'HIAHS Oji' '('dE ^'l'lllli~dEH'.r (GHIlYi'IOOn F'HIJ\I1S)
1'. O. Box 30(J
Gax'x':lsOl1, 111' lO;~21.1.-(J300
2.
3.
1~.
5.
TOTAL CHARITABLE AND GOYER~IMEN1Al8EQUESTS lAlla en'e, on Ii... 13, Recapllulolion}
IIf moro ,po.. I, n"d.d, 1.",1 additional ,h"" ., ,am' 11..1
'~".__ .~..~~.-~w._<_..._....._____
..._--~_._------
;~1-9'1-00bo
1 (I'),{-OO(JOO
_....,,'.~.., ,'_< ''''''."'''.._~,_.__._.h~'
AMOUNT OR
SHARE or ESTATE
:;:;;00.00 o!\flh
bequofJt,
:::;:;00.00 ounh
boquest.
Ono-halt share
residuary eo tnt,
:1:500.00 oush
bequest.
:1:500.00 onsh
boquost.
:i:;;OO.OO oash
bequost.
One-hn1f shure (
residuary eaht,
AMOUNT OR
SHARE or ESTATE
li:;;oo.oo oush
bequest.
:j)500.00 cash
bequest.
:~500.00 \lush
bequest.
:1:500.00 oo.sh
boquest.
q:500.00 oash
boquest.
S Oarl'led ji'orNur,
PJ\OE - 1
6~ eMS II
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
c!-.
*'
BUREAU OF INDIVIDUAL TAKES
INtl[RI lANCE TAM DIVISION
O[PT, l80t>>O l
tlARAIS!lURO, PA 11128.0601
NOTICE OF INHERITANCt TAK
A~~RAISE"ENT, ALLOWANCE OR DISALLOWANCE
Of DEDUCTIONS AND ASSESS"ENT Of TAX
U,.lhl 1.1"In."1
J ROBERT STAUFFER ATTY
MARKET SQUARE BLDG
MECHANICSBURG PA 17055
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
CAMILLA
06-02-98
POWELL
09-10-97
21 91-0800
CUMBERLAND
101
I-:=-~ A~~=L!"!IJ~d J
MAKE CHECK PAYABLE AND REMIT PAYMENT TOI
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17D13
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~
ii!V: is'i; "EiC Aiiji" i 09-:97"1" iloYi CE""eiF' YNH Eii i;: ANtE" YA'X" APpjiiii SEj.fEili'"; "Ai. rciwAN6 E' iili"' -. - -""""".. "."-
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF POWELL CAMILLA L FILE NO. 21 97-0800 ACN 101 DATE 06-02-90
TAX RETURN WAS I (X) ACCE~TED AS fILED
RESERVATION CONCERNINO FUTURE INTEREST . SEE REVERSE
APPRAISED VALUE OF RETURN BASED ONI DRIGINAL RE~
1, R..l E.tlt. (Sch.dul. AI
2, stocks and Bonds (Schedull 81
5. Clos.ly Held stock/Partnership Int.r..t (Schedule C)
4. Hortg.g.s/Not.. Raclivable (Schedul. OJ
S. C..h/Bank Deposita/Hisc. Parlonal ProPlrty (Schedull EJ
6. Jointly Owned Property <<Schedule F)
7. Trlnsflrs <<Sch.dull OJ
8. Total A...t.
I CHANGED
.00
4,000.00
.00
.00
43,429,75
.00
.0lL
(8)
(1)
(2)
131
(41
(51
(61
(71
NOTE: To insure proper
credit to your account,
.ubnit the upp.r portion
of this forM with your
tax paynent.
47,429,75
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Fun.ral Exp.n.../Adn. Co.t./Hi.e. Expensls (Schedule HJ
10. D.btl'"ortg.g. LI.blllt:.I'LI.nl (Sch.dull I)
11. Total Daduotion.
12. Hat Value of Tax Raturn
15. Charitable/Govarnnent.l Baque.t.; Non-alectad 9113 Tru.t. (SChedule J)
14. N.t VIlu. of Elt.t. Subj.ct to T..
(9)
(l0)
5,500,24
2.102,17
(11)
(12)
I1S)
1141
'1.6D~ 41
39.827.34
6,300.00
33,527.34
NOTE:
If an a.se..ment was iBBued previou.ly, lines 14, 15 and"or 16, 17 and lB will
reflect figure. that includ. the total of abb r.turn. a......d to dat.,
ASSESSMENT OF TAXI
15. AMount of Une 1'1 at Spou.al rat. OS)
16. AMount of Line 1'1 taxabl. at lin.al/Cla.. A rata (16)
17. Anount of line 14 taxable at Collateral/CI... 8 rat. (17J
II. Principal Tax Du.
TAX CREDITS I
~AV"ENT
DATE
02-20-98
,00 X .00.
_ ,DO X .06.
33,527.34 x, 15.
(l8)
.00
,OD
5,029,10
5,029.10
.-
RECEIPT
NU"BER
AA269774
DISCOUNT (. I
INTEREST/~EN PAID (-I
,00
AHOUNT ~AID
5 ;-029, io-
. IF ~AID AFTER DATE INDICATED. SEE ~EVERSE
fOR CALCULATION Of ADDITIONAL INTEREST.
TOTAL TAX CREDIT 5,029,10
---- -----
BALANCE OF TAX DUE .DO
INTEREST AND PEN, .00
L-.!.~TAL DUE _H ,00
If TOTAL DUE IS LESS THAN .1. NO ~AVHENT IS REqUIRED.
If TOTAL DUE IS REFLECTED AS A "CREDIT" (CRI. YOU HAV BE DUE
A REFUND. SEE REVERSE SIDE OF T"IS FOR" FOR INSTRUCTIONS.)
l
.- \:'0;(
- .-
0 ~ , ;JIl:
.-
'"'-~ l?
.If'
',,1 ~
b ~-I i'-'
'(-,]) ~l
U m ~ ~ ~
&!Cl': ~d
RESERVATION I Eltat.. of dlctd'n" d~lnll on or b.for' Olc..b.r U, 1912 -- If any 'Ulllf' lnt.r.., In thl.,hlt, is ,ran.flrred
In po.....lon or enJov..nt to CI... I (colla,arall beneficiaries of th. dlc.dent .'t,r thl ~~plr.tlon of 'ny ..t.t. for
11'. or 'or v..r., thl Co..onw..lth hlr,by ."prl.slv r...rv.. thl right to appr.l.. and ...... tran,'.r Inherlt*nel laM"
at thl lawful CI... . (collat.ral) rat. on a"1 such future Intlr..t.
PURPOSE Of
NOTICE I
to fulfill thl r.qulr...nt. 0' Slctlon 2140 of thl Jnh.rltancI and E,tat, TeM Act, Act 21 of 1995, In P,S.
S.cUon 9140),
PAVHfHTI
Dttach thl top portion of thl, Notlet and subMit with your pay..nt to thl RIgllter of Will_ printed on tha ravar.. .Ida.
-~Hak. chack or aonay ordar payabla tOI REGISTER OF tlILLS, AaENT
REFUND (eR)1
A r.fund of . taM cr.dlt, which wa. not requ..ted on the TaM Raturn, aay b. raque.tad by ~o.pl.tlng an "Application
for R.fund of P.nn'Ylvanla Inh.rltanc. IInd E.tat. Tax" (REV-IUl). Appllcntlollt ara ,,,,.lhbl. at the Ofllea
of the Ragltt.r of Wlllt, any of th~ ZS Revenuo Dlttrlct Office., or by cnlll09 the .peclnl 24-hour
an.w.rlng ..rvlco nuabert for forM' orderlngl In Penntylvnnla'I-800'l6l-20~Q, out,lde P.nnuylvnnla and
within lMal Harrhburg arn 011> 787-8094, ToOIt (7171 nz-n.~z Ul.ar\ng IMpalr.d Only).
OBJECTIONSl Any party !n Int.r.,t not ..tl.fj,d with the apprals...nt, allowanca or dlsallowanca of d.duction., or at......nt
of taJll (including discount or Jnhrutl III shown on this NoHc. .u.t objact within tbty (60) days of receipt of
this Notlea by:
"wrltt.n protest to thll PA D.partM.nt of Revenu., Board of Appeals, D.pt. Z81021, Ilarrltburg, PA 11128-IOZI, OR
-~.I.ct1on to have the ..tt.r d.tar.ln.d flit ftudlt of the IIccount of the par.onal feprn.ntatlve, OR
~~.ppeal to the Orphans' Court.
ADMIN
ISTRATtVE
CORRECTIONS I
Fa~tu.l arror. dl.cov.red on thl. .tt.t...nt .hould b. addr..t.d In writing tOI PA n.partaent of Revenue,
lur.au of Individual TaMil', ATTNI po.t Au.....nt Revl.w u...lt. n.pt. ?a060l. U.rrhburg, PA 171ZI~0601
Phone (717) 111~'SOS. Se. page S of the bookl.t "In.truetlont for Inherltnnc. TaM Return for a R..tdant
De~.d.nt" (REY-I~Ol) for .n .xplan.tlon of ad.lnl.tratlvaly correctable .rror.,
DISCOUNT I
If any taM due It p.td within thru (J) calendar .onths aft.r the deud.nt't d..th, It flv. p.rc.nt (S;O dltcount of
the tel( paid h all ow.d ,
PENAL TVI
Th. IS~ tal( a.n..ty non-participation p.nalty I. coaput.d On the total of the taM .nd Jnt.r.tt at,....d, and not
paid b.for. Janu.ry II, 1996, the flr.t day aft.r the end of HIe tu a.nnty p.rIOd, Thlt non-partlc1patlon
penal ty It appealabl. In the sa.. aMn.r Itnd In the the 'II" t I.. per lod 8t you would .ppul the talC and Int.r..t
th.t h~. b..n .......d .. Indlcat.d on thl. notice.
INTEREST 1
Inter..t I. charg.d b.glnnlng w!t1'1 first dllY of d.llnquency. or nln. (9) .onthll and one (II day fro. the d.te of
de.th, to the date of p.___..nt, TalC" which baCD" delinquent b.fore January I, 1982 be.r Inter..t at thl rat. I)'
.IK (b~) percent p.r annu. Cllloulat,(1 at a dailY r.t. of ,000164, All tllM.t which b.ca.. d.lInqu.nt on and .ft.r
January 1, 1911 will blar lnt.re.t at a rat. which 101111 vary 'roe calandar y.ar to calandar year with thlt rat.
announc.d by the PA D.part..nt of Rav.nue, The nppllcllbll tnt.r..t rllt.. for 11182 throuvh 1991 ar.l
'!!!! Inter..t R.t. OftllY In'.;.rut flletor :!!!! ~J!.!.!.! O.lly Inhr..t factor
1912 ZO~ .000~4t 1987 9~ ,000241
ll1aS l'X ,00045. 19U-1991 11% .000101
1'14 11% .000501 1992 ,~ ,000l"7
I9IS ll~ ,0001S6 199J'1994 7~ .000192
1~a6 10~ .000274 1995-1998 9~ ,000Z47
~.Inter..t I. calculatad .. follow. I
INTEREST . BALANCE OF TAX UNPAID X NUNBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR
~-.ny Hotlel Ittuld If tar thl t'JIl baeo.., d"llnqu.nt 101111 r.fl.ct an Intlr..t c.l~ul.tlon to flft."n (Iil deyi
beyond thl date of the ....,...nt. If p.y..nt It .ade .ftar th. Intar..t eOMput.tlon date .hown on tht
Notice, .ddltlonel tnter.tt IN,t b. calc;ul.t.d.
r f p ~
a (J
('I ". r 'I"
, n, I,
(i
~ _~ J t ~
(J Cl. 1,1 I,' )> z
u' <^ f. 0
fr.. Z
IU ,.' -
'" 0 0 ~ ~
'j 'b l'
1 ;: I~ . ~ ~ 0
"
... :j' III 0 t"" 'T1
rt r I ~, f.) 'T1 t"" ... ~ ~
111 ... I' ,',
II " :.; 0 'N
~~ oQ 0 II> 1'1 ~ 0
. It tJ ~
~ ... ~
HJ I' ). !lJ
IU l 'I iTl
'j 0 ~ ~
:1:
;1
'n
I"
:.1,
'~I
'6"6110 10'11 I8'J~lonpl~ '^'.,OIIIV 88S 'y
~1I"1 JO ~lIVUO'19d 0' Ii' /,0',09/1V .9 ~VIU '1.9~' ,vuolIlppV '[
'11.'u I.uolllpp' 10 ~1.^OO"P 10 ,~op ~IJlllI "I'IIIM p01l1 99 "nw ~Jol".AUI 1"9lU.,ddnl V 'l
'.^IIVIU.ludu "uou.d 10 IU9lUIUloddo J911V "II"OIU 89J1I1"I'IIIM 1'9111 .9l'nlU ~IOI".A"1 uV 'I
5NOIJ.001lJ.5NI
~"A
IllUOVi Aea
.-- ~eqtiie~-iIo8 -"--~-----'-'--O':C~-'-- '110.0 10 .1'0
L661
....pP'l'
%OL 1 Vd '~J,mcl8D1'lililiOelr
.eAV MBIApun~o 91St
. 'lt~.ln...~' J.----'
- ff'/~-YVilP:'--
--~'7 61
8\.'
'9lU .10109 p.9!'O'9"' pUo
II ,WNS
"110.1' ',1"9pooo/, 10 0'01' .'1110 IV
.nl" J,VI ",lIIU".ldol ~JOI".AU' .~I '0 '''9'' '''09 911,oddo ..mr'll 9,' 10'1' 1'''0 '",,,"^,AIlI""d JO ""OO^"'OUllllO:) AlII
.pl'lno .,V'18 ,.u Id.... '0101'0 "01 1'''' Allo<lol<l '""0110<1 0'1111" '0 0"11'1'''0' ',"apooop PI"' JO "'""0 0111"0 0'11 )0
--------1'10' 9'11 ,--.~. ".. "... -- . ~..~--- - ~"~'C'" .~ ~'1 "POiu ~lol"OAUI Uo " UI"IIM
.xoqnoex:,[ UDlI!.JJOII '8 A,l.n"[ "
.~I f'~' puv 1'.'..0.1' "vd 'Aluno:) p".1l.9wn:) ,- ~... .~.. dl1111UllO;1. U81'-L v-.teiI6il'--- '0 .",
- n lJ('IOd--'-;-j11l tT1iili?1- '0 0""3 0'11 JO'.....-.-- '.i:oljnrl[l.Ji:,:..-------'-------
"----84qsl-- .11 10'1' ,~.. 1'''0 lI,odop 'MO, 01 6",pJOOOO -'--------....U.lomr-. ~Inp 6u,.~
-_________.__ _R~____ ........,.. .,._______._. _,. _____._____..._______. ...._.'._....______~__,
I'[Vl'I.'l.!tOj[ .~ AUllV'l
III
( QNY111181~00 :10 J.J.NOO:l
1 VINV^'ASNNid ..0 unV3MNOWWOO
v
IN 'rilE OOUll'I' OF 00l1lo10N Pf,J~AS o Ii' om.mmlLAND COUNTY, PENNSYLVANIA.
97-00000 Ol1l'llANS' COUll'!' DIVISION. .
FInS'I' AIm l/INAI, ACC()\Jll'l' OF I.AHIlY B. 1I0li'li7-1AN, EXIWUTOll OIP 'I'UE LAST
v/ILL AND 'I'Ji:S'l'AHEN'l' Ole CAIULl.A L. }'OHg['L, l.A'rm OF 'I'H1~ TO\~NSIlIP OF
LOWER AIJLJJ:II, COUN'I'Y Oli' O\JI1BJimLAND AlID S'I'A'],E OF PENNSYLVANIA,
DECEASED.
Date of Death: September 10, 199'7.
Dates of Advertisement of l,etters 'I'estamentary:
In the Oumberland Law Journal: November 7, 1!~ and 21, 1997.
In The Santinol: November 1, 8 and 15, 1997.
PTIINOIPAL AOOOUNT
Debits
Aooountant charges himself with the following prinoipa1 assets
and reo9ipts of deoedent's estate, consisting entirely of
personalty, as follows, to wit:
1997
9/10
9/10
9/10
9/10
9/10
10/24
10/24
10/2!.i.
11/26
11/26
12/2
1998
1/19
1/19
3/19
Eight (8) $500,00 denomination, Series HH, U. s.
Savings Bonds. $
PNO Bank, N. A., Oheoking I\coount No. 5140237264.
PNO Bank, N. A., Oertifioate of Deposit No.
21001020753.
Members 1st Federal Oredit Union, Share Aooount
No. 0935-00.
Crazy patch quilt, as appraised for Inheritanoe
Tax ptU'poses.
Penn Treat'j" Insurance OompanJ', medical expense
reimbursement.
Sperry &. Hutchinson, 3&H Green Stanlp l'edemption.
Bell Atlantio, refund.
PA Blue Shield, medical expense reimbursement.
Pinnacle Health Services, luedical expense
reimbursement.
Members 1st Federal Oredit Union, proceeds from
Group Life InstU'ance ooverage.
u. S. Oivil Servioe Oommission, death benefit.
Prooeeds of Federal Employees' Group Life
InstU'fJ.noe.
Oomfort Oare of Holy Spirit; HospHal, re,fund
of overpayment.
GROSS PRINCIPAL ASSETS AND RECEIPTS OF ESTATE...........$
4,000.00
15,212.60
6,055.7~
20,832.47
300.00
415.40
2.10
15.64
219.00
25 . 00 '
1,425.10
332.39
2,539.45
24.25
511399.13
PRINOIPAL ACCOUNT
Cred! to
Acoountant asks orod!. t for t;he followJ.ng amount!! paid
out of prinoipal 1.n tho adminJ.etration of deoedent's
eetate, to 1'Iit:
122l
9/15
9/15
9/15
10/1
10/25
10/25
10/25
10/25
10/25
10/25
10/25
10/25
10/25
10/25
10/28
11/8
12/4
12/L~
12/L~
12/27
1998
2/20
2/20
3/13
6/1
Malley's Restaurant, funora1 lunoheon.
Pealer' s Plo~'e,t's, funeral flowers and spray.
U. S. Poetal Department, postage.
Register of Wills, Lettere Tee tamentary.
Bethany Village Retirement Center', skilled
nursing oare, 8/31/97 to 9/19/97.
Alert Pharmaoy, due for medioations.
Sue Oarr, hair oare on 0/12/97 and 8/26/97.
I,ower Allen ID1S, ambulanoe servioe.
Pinnacle Health Hospitals, medioal servioes.
Holy Spirit Hospital, ba1anoe due for servioes.
Vasoular Assooi atos, Inc., medical servioes.
Quest Diagnostios, Ino., medioal servloes.
Olwlberland La1'l Journal, Estate Notioe.
Malpezzi Funeral Homo, Ino., reimbursement for
cost of olergy, organist and Death Certifioates.
Cowley Medioal Assooiates, P.O., sorvJ.cos
rendered on 6/16/97, 6/23/97, 7/11/97, 7/16/97,
'7/18/97 and 7/21/97.
Cordier Antiques, appraising "Orazy Patoh" quilt.
The Sentinel, Estate Notioe.
Oornerstone Adminisystems, ambulance servioe on
'7/11/97.
Oowley Medioal Associates, P. C., services
rendered on 9/8/97.
Internists of Contral Pennsylvania, medioal
servioes on !J/27/97 and 6/2/97.
Ilegister of \H11s, filing Inventory and Pennsyl-
vania Inheritanoe Tax Return.
Register of Wills. Agent, payment of Pennsylvania
InhE\ri tenoe 'ro.x.
Internal Revenue Servioe, payment of 1997 personal
Inoollle 'fax due.
Tamdot I1omeoare, rental due for lIse of Halker.
T"arry S. I1of'flllan. Exeoutor's oOlllInission.
J. Robart Stauffer, Esq., attorney's feo.
Cush, reserved to final tax preparation and
oont I.ngo noies.
Hegister of \o/111s, filing Aocount.
TOTAL PTUNCIPAL EXPENDI'fUm~S............................$
-2-
$
103.78
131.39
3.31
115 . 00
1,426.00
80.21
20.00
144.00
25.00
16.80
10.00
78.14
60.00
145.00
60.00
,0.00
56.76
225 .00
10.00
7.02
25.00
,,029.10
356.00
108.00
2,350.00
2,3,0.00
400.00
110.00
1).495.51
I NOO~UJJ AOOOUNT
DebitlJ
Aooountant oharges himself wIth the following items
of Inoome I'ooeived, t(lw1tl
1Xll
9/30
lOllS
10/29
10/31
11130
12/31
1998
1/21
3/9
GROSS
Hembors 1st Federal Credit Union, intorest on
share aocount No. 891~-00.
PNO Dank, N. A., interas t on Choolc1ng Acoount
No. !.>lJ+023 'I 261,. .
rNC Bank, N. A" interest on Cheoklng Aocount
No. 511~02..37?()I~. .
l,lembers 1st JPederal Crodlt Union, :l.nterest on
share aocount No. B93$-00.
t1embers 1st l"ederal Credit Union, interest on
share o.ocount No. 11935-00.
Hembers 1st Fedel'o.l Oredit Union, interest on
share o.ocount No. B93S-00.
$ 56.50
23.86
4.87
58.55
56.82
62.74
Member's 1st Pedera1 Credit Union, interest on
shal'e acoount No. 8935-00.
PNC Bank, N. A., interest on Certifioate of
Deposit No. 21001028753. .
INCOf1E" It " " " , " " , , , . " , , " . , , , , , , , , " . " . , , · , . , , · · . , " .. .$
INOO!<1E AOOOUNT
Credits
Aooountant asks oredit for the following items oharged
against Income, to wit:
1997.
1998
None
$'
None
TOrrAL INCOI1E DISBUHSEHillNTS AND OHARGES............. .H..$
,
-3-
40.67
137.21
W/l.22
0.00
9.!.QQ
0.00
-
-
IN rrIlE OOURT 01" CO~II.10N prJJ~i\S OF CUMBrunrJAND COUN'l'Y, PENNSYLVANIA.
9'7-00800 ORP]lANS!.....Q.Q!JHT DIVISION.
IN REI mSrl'Nl'E OIP CAllILLA I" PO\'lELI., I,N]'11 011 'l'H15 TOIVNSHI P OF LOWl1JR
Ar,LEN, OOUN'rY 0]" OUl-mrmLAND AND S'l'Am 011 rmlllSYLVANIA, DECEASED.
SCIIlIDULill 01<' PROPOSED DISTRIBUTION
_....4 _ _
Suggestion is lnade.. that the balanoe in hands of Aooountant
for Distrlbution, to I-lit, t.he sum of *38,3h.1I..81~, be made partly in
OASH and partly in KIND to tho benefioiaries and legatees designated
under items 2.,3.,1\..,5.,6.,7.. S., 9.,10.,11.,12., 13.,14.,
15., 16., 17., 18., and 19., of deoedent's Last Will and Testament,
in the amounts and proportionn as therein direoted and therefore
Distribution is proposed as follows:
To PERPETUAL, HEr,!' CENTER, oash bequest.
To SERVANTS OF 11ARY, cash bequest.
To FRANCISCAN MISSION ASSOOIATES, oash bequest.
To S'l' ANTHONY'S GUILD, oash bequest.
To GRAYl100R F'RIARS, oash bequest.
To OENTRAL ASSOOIATION OF TIm I1IRACULOUS l.lEDAL,
oash bequest.
To LARRY HOFFMAN, oash bequest.
To MEOHANICSBURG HUSEUl1 ASSOOIA'rION, in KIND,
mu1ti-0010red "orazy" quilt.
To LEE MATHIS, JR., oash bequest.
To ST. JOSEPH'S INDIAN SCHOOL, oash bequest.
To VIRGINIA MATHIS, oash bequest.
To WILLI~l J. RATCHFORD, SR., cash bequest.
To ST. JOSEPH'S OATHOLIO CmmCli, oash bequest.
To AMERIOAN INDIAN HERITAGE FOUNDATION, oash
bequest.
To OAPUOHIN Ii'RANCISOAN FRIARS, oash bequest.
To ST. ANN'S SHRINE, oash bequest.
To RED CLOUD INDIAN SCHOOL, oash bequest.
To JEANNINill KJUSTAN, oash bequest.
To LEE MATHIS. JR., and DIANA MATHIS, share and
share alike, bequest of entire residuary
estate, payable in oash.
-5-
$
500.00
500.00
500.00
500.00
500.00
500.00
500.00
300.00
500.00
500.00
"00.00
~oo.oo
500.00
500.00
500.00
$00.00
$00.00
"00.00
29.$1ili..84
$ J8.31ili..84:
Reoordo(jO'lico of
Rel/lfk' :: Wi!l~l .'
'98 JUL -7 P;? :33
Olerl
GWli
< - ::\il ~
'-'I
_,1-\
. .~.J.as!JqqS.AcOo"'" Conllrmod
1t;;'"(;'Q'''IY Ilnd <H(>,IIl{Hrtl~);; d(1()(I'.loH
In actlHdanotJ >llIgl IHP!,(/I,lJ'..\ ti(;hod.
ulo~.1 dl&trlt,"II"" '''''OIvlll1. By IIIl1
.~rtJ~~.Rln~~._~~j~t~,
~~ .
I2l ~
.~ .~
gi~
1k<8,:'l
o 1:-1
E-<~g;
~88
8&;_
~~i
~I'<P:;
HOO.
.
o
o
u;l
o
o
I
t-
O'
~ ~!;j
~~~j~~I'< .
~!iP'8~~:0~
" E-<~ ~~r.>'l. ~
... 'O)"'l~Sf~
Cl.loolO o<1lr
~ ~ . H ''-' E< 0
~r~r.. (I)r'1
'01'< . A
E~ I~O~~.
,~ ~ r1:1 &'J1
~~o~j ~~
~~~.~~~~~
r::~a~2fj~~
~ A
r,j ~
o 0
u p..
U 01<1
-< cr:o
fl.<H
~~ r.. ~'
,-. 8 -,
11 ,.:; C
1'1 n: !~ ~
8 pCI)
"', ~H
o{'{: T: A
.,
~ ~
p::
H
f:<.
.
o
1<1
~~"";,~
1.1011-' ;
'!tlll 'AJD!OHfJUaq 'JO\!P~'J.ltl 'il' ;)\['t'p:, "\I Lll IS[.lJn\lI: llf! II_I"
';Jl\oq Ol \Ulnuno:)tHl I1tll t'i\ Uf\l\OUi! \ I;){l HId JHI.1l0 ^JHI\<J
.\1J9UIIOlO I'llld"n AJO^S 0\ 1I,,^IO w'~q ','''I 'UO!lnqplsiU I""
)0 IIl1llUlJIlJIS Pies 01 S\JOII,,,,lqo unUiJM ~lIj 01 A~p Itil,! ')l.
,11IO uli!leUUIIUOO JOllJOO:> alII 01 p,'jUBSUJd 11(\ 111M auw:; ,
";,lilY\ "oeld pue sum 'alep mill') Pll(! 'UO!lnq!JISIQ pasotlrlid
li.1DlU9llJIS 914110 l)UlIlI 94110 SOIIOU uau\JM IU41 ^IIP90 Aqajf"i I
,..
"
~-,
,
;.
1'.
(,
<l;
'i;
it
'~
on
~ I ~ I
~.~ ~
~~1Il ~
~I!~
~. ~ J ~
t\)
...; ~
"
,
,', "
.\' :. ,I]