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Home My WebLink About97-00810 Tlli" i, II! (1,'lll!"\, Ill;ll 111-_' 11l11111l1;1l1lJl1 ht'll' !"iVl'11 j;, IIHln II\' i (lpinl Ir'lI!\ ,Ill OIWill;d '~I\ITR~(7'~hqkdtl\ dill\- lik,l with lilt. .1-, I(h'.\ll{q.,i~ll_n"'lh' II\'il~;I,I;d Il'll!lll,l\(' \\i1II11 1'1I\\,lIdt'lllll illl' ".1 Ill' Vii d HI'I""II\" {lfli(\. fill 11l'IIII.11l'-'111 lilllll'. WARNING: It Is 1I10(]01 to dupllcato this oopy by photostat or photolll'ilph, No, il"I~~\,W'riF"Pf~'<';' ;;? ~.- ".4'j~\;, ,~/"/~" .."",~/.,~,\~ 1M. :....',i........;\O':_' \ f.3..... . ,'fj. ,:~~ \1 .. -:., .' " . " \.' .fj'" \ c:;l . ",.' ,(Q, {S... '\ "I,p,. . ,\\''<';,.",: "" ,1'["1 "'''", "l;.ry1"" 11 U 111'1_ -.!t.!!!_"!'_'I!/lJi," ~7. ,/0'" ~ ,?"""",,!,,_ '~', )[iQ'<!\~-4.!,Ir1,..d~ ';'1' ~ Illl.IIIZq'y,I!;11 II h'" l;ll dd~ (l'ldlh ,1((', ~<'llp 4565618 un .OOf .1I3lW7. 1 l,l!c COMMONWEALTH OF PE,INSVLVANIA . OEPARTMENT OF HEALTH' VITAL RECORDS CERTIFICATE OF DEATH irATI "I~I1IJl.l~.1I ~~ME~:~:~~:'I~ Z:~~lll7~ t( ren .~.__._.._- ~n 1"ef~:J~i~~St(:U".ITY',jijM6~~O ~_._~~.;~ FO?iJ~-;-; .~~ 'Ili~~' AQEUu'ik!Mllvl UHOE"I'l'lAA I,INOe"'~~- OAf~' 1IIRlt.,LAC..f:IC,;..." P'tACiiiiFiEAm7r:t:i;--;7;;;;.;,,," _~_~.~!"~I~:'I':':!".'!'.~~! ~ 85 ,,,"'''T''~-':J''"_~1^:;~''';'~~~'2 l'i':~'~~::;~';I;""'Pil ':~~~:::'[-I-",~=:::j< ,,,,[I ~[I ,_~i 1 --:~;~'-i erN e6A0-rwpor O"A,III FAmlhN"AAl"ifiIr;;;;;-;~,i.c;:;-;;:;;'~~~;"~.'~''''h'''' ---JE1~SQ<<'EDF-':fI., OI'~lIS. ~N~OI1IOIN1J~i .A",...:an Ir>dI.I\,... WM. 1M<: H<> 11 'M 1 J ~ rH "*,,,. ClJbfIil, 1~I""'l,1 f-!drrisbul'g __ It. Ilarri8bur.g U08pj Ull 3M.' _'LlOH1Q!\lc.Il,,", II. White ~CEOC!'fUI!Wl ocQ..lti'A'rlO!i.__ .__ .m.....!(.I!:1!l~~t.!.~!'!.l!.!!~'-N.Q ~!!l~____ ..__ w...SDfCEOUI'l(Vl;f\IH ... "fe. EOf'N"!IfOlJC. .(lION .~A~.Tt}..'lS lATliii-:M"J:.-d . SUlwiV1N(l Sl'OoM IO,...k""-'ol~Ulk'klf'll<lo,,{'''Yrn(leI -- us Ml.l~O~(JACE!l1 ---~1~~lt'-;J/I'II:!t;'t~'~"l~~l"-U.-_.._,- II".lltltrloe<l_W,_ed. Itl~'J. 'I",."'~''''I''N'''I I'W<Il''"9k1e.t1'!fI9IrMrllil'''j 0 ~'t] EI'''''''''r)'I!hc<lro''tfY C<l!llqt ONOl,e<IISI'.<:"ll I t' nace On cer FaLCjvil Service \'e. - -- lOll) .:1 \'.,11'1 Wldowl.-'C! Of!CEOf:N"i"iiAiliiiOAPClIIEl8lli11_C<trlbon~~IIJ.-li'i"CiOe:N':'..-.- - 'I' . -.--- -----~l 1L-._.___.__ I.ntJ~~. ^llei~----- 325 WeBley Dri.ve ~~~:~l'iCE "._1111____ u___.. -.. :.,..,,, l'I,~ Ye4.'*........IMdIrl._.__~________._"_..::-...._ -------~ i b 1,' I""""'''''ICI.)/\I ...."'. It, Mechan cs ur~":'u:~_~055_ ,",,,'r..,.,,,I~l uIlE~~_Olnll.1cr.lt1!ld. 10'00"1"'1" __-'.!!.L~~;-~-;r~::gL .CO!y~~ ~AtHEI1'S NAME If nl.IoI,,~~. l do;/l MOTlI~R'5 NA,M~ if ,,'>I /01.",.. YJ"." ~rl.I"'~"~1 'I. Fr.an~lin 1~~~cll1.~~~________ !L.-L~:'~~~~~_}x._._________________.__ IH,OOM4NT'tHAr.tl\ll....P'.,'1 IHmI1MAN1'IMAllINOA,IlClf1tS91~'ewl C'llll"~,,~,, 1'I,e""1 Hobert (bId 110 'I'rulrhull DrIve lIudson Ohio 44236 MEltlODOf DlWiill6H-. -_-----.-~-.~il-(OfiOiiPOiii'iON 'IAr, Of OISPO IfION.N.""<llC."'.I.'~_C,.",.!ory lOOAfI<lN' CotylTtrwn, SIal. I~COdI-'-----n _ IllilllOO C'tmlllllnLI ,..movllrlom91,,,! J . Il,I,)rll,()u, "'*"1. <lIOlJ1tlPI.,. , . _~U ~""""',"L.._._.._._.______.__m,m._..ni I O::tober 4, 199'1 fIoll1ng Green CCII'Ctery Cilmp lUll, I'a nOll .A1UflOoi, i,.j,-'- R!JClN ACTINCI ASSIICH . l!!:........-Juc~N~eNjJIJI8ir----.- ~l -.'--FE AJjDA.DOllfSSOf'FACllIW'- . I I 'JOJ MarKet street . 0116.>4-1. JIl__.Myers-lImner Jo\:neral IklOO Inee",,, 11111, Pil 1'1011 Mil my.I\O.....,<JIllh""("II..j~~~lt;;;.:<i;,.t,;;;-Pil;.lilitd---.~.- . ----fICEN-SC'NiiMlIEI1- OAlt:SIONiO ISouo"""'III'dlj"'l I""~'lf> ll.l~ ",Ill . .M".....;..."'...;;;., ""'C"'~'IJ, j) ~')J;""t:;'<b;"""'''''')f''rl () rI ...e"'''''''''",O"",e,,,,,",,,,,,,, AO"'",--m---- l*1OO..hOll'OI.,.,~..dllI" u.--.Jde..-'__lA i' 'Lilli. /L9/_ ,..{-) ~Ll "."""1, I;m.llh.<lo...... "'1U<oO.OIe0111jl1ol:tIoOIII..hOChCfl/HoJlh.<IUlh 0<1 ool'OI"lh. """"'01 ""J 1"""..C"d<.O"l'....,H4Ilfl*..,I/I<l<;.QII..IItI..I"l~ j"Plli'O'I/Tl.I. ''''''111: ~~.~tf\cIoill~~r.....~lo'I..Ihbu4 lollQlltjgIllCI'''',,"I''-ll'I~''' . JJ ~j' i=~=~ OOII"llIllllll"IN~I\dII'T"'90:6_IJ"IeIl",PAllTI =~~=;;:. L__'f'N_'j!,/i1.!;.Iz~__ ./'lfl-- '-f----- - -.-,------- nn_____ _......~.M. \... _.l~~k1~"~,;c - W:J/tl~ l .._u____________" =~~::~ ~.______~I~~_~I:~~~~I~_j.>_:_)I.)f~ll ~.~l __.____________._ ___ -I... _._~_____ .____~~____.." ::=::::tA" 0I,"roIOll1.~~CO"S[l)L!~~IC~(Jl) I d_ _ ___ _ __._._ ." ._.. . .________.__._._ _. - _.., ...1... ....__. --... W1!nrA,UlOPl'I'''HOIHG~ MANNf!iOFOEA1II ----- IlAlrOf'HIlJfl'l' Tll,IEOfIN=rU1W 1N.IIJIIV.(l'M."lRK1 Ol!$CRIDEIiQWlt'UliRVOCCliRRIO Ull,l...f.PfllOfllO I"''''.'' 1l~ll..KI ~~~~)NOfr.AUSli ~f1",~ [1 '4oI~~.1oI t-] YlIIIllkl[J A(c.IIIIll [ J 1""~'''~I'''o''~~I.,n { . J N<1ltl y.. CJ No II 11-"".11I II C<l,>"I'~)lbe,-,"t""",...J f] ~CE.O"-i~iJ'IV--:-Ai-M;'i'--I'i~~;.;,jil';OiY;I,jii'-'!!~-~----ltOCATION(SI,~tyTt;"';;.S""'l .... ~", b"'~"'''j IIC L!,p':"jl )Of ea,""iii"IQ.;"'7k~~"'''1 ------- !!.--~--- ......~--_...--.---~ )~--_._-. ._"-...-.._..~_. "I(iN"''f'\~~'iOII~:?if.----'~--'---'- '~::'=t:::~~=~:'~;~'~~;;::J~':::;:~;'~~:~:~:'~~'~~~~~";':~'~'I~~~.,,,~.'~""'''I''''''''<I;.''t'I''QI'''l'''"''l.I' ( ) HL "1._'--.___. ___ ~ . _ __ ______. lICH4Sf.'HlI,lOI!l jOAlfSIONEOIM,..IlU"lU\ "IIOMOUHC:IMQANUCI"Ul'VIHQ'HYlICI""II1,,'o<-""h,I,.,,-...,-,," hl'h""I',";!"P",l",,,,,,~,,.,,,"',I',IU,1 '^"'" '" 0 3"" I... &. L q ..ad q7 '.1M1I...1l.I"'VlflO"'IedIje,4""'oc~.uI"IIIl\.l!n,.,4,1.."q"I".,,,"'''u'lglhec.u"ltflr.4"'I,,,,.'tttllletl ,. [JUt.'.!_,..,.. _ Oil_VI .-~___ Ilf~ _ _ ..~~'-,.. .._ 'l_~~ ""m il.DOI~U!iOf p~n~;()tj WIIOr,Ol.ll'l[1EOZSfi Of OEil.l~' '''"'''''''''''~'''"' -;I//Z /. '7'1 'UIDtC.U IIlAMltlIR/COMON'" . . ""'~I tIlES ',7 V.I v , I / 1'1 ~~~~~~I:I::~~~~,I::t.~O~ ,.~,~:~:.:~~~~~mf :'~~~ d~.~h ~C~UIl,..~ :t,n: r,l~n~..:~~::~~:~~~ ~I.~:. ~~:~~~~~.:~2~~"~') ~J. ~':li bfi-./LQ_ J. ~~..<_-,._II i!~.~_ ~___.._. RIOI9'flA""IQNA1UI1I'NIJ~ . ,.. . 11"~'lltPIMjA'[).f"""1 ~~. 7. ~~--- 2......U? _7.a~~ n nlilj ~iI'L "~~? 711..21------ FOUH'l'n: I give my clothing, includinq my fur coats and fur hatsr my jewelry, my Gorham sterling silver table service, my cut glass items, and my antique ladies denk, and any insurance thereon, to my niece, PNl'fnCIA MAY HUD!':, if she shall survive me. Any such property not so distributed shall be distributed in accordance with t,he provisions of AH'I'ICLE fnGlI'l'll hereof. FIFTH: I give my beer mugs, including my three antique German beer mugs, my cherry desk, my black & white wing back chair, myoId small trunk which was hand made by my great grandfather (on the Bachmann side of my family) and which is antique white in color with various decals imprinted thereon, my photography items and equipment, however, excluding all pictures, all picture albums, and all transparencies, and any insurance thereon, to my nephew, WILLIAM F. BACHMANN, if he shall survive me. Any such property not so distributed shall be distributed in accordance with the provisions of ARTICLE EIGHTH hereof. SIX~'H: I give my round maple k Hchen table, including one board and two matching chairs, my gold couch, my maple end step table and my cherry three drawer marble top chest to my nephew, ERNEST E. BACHMANN, JR., if he shall survive me. Any such property not so distributed shall be distributed in accordance with the provisions at AHTICLE EIGHTH hereof. SEVENTH: I give all at my pictures, wall pictures and table top pictures, and all of my albums, and any insurance thereonr to those members who shall survive me ot a group -2- consisting of my niece, PA~~ICIA MAY NUDE, and my nephews, WILL,IAM F'. BACIlMANN, EHNES'l' ~:. IlACflMANN, .lH., <'Ind HOBER'l' H. GOLOr in such shares as they may agree upon, or, if they shall be unable to agree, then in equal shares. EIGfI~'II: I give the remainder o.f my tangible personal property, including by way of illustration, household goods, furniture, furnishings, books, chinaware and personal effects, and any insurance thereon, not heretofore bequeathed as aforesaid, to those members who shall survive me of a group consisting of my niece, PATRICIA MAY RUDE, and my nephews, WILLIAM Fl. BACHMANN, J!:RNES'l' Ii' BACHMANN, JR. , and ROBERT H. GOLDr ". in such shares as they may agree upon, or if they shall be unable to agree, then in equal shares. Any such property not so distributed shall be added to my residuary esta te. NIN'I'f1: 1 direct that there shall be paid from and oharged exclusively to the balance of my estate remaining after providing tor the foregoing bequests, all inheritance, succession and estate taxes, other than any generation-skipping transfer taxes, together with interest or penalties thereon, imposed upon or payable with respect to any property or interest in property which may be included as a part of my estate for the purpose of such taxes. My Executor shall not collect or seek reimbursement for any such taxes from any other source. In the discretion of my Executor, taxes on future interests may be prepaid or payment thereof may be postponed until the future interests vest in -3- possess ion. I author! ze my Executor, in my Execu tor's sole and absolute discretion, to use administration expenses as deductions for estate tax purposes or income tax purposes and to use date-of-death values or optional values for estate tax purposes, regardless of the effect thereof on the interest of any beneficiary of my estate, and I direct. that there shall be no adjustment of such interests by reason of any action taken by my Executor pursuant hereto. TENTH: I give and devise my residuary estate equally to those members who shall survive me of a group consisting of my niecer PATRICIA MAY RUDE, and my nephews, WILLIAM F. BACHMANN, ERNEST E. BACHMANN, JR., and ROBERT H. GOLD. ELEVENTH: In addition to the powers given them by law, any and all fiduciaries acting hereunder shall have the following discretionary powers applicable to all property held by them, exercisable without court order and until actual distribution: to distribute in kind at valuations fixed by theml to cause any share to be composed of cash, property or undivided interests in property or property differing from that comprising any other sharel to distribute without regard to the income tax basis of any asset and without adjustment for distributions resulting in unequal allocations of income tax basesl to retain any property received by theml to exchange or sell any property for cash, other property or credit, publicly or privately, or to lease the same for any term, without liability on the purchasers or lessees -4- to see to the application of the consideration, and to give options for these purposes without obligation to repudia~e them in favor of a higher offer, to invest in all forms of property without restriction to investments authorized for fiduciaries, to hold property in the name of a nominee, including any f'iduciary hereunder, to borrow money, inclUding the right to borrow money from any fiduciary hereunder, and to pledge, mortgage or create a security interest in any property held by them as security therefor/ to make loans, to exercise options of any kind, to compromise, submit to arbitration or release any claim of my estate against others and to pay, compromise or submit to arbitration any claim of others against my estate, to operate any business, to effect or join in any incorporation, partnership, recapitalization, merger, reorganization or voting trust plan and to delegate authority with respect thereto/ to deposit investments under agreements and pay assessments, generally to exercise all rights and privileges appurtenant to any property held by them, and to execute and deliver any and all instruments which may be necessary or expedient in the exercise of the powers granted herein. TWgLFTH: If, at the time distribution is to be made in accordance with the foregoing provisions, no person named or described above is living to take his designated share, thereby causing such share to lapse, such lapsed share shall be -5- r''''- d ,:rJ' 110- I ,,:,) ", ,'- i i ~ '. ' ~! ~. ~ ~ 0410 ~ ~1 ~ [:l . H ~ '~I ~ ~ ~ II ~ E-l II ~ ~ i'r ( " , 21-97-010 . COHEN & GRIGSBY, P. C, ATTORNEYS AT LAW a900 eNO TOWER 6211 I.IBERTY AvENUE PIT'fSBUROH, PENNSYLVANIA 1~IiI11e'311" ,,--- [";":'::'1"1.',1 n ..:; ';1_ _"1 \} ,;,' 1< ~, C)t r-' . ,. ~-~ t~ ~:. ~ C.i Register of Wills Cumberland County Courthouse 1 Courthouse Square Carlisle, PA 17013-3387 .-.. ~-::J \,(j\1)'1':!l':!l'l~ tl'l ,llIlllllllllllltlllll"IIIIIIII"lllIlltlIIIIIII1I1'lrlll'lIll ~'-,," "",~~,,,," ;~~",r""_ '''',n,''''T ,'! ,:-," , .'1 ~ .,'_i " ,- 'n ,i' ~H (-, ~, / f)") () {, (I INHERITANCE TAX RETURN RESIDENT DECEDENT (TO BE FILED IN DUPLICATE WITH REGISTER OF WILLS iI~V - \~llO f,X I (I -n<\) D E C E D E N T CAB H P L E PO C R C K 0 K P S CUMMONW,AW III ()I I'l NNr;" VAN'A nff>Af'I\-NT 01 mVrNU[ ): q,' 6011(1\ HAllIHS IIJtHl,"A \ 7 \;tA"OlIIJ \ R E C A P I T U L ~ I o N I x C o ~ U T ~ I o N (l I oflllll.ll ',IJI Of AlII 1\111111;>/11/111 CIII.(;I<; HrfU II 1\',1'111)'1111 ['''J'' !_'{'IVLLLL'C(ij\LUU_\~_S;Ul!M.llL_. ..- ~~._~~_._- FII.E NUMBER IOUNIYU1IH (9) 7.?,1,611,60 ~ I "" 'II" Oil I 0 16 ()1 ( >,;: "".- (J)~ ') i'-J r-:. (I~' (12) (13) (14) x X ,06 . (18) (19).. (20) (21) (21A)" (21Bt VI.All NUMIIIII nrCE 01' N "!\ NAMI (\ ^~;!, I' If\!il, ANO MIPlll I INllIAl! III I'l III N I'n clIMl'1 I 11 1\[IOHI '\~J 1I1~I..!.Mc!'.'~L ^d"llItdCr' _.G.-"""_"M"\"_M"'_.""'''''''__'''''' 'I:J', H,," I (' Y ill' I VC' ~IOCIAL~lrCUIll!YNUMnUI 1l/\I[OI [IU'111 [lAlrOf t1IIHil M{'{'hH\llc~dlll1"'" p^1/0')I) 19~,,"1 0 ~~,,~~,,__ "(::~:~,I~~"I"",, ~~~~~Il"r- ~"J""'L"..."_~\I"'b"I'J..il'~,c,I""_,,,, ",,,,,---,,, """"",,-_...,,-_..,--- I" AI',,"CAIII'I ',\If\VIVIN(I ""IlIJ"'''' NAMI II A'II .'IJI'" ANII MIl"JI I ",ll 'At I .. ""ClAI 'II (1111 II Y IlIJMJI'. fl AM<:IIHI! fU:cIIVUl(!lf I: INn! 1l\J~~I,I(~)~ll [']fi":-o,lqi;;;;1 ROh~~""---"-D2.""s,;;;pi;;'I~;;t,;II10h;~;-". "-""~-----""-"" 3, R.""nllldo;f1oW;r;-'-~-~ D 4. Unlilod Entoln D 4a. rlltulo I,,!WUBI Comprotlll!lO (101 datou oj doalh pIlar to 12~13~02) (lor daloH 01 donlh al10r 12-12"02) [] 6. Fodnrill Estalo Tal( Holum Aoqulrod ITl e. Docodunt Dind TOHlnlo [J 1. Oococlonl Mnjnlalnod fl Uvillq Trlml 1 8, Tolal Nurnbor 01 80.10 Doposlt BOllos (AlI.eh" copy 01 Will) (AlIaeh a copy OU"IlI"') ,-""---"~""" C P ALL CORRESPONDENCE AND CONFID~NTIAL TAX INFORMATION SHOULD BE DIRECTED TO' R 2 NAM' coM!" In M~"."'''~;''~------'' R D c, Edc I'L(d] Cohen & crll'"by, P,C, E E ' {1. S N TEU:PHONE NlJMBEIl 7900 CNG TOW(!I: T 1,12 /3%,,1,900 l'iLl.sbut ,h I'A 15?72 I, Roal E'I.la (Schedulo A) (1) ____tion~ 2, Slock, and Bonds (Schedule B) (2) __!!? , 116 r. , ? 9 3, Clo,oly Held Slock/Porlnorahlp Inlor03' (Schodulo C) (3) NkfJ 4, Morlgagos and NOlO' Rocolvabla (Scl)Qclule 0) (4) N . €; 5, Cash, Bank Doposlls & Mlscollalloous POlson.' ProporW (Seh, E) (5) I,; , 545111 1. 8, Jointly Ownod Proporty (Schodulo F) (6) Non;; 7, Tramllers (Schodulo Q) (Schodulo L) ("I) NOll" 8. Total Gross Assots (total L1nos 1-7) 9. Funoral Expenses, Admlnlstrallvo C09t9, Miscollanoous Expenses (Schedulo H) 10, Dobis, Mor1gogo Liabllltlos, Lions (Schodulo I) 11, Total Ooductions (Iolal Lino, 9 & 10) 12. Not Valuo of Estato (Uno B mltllm Uno 11) 13. Charllablo and Govornmental BoquoslD (Schedulo J) 14. Not Valllo Subjoc' to Ta, (Lino12 minus Lino 13) 15, Spou,ol Transtors (lor dalos ot do,'h attor 6-30-94) Soo Instructions for Applicablo Percontage on page 2. (Includo vallles from Schoclulo K or Schedulo M.) 18. Amount 01 Uno 14 taxablo at 6% rate (Include valuoslrom Schodulo K or Schedulo M,) 17. Amollnt of Lino 14taxablo 8115'% rala (Includo valuoslrorn Schedulo K or Schedulo M.) 1a, Principal 'a' due (Add la' from Lino 15,16 and 17,) 19. Crodlls/Sp Pover1y Prior Paymonts Discount Intomst +_~,Lll;,OO + 1,113,00 ____ 20, II Lino 19 Is groaler than Lino 10, onlor II'" cllllolOnco onLino ?O, This Islho OVERPAYMENT, ~ 0 [Ci1eCkhor. II yqU are re~ueallng a ,etund 01 you, "oue,paymen!:l 21. If Uno 18 is graaler than Uno 19, onter tho dlfferonco on Uno 21. Thi~l is Iho TA)( DUE, A. Enlor tho inlerosl on lho balanco duo on Uno 21A. B. Entm tho lotal 01 Uno 21 nml21A on LInn 218, This 19 HlO BALANCE DUE. Make Check pa able 10: Re Isler 01 Wlllo, A ent ~ ~ BE SURE TO ANSWER ALL QUESTIONS ON PAGE 2 AND TO RECHECK MATH .. .. UnllQrpllnilllill~ of pllrjury, I dllCliHfI ilia! I ha'ltlllKAniiiiOdih"i'!l7alllrn, itlf.h,{tInOilCC1HllIMnYlng ~ctHldl,Il'\" dllll stahllTlonts, ~fld to tho IH)!;l (If my knllwlodgllM,'! bllhltf, 1\ l!lll"~ GtHfllCland cnmplll!lI.1 tlQctaro thaI dllllldl f)~!alll has hOIl!1 Illpor!lld ,11 !lIJQ mMkol v.lIiIB, (lOr,liHilIllHI of fHCflil'IH olhor II1Ml tho f10fSIIIli\1 rlJflrllijlllllallvo IS bd~Otl on all informatIOn of WhiChflrflpMorhar,,111yknowlodOfl. (10) ?0,309.:ll5 .f~ ;oJ J'J ::Uw 'I 110. OJ?,,: 20 (I) S>.. 1,2,173,95 67,238,25 67 , 238,25 0,00 0,00 ....!Q..J? 8 5 , 71, 10,085,71, 8",860,00 0,00 1.7.2,>,]11 0,00 J ,27.5,74 !3\(lNAT)U~~:~P PfHflON IlESf-:(l~~lI[J)I: f-(in ~_llJrHl~\?'lmN /'< ;/ ) .,.r'"" ,'.. .____ , /" ,".'''' I ; 5IGNATUflF: OF PHEPA!1E fl on if. n THAN AI: rIlVi!- N r^llVI . I '( II ' t UK"J /. l " (.. 0 1) f.l".-' COPYlIght Ie) 1994 form softwarn only CP~_;y"tllrn!l,ln(:. . - -.------ I<:vnns R()!.H!, J r , ? 900 CNG '1'01'''' r i;i"I"i;:j,"lil:~i;:" j,^~" i "',;?7"" -~...:.:..:..:.~~~~~~ "n -" - ,,- CotWIl &. Grlgshy, P,C, 7900 GNG 'l'C>\' " " j'-j"ti;,j,-,il:ili;: - i't,~" i ;,~W"" -".""" - ,,"",," -""""" "-"",, -" (15) (16) (17) 67,2311,25 X ,15' OAT[ ., I....... ,..,',' :J ,//' (j DATE Llif JI ~j) q?, f-orm 1600(118\1, 1-94) mV'1!iO:IIK+ (.I-fttlj COM\I.'!N'XIIi.W"V ~'INN!I'I~^NIA ,ib lilN)'hlcUlt.l'1 UTATE OF SCHEDULE B STOCKS AND BONDS lido 1 II Id.. I" lIultl',I'l'1l SSII 190-1()-')~'il ()9/~ /1199/ olntlt:owned with Right of Survlvorohlp muol be dl.ele.o~ on Sohedul. F,) DESCRIPTION 216 Nhllrn. Uo18"to-Palmnllvn Co - tradod on the NYSE, common 2 16 "hares Electronic Datil Sy. NW, CUSH' #285661101, - Tr IIde d (in NYS E Accrued dividend on item 2 to date of death 3 528 shares Exxon Corp - traded on tho NYSE, common Accrued dividend on item 3 to date of death I. 90 shares General Motors Corp - traded on the N'ISE, common Accrued dividend on item I, to date of death 5 4 shares General Motors Corp Cl H . traded on the NYSE, common 6 100 shares GTE Corp - traded on the NYSE, common Accrued dividend on item 6 to date of death 7 3 shates USX . Marathon Group - traded on the NYSE, common Accrued dividend on item 7 to date of death 8 $2,000 Cooper Industries Inc Sub Deb Conv, 7,05% due 1/l/20l5 Accrued interest on item 8 to date af death TOTAL AI., ente, on line 2, Reoa lIulatlon '" more .paoel. needed, In.en additional .heel. 01 .ame .Izo,) capyrlghl1c) 199' form .oltWAre only CPS'l'8toms, Inc. FILE NUMBI!R ~1-9/-0810 VALUE AT DATE OF DEATH 68,1093 1.1,,711. 63 36,0937 577 , 50 ,15 2,1,0 64 , 125 33,858,00 ,468571 216,48 66,25 5,962,50 ;51111.1 46,00 66 261., 00 45,92187 4,592,l9 ,47 47,00 37,28l2 111. 84 ,l9 0,57 1. 02125 2 ,042 , 50 .Ol684 33.68 . 62 466,29 FOlm 1800 Schedule B IRe.... 4-86) nEV ~ \508 EX + (2~87) SCHEDULE E CASH, BANK DEPOSITS AND MISCELLANEOUS PERSONAL PROPERTY COM\'I,'1tt~rV\WWA~'JiJ'jY,'M^NI^ ndJ1HF.NT tJECI{O~,NT ESTATE OF Plouse Print or T 00 FILE NUMBER H-97-08l0 Adelaide L, lI11l tgren SS/I 190-10-',?',1 09/?l/199/ - - olntl -~wn.d with Right of Survlvorahlp muot be dlaeteoo~ on Sohodule Fl....____ DESCRIPTION Cash Found in wII11et 2 Cash Found in room 3 IHghmark Blue CrO!HI - Oet $1:>9,95) Medical Premium Re1.mbursenwnt (Sept $15,99, 5 PNC Bank, N,A, - Ccrtificate of Deposit #31200042980 4 PInnllcle lIealt:h HOflpaal - Refupd of overp"yment from Polyclinic Accrued interest on Item 5 to dllte of death 6 PNC Bank, N,A, ., Certlficllte of Deposit: #3l4003681,7 Accrued interest on item b to date of death 7 PNC Bank, N,A, - Certificate of Deposit #31500045851 Accrued interest on item 7 to date of death 8 PNC Bank, N,A, - CertIfIcate of Deposit #3l?00036745 Accrued interest on item 8 to date of death 9 PNC Bank. N,A, - Certificllts of Deposit #31300084928 Accruod interest on Item n to date of death 10 PNC Bank, N,A, - Certificate of DeposIt #31700067452 Accrued interest on item 10 to dlltc of death 11 PNC Bank, N,A, - ChcckInr, Account #50-7009-1,957 Accrued interest on item 11 to date of death 12 PNC Bank, N,A, - Money Market Checking Account #50-8003.4552 Accrued interest on item 12 to date of death 13 Symphony Mobilex - Reimbursement of payment also made by insurance 14 Personal Property - Per attacbed appraisal by Chuck BrIcker Total of Continuation Schedule(s) TOTAL (Also enter on IIno 5, Rocopllulatlonl (Alloch oddltlonaI81/2" , 11" sheets II moJO spoco Is noodod,) Copyright (0) 1994 form Boftware only CPSystllms, Ino. VALUE AT DATE OF DEATH 15,00 0,39 l75,91, 10,85 1,000,00 1. 34 6,000,00 22,57 3,000,00 lO,92 20,000,00 69,44 3,000,00 4,56 4,000,00 lO,09 2,l58,58 1. 78 5,659,10 8,45 27,54 11.5,00 2 224,36 $ 47, 51,5, 91. Form 1Soo Schedule E (Rev. 2~&7) Estate of: Adelaide L, Hultgren Soc Sec #: 190-10.525l Date of Death: 09/27/l997 Continuation of Schedule H.C (Miscellaneous Expenses) Item # Description Amount 8 Parker/Hunter Inc, - Sale expenses of investment of Colgate Palmolive Co, 292,53 9 Parker/Hunter Inc, - Sale expenses of investment of Eleotronic Data Sys NW 20,02 10 Parker/Hunter Inc, - Sale expenses of investment of General Mtrs Corp CL H 20.01 11 Parker/Hunter Inc, - Sale expenses of investment of USX-Marathon Group New 20.0l l2 Parker/Hunter Inc, - Sale expenses of investment of General Mtrs Corp l3S,22 13 Parker/Hunter Inc, Sale expenses of investment of GTE Corp, 14 Parker/Hunter Inc, Sale expenses of investment of Exxon Corp, 15 PNC Bank. N,A, Es ta te Checking - Bank Service Fee - February, 1998 16 PNC Bank, N,A, Estate Checking Bank Service Fee March, 1998 17 PNC Bank, N,A, Estate Checking Bank Service Fee Apr 11 . 1998 l8 PNC Bank, N,A, Estate Checking Bank service fee May, 1998 19 PNC Bank, N,A, Estate Checking Bank Service Fee Junp., 1998 20 PNC Financial Corp, - Es ta te Checking Account #lO-0598-l009 Retur.ned check charge 129,16 575,15 10,00 lO.OO 10.00 .10,00 10,00 7.00 2l PNC Financial Corp, - Eotate Checking Account #10-0598-1009 Check printing feo 10,75 22 Register of Wills - Inventory filing fees 37,00 23 The Patdot-News - Logal Adver.tising 137,80 24 Veronique's Antiques - Storage of Personal Property - February through .June, 1998 '125,00 25 Veronique's Antiques - Personal Property Appraisal Fee 200,00 ~fr'"~"- "''''j''"'' ,\,~,,,.,,~,.. "'T"I"I('1'..'~"~" ~',., " .,.,."",,....-, ,', I..j t Ii; ,I: :\1""", 1,\'I'i~[\'J^ ~l^Y HIJD"', ilnU lilY fll:!phews, ^ll.l.li\I': I. H,.,,'IIi'IM,N, 1;1<1'<1';;;'1' I:. BAl'II~lANN, ,JR., and Honr:H'j' II. GOLD, in nUL'1l ,;11<1["(''-) iW they m"y "'1ree upon, or, if they sh1tll be unable to agree, then in equal "haros. EIGHTH: I give the remainder of my tangible personal property, including by way of illustration, household goods, furniture, furnishings, books, chinaware and personal effects, and any insurance thereon, not heretofore bequeathed as ,1J.oreBdld, tu thfHit: rr,(.rtdH...'fF> v.'l1o ~..;llall. surV1Vl' Ill(' of a qroup consistin'J of my niece, PA'l'HICIA MAY IHlDE, and IT,y nephews, WIl,LIAM 1;\ IlACHMANN, ERNESrp E. BACIlMANN, ..HL, and ROBER'l' H. GOLD, in such shares as they may agree upon, or if they shall be unable to agree, then in equal shares. Any such property not so distr ibuted shall be added to my residuary estate. NINTH: I direct that there shall be paid from and charged exclusively to the balance of my estate remaining after providing for the foregoing bequests, all inheritance, succession and estate taxes, other tban any generation-skipping transfer taxes, together with interest or penalties thereon, imposed upon or payable with respect to any property or interest in property which may be included as a part of my estate for the purpose of. such taxes. My Executor shall not collect or seek reimbursement for any such taxes from any other source. In the discretion of. my Executor, taxes on future interests may be prepaid or payment thereof may be postponed until the future interests vest in -3- If' (;OIl~1'~I~{j;'~:-'~tT~-j),' '~'jl'cr-"ro-"'(Jrve"-' (jpt.lon~; JIll UH'"'' (""'1'"'''''' wil.llout obligation to repudiate them in favor of a hi'lher o/fer; to invest in all fOrlns of property without restriction to investments authorized for fiduciaries; to hold property in the name of a nominee, including any fiduciary hereunder; to borrow money, includJng the right to borrow money from any fiduciary Ilereunder, and to pledge, mortgage or create a security interest in any property held by them as security therefor; to make loans; to exerclse options of any kind; to compromise, subrnlt to drtJitrat.lon or reled:3e c)ny claim of my estate against others and to pay, compromise or submit to arbitration any claim of others against my estate; to operate any business, to effect or join in any incorporation, partnerShip, recapitalization, merger, reorganization or voting trust plan and to delegate authority with respect thereto; to deposit investments under agreements and pay assessments; generally to exercise all rights and privileges appurtenant to any property held by them; and to execute and deliver any and all instruments which may be necessary or expedient in the exercise of the powers granted herein. TWELFTH: If, at the time distr ibution is to be made in accordance with the foregoing prOVisions, no person named or described above is living to take his designated share, thereby causing such share to lapse, such lapsed share shall be -5- ~JI\fl1 llnl1llflll BOl{ HIH:lll'llllHI Oate or DCl/lt:h I ValuAlioll Datu I P.\'OcofHiing DtH.lll Oll/::!"//1 ~}y., 09/2'11199" 06/22/199H r.h"l'{1fI 01' I'ar f1lloudty !l(lllm'lpUI)Jl II 216 COI.llM'l-l \lfll,MOI,IVN co (1!I4If1~tOJl NYap. 0>/26/199'1 09/29/199'/ 21 2000 coolllm lNOS INc (:.!16fi69MSI NYBE DTDI 01/0i/l!l!Hi Mat I 01/01/2015 1,05_\ 05/16/1991 lnt, 01/01/19!l" to oSl/a'I/199'1 Last pdce available on OS/16/U9'/ 31 16 ELECTRONIC DATA RYS NW (2eS66U041 N'iSE 09/2&/1997 09/29/1991 41 51 lIiUh/Allk (,oW/Bid till, ~lClOOO {HI, [10000 fJ'I.1.moo II/L G'}, HUiO II/I, 102,12500 Ala 36,56250 36.560150 35,31500 tilL 35,B"/ijOO fl/L DiV, 0.41 EICI OB/20/1991 Rael 08/22/199-" PAY1,10/01/199'1 90 GENERAL MTRS CORP /3704421051 NYSE 09/26/1997 09/29/1991 61 1) 4 GENERMJ mRsCORP Cl, tl (310442501) NY". 09/26/1991 09/29/1997 8) j USX ~lARATlloN GROUP (912656105) NY". 09/26/1991 09/29/1991 Tot.<<l Vl:iluel 'l'otal Acorual I 'l'otall $60,158.34 /tI.fI"lOO..8t( 0, ~:flL"t II ur j Blllat:n of ^,(('Itlll\tl 1lllllqrnl1 1{f/pOl'l'l'Y!J(l1 [l;l\:u uf I)wllh tNililw!.. o( !lnrjllt 11.1(1111 1\ 1.'11(1 Wi !i4b(,(J(I()1 !-1e/\n ttlld/tll' Dlv tint! lilt Adjljntrnol1tl-l ^u(!l"lhll II 160,1093."r. loa ,1aMoO 36,093'150 66,!l31S0 65,25000 .'n/tl 66,B1250 66.00000 IIIL 66,250000 66.312!10 6S.B1500 II/I, 66;12500 6S,681S0 11/1, 66,000000 3'1.25000 38,19150 36,15000 II/L 36,93150 IIIL 3'1,2812ijO 33,68 47,00 ~ $80,68 IInO\lrlty VI\IIll1 14, "ll.l1J ~tJlI-~. 60 ~ 5'17,50 33',8S8;00 4,$92:19 6,963,50 264,00 111,B4 $U,O':'':'.C6 /iJ 'J,I;J., 0.1 & This report Was produced with ~lJtl\teV~l 51 a produot of Estalo Valuatlona & Prioing SyatElm/J, Inc, If you havn quofltiOl\a, 'plM9(1 contMt EVP Systems at (RIlll 3lJ~6300. (Rev1slon S.l/?) P<\ge 1 Per8onl~1 Property of --------- --.-.--.-.-,. APPRAISAL ~___I!j/Zl21(' 11_ Appraised by Chuck E. Bricker AU094.L -~-- ._.__._~__,___~._..u .'.,.._..______ '0.___' .-..---------- " --,- ---- _______. - -- -- ITEM VALUE ITEM VALUE -~._-_..__.---_..._._--.-------.-._.._._---------..._..--.. ~~(L~L 1__ _""__~__~________"n~_'-----------'------...--- ~~Ii I!..._ ( ItC'sT _____________ ------_.._......_--~--, ,------",,-- --- ::: c: ;Jr:csk 0?J , t{~ - -_._--_._---~----_...--_. ._.~_.- .. ..,.----.---.-----........ " n___.~_.~ -~- hl/L~M:L------------, -------,- __S,d~ .... ......---- ------_._...~._.. ____n_ ----.--. C41-cl71iJ{c /v/Cli1IJ1_~______d" l..o.1_49..~ __ ______.___..__0..__. ------ ..--- .J1S~ _..~~~-~--_._- _,'D.~_tL .__._-_._.,--,-_.~_._- -----,-- -.---- f/ltJ - lJ!~(dY".L___ n~..Q --'._-~-_._._- - n____ --.---- t1Mf ~:_p U__ __n____'___________________________ --.-, ENr-1 711J (?t' ----- _ SLiiY_ --- if --- ~~]J;;~L!1~~ - --:;::-- -...-- lLfSA --- 'I n. - (!Jit..<'& €... 1 a, ' --- '/J V t)...:i1~L / r) - al- q '} --,--~- ._---_.~~-- -- --- - - -- -- - --- - - . - - - -- . -- ----------. - --, Date / D -- q / - C/ ? CLAUDE C. WOLFE & ASSOCIATES t\1I(""'()NI':I:H,~ & ^,'I'HMSUIS I'AMI!, t' OWNU, SINn IVI.' 200911NCOlN STREET. CAMP HIli., PA 1701' 717.761,/763 Appraisal for the Hetate of Adolaido L. HUltgren Apartment ~37, Bothany Village HeohanJCSburg, PI\ 17055 Ootober 30, 1997 lif!ili.TII EN l' CQ.N1'EHTli. Houok paintihg 10.00 Foot massager , 1.00 5 Drawer Chest . . 110.00 Pair of Eagle motif table lamps , . ,. , 10,00 Ladies Oak Slant f ron t desk , , 465. ~0 Misc. COstume jewelry . , , 25.00 Zenith portable 19" Color tv , . 65.00 Tv stand . , . . . " , 5.00 2 WOOden chairs , . , , . . 10.00 Walker , , , . . 5.00 Trash can , , . . 1.00 Smal.! 3 drawer chest . , . . . 40.00 GPX ,radio/tape player 12,,0el Brass table lamp . . . '. 10.00 MUsic bOle . . . . . 5.00 Wing chair 6< foot rest . . 60.00 Single bed, mattress, bOle SPrinq 6< frame . . . . 90.00 Misc. live plants . , . . . . , 5.00 Alarm clock , . , . . . . , 2.00 1'elephone . . , , . " . . , . '12.00 Afghan . . 4.00 Marble top wash stand . . , . , , . , . 450.00 SUitcase . . . , . , . .' . , . . . , 1.00 Misc. kniCk-knacks , . . . , , . . '. . . . . 10.00 Misc. Contents of room , . " . . , . , . lS .0@. I ", I , I ~i'TUlJ,C':'I) J..EFr IN sNPJD ~y 1b1J..J,. ,$/Ie..~II-,j . e~ rlrT"E ~F Itl)G /.. ~'Il>" Ii tJArt:a~EN ,,{ , (.il I{ , __1 rEm 1-1'~. /b..~HsrEe ~"'h,<J4j - ~.\I6N ~~p" A . t(,I(')PD~N FeRN cr5mN/)J - (J)1hb/(eN .3~.p c) . I. ';1t:w"vcS /)1At::/f 11V6 I6I1S6' t/ts: rt; 1- IJ?I1-R~"t:= ;dlc:~e mi'rwAs.4)NIII!H)V~MSIF'5b.~~ 1- A/fm/', ~ ~()Gt::J:r.s I~. "0 1- teoCK Wf~i.. r'1f INr IN "~1HtF /0.1) () 1- eh~r e>F ~~IkVIi~.s-/)!,fR&('En;O Ao(;.() (> /O,qCI( #1t:e.E I~ 111/.:5 S /Nt9- I . - a/{lJ(-~r NE'If1)S Rif'FINI.:iA'lI1/~, - f;7/f1, _ 7,J$"().p d . I I , I I I I " VIJ:nOOQUE'1) AN'flQtJll:al HH S. MAlu.IJ.'T S'fMtt~ lI<<lIC8ANICBBU!O, PA.. , ',1C'~'l " Regl8ter of Willa of GtJMBI~lllJ\NIl County, Penn8ylvanla INVENTORY Eot~toof Adlllllldo I., 11\111:1\'"011 No. ?l-9/-0!\10 aloo known a. Dolo 01 Do'lli _ 09 /21 /1997 ,DOCOOllOd ~0,,101 SlJcurlly No, 190 -10 - 52 n ~vans R~fll] I '-, r 'I. " _ Paroonal Reprollonlallvo(o) 01 tlio abovo ElItOtO, d""OOllOd, vorlty Iholllio Itomll oppoorlng Inllio following Invonlory Includo all 01 tho personal assuta whorovor slluftlo And aU 01 tho roul outala ill tho COll1monwoal1h of Ponnsylvania of flold Decedont, Ihal tho valuallon placod oppoallo eaoh 110m of said Invonlory roprmlOnln Iltl fair valdo as of tho dalo ollha DocodArll'U doath, and thai Decodont ownod no roal 09tato oulsldo 01 tho Commonwuulltl 01 Ponnsylvanla OIc:copt thai which appoars In n memorandum at tho and 01 this Invontory. I JWo verify that tho statomon!s mado In this Invontory aro tnl(I Rnd (10rrDet. IfWo undor!:'lland thallalso statements herein aro mad..] subject tu tho ponalUas 0110 Pn. C.S. Socllon 4904 rolRtln~ 10 unsworn lalsllioaUon 10 RulllOrltleo. Personal Roprosonlallvo Name of C, Eric PfoJ! Atlornoy: I,D, No,: 1,1,81,8 Address: 2900 CNG 'l\')Wflr pj,ttsburgh , PA 15222 Tolephone: 1112/391,-1,9<2.0 Slgnolure: /, J~ ..] // ~ / , r EVilns Roso, J I' , ".);\)2/ Slgnaturo: Address: 2900 CNG Tower Pittsburgh, PA l5222 Telophono: }il,2/39i1-1,900 OOlod: 06/.19/1998 Oesoriptlon Volue /?C"l .;:<<' ~;.':":' ~ \: "" :0 ::om III ("I '-'~ 0 "..'" ,.iI [) ': n.l t-" (See oontinuation pnge(s) sttached) "', '0 "() c. .', \'.>) h', m U>- 0 - (Atlaah additional aheots IIneaeoo"y) Total: 1.14,270,37 NOTE: Tho Morilorond"m ef realestole o"t.ldelllO Commonwealth of Penn.ylvonla moy, alllie oleollon ot tlie pe,.onol reprooentollve, Inolude the vol"o 01 ooah 110m, bill ""oh IIgur09 ohould not be o,'ended Inlo Ihe 10lal 01 tho Inventory, Prell.red bYlhe ""onnSYlv~'liA (JM AssooiAtlon CllPyrlghl(ol19911 10fm BnltWMll only CPSY!lIOnlll, Inc;, Form tRW-7 (1992) /,J ,( (J{, fc IUUAU Of INDIVIDUAl. TAXES INll<RIIANCI' IAK DIYISl,," lIfPt, Z80601 HARRISBURG, PA 11126"0601 COMMONWIALTH OF PENNSYLVANIA DEPANTMENT OF REVENUE ( ..- - NOTice Df INHERITANCE TAX APPRAISEMENT. ALLotIANCE OR DISAI.LOIIANCE Of DEDUCTIONS AND ASSESSMENT Of TAX .IHW U." ~'''''I 09-07-1998 HUL TGREN 09-27-1997 21 97-0810 CUMBERLAND 101 F - ---A.ounCR."lH'~:::J MAKE CHECK PAYABLE AND REMIT PAYMENT TOI REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YDUR RECORDS .... iiE"v: is'47"ifif" Aiiji"iii9':97T" NiificEnOF- i:"tiHEiiii'AiicE";'"AX-APiiiiA"isEiiENT ","-ALl"OWANCE"OR ---""----" n -- no DISALLDWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ADELAIllE L FILE ND. 21 97-0810 ACN 101 C ERIC PFEIL 29.00 CNG TOWER PITTSBURGH DATI ESTATE OF DATI OF DEATH FILE NUMBER COUNTY ACN ADELAIDE PA 15222 ESTATE DF HULTGREN DATE 09-07-1998 TAX RETURN NAS, (X) ACCEPTED AS FILED ) CHANGED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE DF RETURN BASED ONI ORIGINAL RETURN 1. R..l Eot.t. ISohedul. Al 11) 2. Stocks ond Bondo ISohedull Bl (2) 3. Clo..ly Held Uock/P.rtn.,..h1p Inter.st (Schedul. C) C 3) 4. Nortg.peo/Not.o Receivabl. (Sohedul. D) (4) S. C..h/Dank Deposlts/Hiso. Perlona1 p,.ope,-ty (Schadule E) (5) 6. Jointly Dwnod Prop.rty I Sohoclule F) (6) 7. Transfa,.s (Schedule G) (7) 8. Tot.l A..oto ,00 62,466.29 .00 .00 47,545,91 ,00 ,00 (0) _ NOTE I To 1nsur. prope,. credit to your account, sub.it the upper portion of this forll with your t.x p.YMnt. 110,012,20 APPROVED DEDUCTIONS AND EXEMPTIONS I 9. Fun.~.l EKP.n..s/Ad~. Costs/Hisc. EXPlns.s (Schedule H) 10, Debts/MortgAgo Li.biliti.s/Llons ISohodul. I) 11. Tot.l Deduotions 12. ' N.t Value of Tax R.turn 13. Charltabl./Govlrnnlntal 2.qul.tsJ Non-alloted 9113 Trust. 14. Nat Value of Est.t. Subject to Tax 191 110 I 22,464.60 20.309,35 Ill) (12) (131 (14) la,.,,'!. QSi 67.238,25 .00 67, 238.25. (Schedull ..J) NDUI If .n ........nt w.. i.sued previously, lines 14, 15 .nd/or 16, 17 .nd 18 will reflect figur.. th.t includ. the total of 6bi returns asses.ed to d.te. ASSESSMENT OF TAXI 15. Amount of Line 14 .t Spousol rot. (15) 16. Allount of Una 14 taxable .t lin..l/CIIss A rat. (16) 17. Aoount of Lln. 14 t...bl. .t Coll.tor.l/Cl..o B rot. (17) 18. Prlncipel Tox Duo .00 K .00= .00 X ,06= 67,238.25 X . 15= (181 ,00 .00 10.085.74 10.085,74 TAX CREDITS I PAYNENT DATE 12-08-1997 06-25-1998 - RECEIPT DISCOUNT 1+) ANOUNT PAID NUNBER INTEREST/PEN PAID (-) AA242532 443.00 ..-.:- 8,417,00 AA296367 .00 1,225,74 TOTAL TAX CREDIT 10,085,74 BALANCE OF TAX DUE -- .00 ~NTEREST AND PEN. ,00 - TOTAL DUE ,00 . IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION Of ADDITIONAL INTEREST. IF TOTAL DUE IS LESS THAN 01, NO PAYMENT IS REquiRED. If TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF TNIS FORN FOR INSTRUCT~DNS.) ~ L '[I ',t 01 I t~ (.0) r~ '';I ,5u: 0: ~ .. }'-" ~::; 1.)0 flESERYATlOth Elt_t.. of "Cl.dlnh dvina on or bIIfor. O*oHblr 12, 1982-- H any future lnter..tin the 8St.t_ is tranlf8rr.d in po.....lon or .njo~..nt to Cl." B (colllt.rall bln,flciad.. of the deoedent ,Uer th_ IlCplr.Uon 01 .,~ ..t.t. for lift or for Y'.'I, thll COHOfn...lth harebY IKprenlY r...tVI. the right to appr.lte aM a..n. trantfer I~r1t.no. hJC" .t the lawful ClIlS B (1)(',11lt.r.1I rat. on Iny luoh future Interut. PUllI'OSE Of MOlletl 1'0 fulfill the r.quit...oh of Seotion Z140 of th_ lnn.rltnnol and Elbte TrU( Aot, Act 21 of 1995. en P.S. Slation 9140), Detach the top portion of this HoUOI and sublllt wlth your Ply..nt to the RughtAr of Willi printed on tM r,Vlnl aidll. --Milk_ t.hlck or loney order payahl. tal REOISTER OF NILLS, AOENT PAVtE.n I , REFUND etRl I A refund of I telC credit, which Mill not requlSted on the TtilC Return, lay be requested by co.pleUng an "APplication for Refund of Penn.ylvllnla Inhllrlhmce and Eltate TalC" (REV~UU). Application. are .vaUable at the Office of the Regl_ter of Will., any of the 23 Revllnue District OffIces, or by calling the .pecial 24~hour an.wering 'llrvlc.. nuBers for forn orderingl In PlllIOnlylvanla l-eoO~362-2t1S0, outlide P.hn.~lvi3nla and within 100al tlltrrllburg area (717) 181-8094, TOOl (717) 712-22S2 (tlearlng IIIPalred Only). Any party In lnter..t not ..thfllld with the IPprahellAnt, allow8noA cr dl..1\owIf'lCl of deduction., or a.......nt of tax (Including discount or intl,'ut) II' .hown on thls Notice .u.t Object wlthln slx\)! (60) day. of receipt of this Hott"e by, -~wrlthn prntlllt to the PA Depart.ent of Revlnu., Buard (If Appellls, nep\' 261021, Hllrrhburg, PA "-election to ha"'l the .wtter deter.lold at ludlt of thl account of thll peraonal representative, _~.pp..1 to thl orphlns' Court. 17128-1021, OR OR DBJECTlOHS I ADHIH ISTRATlVE CORRECTIONS I Factual errors discovered on thll a..eu..nt ahould bo addrllG.ed in writing tOI PA Depart..nt of RlveOlMi, lur..U of Indlvldull Tax8s, AlT"1 Po.t A.'I,..ent Review Unit, Dept. 2806ul, HarriSburg, PA 17128-0601 PhoM (111) 1a1~6S05. See pege 5 of the booklet "Instructions for Inheritance Tax Return for a R..IIMnt nae_dent" (REV-lS01) for an explanation of ad~lnlstratlvllY corr.ot~ble error.. If .ny lIx due 11 paid within three (3) cal_ndar .onths aft.r the declde"t's dlllth, a five perc.nt (5:0 dlsClount of the tax plld kl II lowed . Th. lSX talC IIK'Illstv non~partlclpatlon p.nalty Is Clollpuhd on the ,total of th. tax and interut a......d, and oot paid before Janulry 1ft, 1996, the first day lifter the .nd of the tax Mnestli p.llod. lhls non-participation penalty 18 IIPP..lable In the 'flle .anner and In the the .... tI.e period as you would app.el the t8X .nd intlrut that h.. bun .......d It. Indloat.d on thls notlce. Int.r..t It oh.rged ballllnn\ng with first day of d.lInquency, or nine (9) .onths and one 11) day fro. the dlte of delth, to the d.te of p8ya.nt. Tax.s which b.ealle del1nquent before January 1, 19M b.ar inter..t at the rat. of .Ix (6%) p.rcent per InnUl Cl.leulated at e dally rat. of .000164, All toxes which bee... delinquent on and atter J...,ary 1, 1982 Mill ba.r Inbrest at a rat. which MUI vary fro' cltlendar y.ar to c.lendar year with that rate .nnounc8d by the PA D.~.rt..nt of Revenull. The appl1cable Interest rates for 1982 through 1.,98 ar.' DISCOUNT I PENALTV, INTEREST I '!!!I Interast Rate DallY 1nter..t Factor ~ Intere,t Rite lIally Int.r.tt Factor 1962 2\1% .00O'i46 19&i' 9% ,000241 19&3 16Y. .000438 19&8-1991 11% .000301 19M 11% .000301 1991. 9% .000247 1985 13% .0003'i6 1993-1994 7% .000192 1966 10% ,000Z74 1995-1998 9% .000241 uIntenllt it aaloul.tad .. followsl INTEREST = BALANCE OF TAX UNPAID X NUnER OF DAYS DELINqUENT X DAlLY INTEREST FACTOR -..Any Hotlce luued aftar the talC becOlle. delinquent Ifill r.flect IIn Interest calculation to flft.,n (15) days beyond tile data of the 1..lu..nt. If Jllly..nt is lado aft.r the int.rut co.putatlon dllt. .hown on the Hotlo., additional Int.re.t IU.t be caloulatad. il\ r 304499 IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION .,,'" .J",' C' IN THE MATTER OF THE ESTATE OF ADELAIDE L, HUL'rGREN, DECEASED ) ) ) NO, 21-97-0810 ~ , "1 RECEIPT. RELl'lASE AND REFUNDING AGREEMENT I, Robert H, Gold, being beneficially interested in the above-titled estate, heroby acknowledge to have received from Evans Rose, Jr" Executor of the Estate of Adelaide L, Hultgren, deceased, $16,654.50, which distribution represents my entire interest in the probate assets in the above Estate after the payment of debts, fees, expenses, and all death and income taxes, I hereby waive the issuance of any notice whatsoever that may be required to be given to me by either the Pennsylvania Probate, Estates, and Fiduciaries Code or the Rules of the Orphans' Court of Cumberland County, Pennsylvania, and release the Executor from proceeding with any further steps in the administration of the above Estate including the filing of a Final Account, holding of an audit, or petitioning for issuanc(l of a Decree, I do hereby approve the administration of the above Estate by the Executor, and on behalf of myself and my heirs, personal representatives, and assigns, and in consideration of the distribution of my interest in the above Estate without a court accounting, and in consideration of the promise of the other beneficiaries, I do hereby waive my right to a Court accounting of the Executor's administration of the above Estate and agree to release, indemnify, and hold harmless the Executor and any all Attorneys and hlW firms involved herein from and against any and all losses, claims, demands, surcharges, and causes of action, 1 ,. '.... 30441111 IN 1'HE COUlt'l' 0)<' COMMON PLIMS 0)<' CUMBERLAND COUNTY, PENNSYLVANIA OUPHANS' COUR'I' DIVI~J.ON ,j\ ' , ~, ) , IN 'rHE MAT1'\<Hl (W '1'1m ESTATE Ol? ADl'JLAIDE L, HUL'I'OREN, DECEASl!m NO, 21.97.0810 RECEWT. UEI,EASE AND REFUNDING AGR!J1EMENT I, William F, Bachmann, being beneficially intorm:ted in the above.titled estate, hereby acknowledge to have received from J<~van.l Rese, Jr" Executor of the Estate of Adelaide L, Hultgren, deceUiled, $16,654,00 which distribution represents my'entire interest in the probate aRRets in the above Estate after the payment of debts, fees, expenses, and all death and income taxes, I hereby waive the issuance of any notico whatsoever that may be required to be given to me by eit.her the Pennsylvania Probate, Estates, and Fiduciaries Code or the Rules of the Orphans' Court of Cumberland County, Pennsylvania, and release the Executor from pI'oceoding with any further steps in the administration of the above Estate including the filing of a Final Account, holding of an audit, or petitioning for issuance of a Decree, I do hereby approve the administration of the above Estate by the Executor, and on behalf of myself and my heirs, personal representatives, and assigns, and in consideration of the distribution of my interest in the above Estate wit.hout a court accounting, and in consideration of the promise of the other beneficiaries, I do hereby waive my right to a Court accounting of the Executor's administration of the above Estate and agree to release, indemnify, and hold harmless the Executor and any all Attorneys and law firmB involved herein from and againBt any and all losses, claims, demands, surcharges, and causes of action, 304499 IN 'I'HI<J COUR'r OF COMMON PLEAS OF CUMBERlAND COUNTY, PI<JNNSYLVANIA ORPHANS' COUlt1' DMSION . ~ ' ' .1'.,' , IN THE MA1"l'EH 01<' '1'I-m ESTA'm OF ADELAIDE I" HULTGREN, DECEASICD NO, 21-97-0810 .B.ECEIPT.l.!ELEASE AND REFUNDING AGREEMENr I, Ernest E, Bachmann, Jr., being beneficially interested in the above-titled estate, hereby acknowledge to have received from Evans Rose, Jr" Executor of the Estate of Adelaide 1. Hultgren, deceased, $16,654,50 which distribution represents my entire interest in the probate assets in the above Estate after the payment of debts, fees, expenses, and all death and income taxes, I hereby waive the issuance of any notice whatsoever that may be required to be given to me by either the Pennsylvania Probate, Estates, and Fiduciaries Code or the Rules of the Orphans' Court of Cumberland County, Pennsylvania, and release the Executor from proceeding with any further steps in the administration of the above Estate including the filing of a Final Account, holding of an audit, or petitioning for issuance of a Decree, I do hereby approve the administration of the above Estate by the Executor, and on behalf of myself and my heirs, personal representatives, and assigns, and in consideration of the distribution of my interest in the above Estate without a court accounting, and in consideration of'the promise of the other beneficiaries, I do hereby waive my right to a Court accounting of the Executor's administration of the above Estate and agree to release, indemnify, and hold harmless the Executor and any all Attorneys and law firms involved herein from and against any and all losses, claims, demands, surcharges, and causes of action, , 304499 IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUN'rV. PENNSYLVANIA ORPHANS' COUR'!' DIVISION ~'H IN THE MA1'TER 01<' 'rHE ESTATE OF ADELAIDE L, HUUraRl<-:N, DECEASED ) ) ) NO, 21-97.0810 RECEIPT. RELEASE AND REI<'UNDING AG:UcEEMEl'i! I, Patricia B, Hyler, being beneficially interested in the above-titled estate, hereby acknowledge to have received from Evans Rose, .Jr" Executor of the Estate of Adelaide L. Hultgren, deceased, $15,788,50 cash, and personal propert,y valued at $1,341.00, which distribution represents my entire interest in the probate assets in the above Estate after the payment of debts, fees, expenses, and all death and income taxes, I hereby waive the issuance of any notice whatsoever that may be required to be given to me by either the Pennsylvania Probate, Estates, and Fiduciaries Code or the Rules of the Orphans' Court of Cumberland County, Pennsylvania, and release the Executor from proceeding with any further steps in the administration of the above Estate including the filing of a Final Account, holding of an audit, or petitioning for issuance of a Decree, I do hereby approve the administration of the above Estate by the Executo!', and on behalf of myself and my heirs, personal representatives, and assigns, and in consideration of the distribution of my interest in the above Estate without a court accounting, and in consideration of the promise of the other beneficiaries, I do hereby waive my right to a Court accounting of the Executor's administration of the above Estate and agree to release, indemnify, and hold harmless the Executor and any all Attorneys and lnw firms involved herein from CSS' , ** NO MORE DETAILS ON FILE ** CRCD 840 001 OF 001 13:03:40 11/25/97 HULTGREN, ADELAIDE L** 325 WESI,EY DR 1137**MECHANICSI3URG* PAt 17055- 35 7 4 * 54 684 7760186 4113 0904 0924 31N 20.00 D 6000 5742 70 01 0823 0823 75414467DJ'I'EMWDSM UHAUI, MECHANIC 0811554 MECHANICSI3URG PA 68,8~ 02 * FINANCE CHARGE* PURCHASES $3.10 CASH ADVANCE $0.00 3.10 .185, 18 .00 .00 68..85 .00 3.10 ' 257.13 17.40 214 . 05 .00 ,00 ,00 214,05 17.40 17.4'0 3.10 .00 ,00 .00 3,10