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. .~ ..... 0 -'I' I) . s 0 Z tit ..... )( PETITION FOIt 11lmnATE l\lld rmANT ()Ii' L1~TTlmS Es/a/e of __ Olarence C. llon!!:_l:l.____ No. .__;;>L-''t1.:::- &.~tL_ also ktlOwn as ____________.__.. __.._.___.______...... To: ____..____________...... . ............ ______ Register of Wills for the _ _ _ ______ . lJec<'u.!ed. County of Cumh(j..r..~.~.~ In the Social Security No. _J2.'7-"''O$-"'.6.3rl1...._. .__ _ Commonwealth of Pennsylvania The petition of the undersigned respeclh,lIy represents that: Your petltlouer(s), who Islare 18 years of age 01' older anthe.execut or_. lu the last will of the above decedent, daled ____N.9.Y_(j_l~h.flr _~.L__.__. and eodlcll(s) date.! _._____.____.__.__.___~___._._________._ na~ed , 19...2.L. _...~~~--------_. (!iIBte relevllllt clrCllmSII\I1CC~. e,g. renunciation, death of f:.'l.('cutor, tiC,) Decendent was domiciled at death In_ OUElberland _...____ COJlOty. Pemlsylvanlp, wllh h..!!L-...... hst family or principal residence lIl_-:J~OO Bast Mar.ble st.. M~ohanlo8burg, FA l70~(; l ful_QJL~1l.t9..J!bl!r.g_Bol'O\!.B.i1_L --.. (liM street, number Mid lTUllldpal11y) Decendent, theu __02.._.__ yers of ageitdied T-g-Cl t<2..2()F_111..t Vl-.-'or--' 19 97 -, at_\:lt1,Ull1L1J.nULQ1lP__tg1L___e,);'r!1.u..x~g .___._~__~.l1..fl..Y van__.!!... . Except as follows, decedent did notlllal'ry, was not divorced and did nol hllVe a child born or adopted after execution of the will offcred for probate: was not the victim of a killing and was never adjudicated Incompetent: ~________________ .______.. Oecendent at death owned property with estimated values as follows: (If domiciled In Po.) All personal properly S 100.000.00 (If not domiciled in Pa.) Personal property in Pennsylvania S- (If nllt domiciled In Pa.) Personal properly In County S Value of real estate in Pennsylvania S situated as fcllows:_HQuse Jl.nd I.ot of Gro.und !.ocatod at 40U East Marble lit.. MeOTianlosburg. Penney lVa~a. WHEREFORE, petltloner(s) respectfully re<Jjlest(s) the Qrobate of the last will and codlcil(s) p,"'ented herewith and the grant of lellcrs 'l'estamenoary (1I"Slamentary; adminiSlr<ulon c.t.a.; adntlnlmatlon d,b,n.c,l.a,) theron. i ,,- 'ij~ "'~ l~ ,... ll"~ SO ~ Iii (~f ,y ..L&~~~- _ Carl..L.....JlMke 1 OJ B E. Falrt gw St.,..llll4- 1!:1orl!ll....IL 1 ill_____ OATH 01; PERSONAL REIJRESENTATlVE COMMONWEALTH 011 !'ENNSYLVANIA } 88 COUNTY OF CjnmJ\nLAND . _ The petltioner(s) above-named swear(,) or afnrm(s) thatlhe statemcnts in the foregoing petllion are true and eorrecl to the best of the kilOwledge and belief of petllioncr(s) and that as personal represen- tatlve(s) of Ihe above decede,,1 petllioner(s) will well nnd truly administer thc estate according to law. e", . t' c /' // / Sworn to or affirm~~Tltnd subscribcd. t .' L .-~. / V-t' "- /?- "'-.-- ~ befor~ nje this _..,______ dl!~ot ___ " Ootob -1.' \I~. 'j , !:. / ' i.J.Jl..0.....f--~l'-JlI"1-t/, ,l/L{.r' - l RY CLEWIS RORis/er ' -1L~-----_____ o!:!. h'..'....H1 W ,,"".l.HlIHT IUf:MINtl i i ,~ .::::~ ~ ...'1\ ",' .'-.'"\~ , rhls b ttlll'rti()' that thl' iIlIOI'Il\~lti'1I1 IH'II' ~',in'll I', l(lllntl.\' l(llli,.d 1111111 ~ll) (lIi!~itl,d ({'!Idi(,lk !trlk,lIh \lId\' likd Wllh Ill(' a', Lill'id l{q',i'df,lt'. TIlt. odgill,t1 ti'r1i1k,lI(' willlH.' 1!lj\\,lI(bl HI Ihe \1,11\' \'il.ll l~L"'Jid,> (llll,,' j(il l'l'IIH.lIIt'1l1 Jlllll!" WARNING: It Is IlIogallo duplicate this copy by pllOltHllill or pholonruph, p('t' !tH- thi.. L-eld,lk;lIC ~.~,on ilill"llliff""",,_ (,i\i"~\-\.\I,\ Qf Pi;',- ,4"'...~...,. .. *~~.......~'. ~'~! "" \c' \ ~.~,~... '.....r! '~~ *."_ ." ,r L ." a" "~I' \~'("..o:,___ '", ~/ -::!%r ti\ ~~~,,:,;; "":,..JN1..",,,u, -""I."i!tJ1110~r I) -) \~ t ,Up (~', 'u k 6ccPYl(,(9t.,tu<t"I' l.oI~,d !{cgislfill U V 4485968 ,l.._j-' jl _Li.\ ',:(i.~jL~ _ \.. {(, I}~ '(j ;' --"~I"'" - 1),IIl' ' Nn, 1.1Q~ .UII,... lJt! COMMONWEAltH Of PtiNNSVLYANIA' DtiPAATMtiNT OF UEAl.tH' VITAL RECORDS CERTIFICATE OF DEATH i ~ 1 tr.<lI"II~U_1\ iW4O,OECi'61"'lrhll l,I.oUt'''1 _.__.___.....__n__..~_~_.__.. n__." .m.___. !lf~ r!i0ClAl~f{;uNNNu-"jiiE"~-~-lO~'-Il~Ht~I"'-;----)-~-' ~~,:.:~::::~J'~~I~~~~ ";:T':'. C~~:,"f,:~!:q-- ::::::~~~ ~;:::, ... :w.~~,j""Tt"ii~~~"4;".;:;,:;,,'I;.~'- f ,U L!!..Jljic .., --,. --- ~" ~~"~:'l.'~JJ.cJl~\':'I~'Y., ,--,,,,,."'..:."-.-.'.'':'::'-~1'3,,==2-. .,-.E...L:_-J:"~' '.1 -. :=;",[j CIl't.1OflO rWPOfPEAIII r"CM./l ~fNf'.I"'''U'''' "'~"M""IJ.'r"" W/l.!lICI0f'!l0f'1M.SI'llNlCOflKl~1 .......I.~...........,..... '" .' . l " II j ( ,...;A .....IJ~r..__"C_., \:>o<<t,1 ",!I,Q~~~~I".:.QiiiiJ_"-OC-""..L'-,. IIdILl..'.I~I..!.~....~;-______ . ___44A,~,."..\t0~_,,",~' t7}f_.!.:_~~:.... w.~"':..~~~.---~I-. .rllIJ.Lc._____~ =~'l="" ~l ~_ !!!~{l~..!!~!~L~I'iQt!i!!!r__ SllHfl1fll f~tll~ [)(C( ttl-Sfot/C."ot<! 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"",..."....""..J Jo.-,.O, "., t......0l.1...'.,"'.IWtt.....Ih....II...._..."'.U~..HI."""'.""....;I.(.4 '. I ""I) -~ !! I" ,., , "\ ~ i 00 !,; i '" ~ ~ fll '~ E..f ~ tt-l; i f3 0:1 ... I:< ~ll . . ~ u ~Ij 8 <d ~ [j I 1-1 ~ ~~J ~ ~ J "" ...:, ~ ~'I 0 j . " " .' " t.. COMMONWIALTH OF PINNSYLVANIA COUNTY OF CUMllltLAND \ J "' Om'l. 1.. lI'Jnlw .11 t liW .101'0'.' .1 tl thin h:Jcouuto!' , ". aecora n9 0 , a .na .iy' I. . _____~__..___._ . of Ih. E.tala of ___ U1.f\.l'onou, (J. l10nlw ______ 1.1. of l,l,oul,n.\li.,eub,1.I..I.'/!,' ,~ b I .J C I P .1 .1 J 'h t th -.____.._, ~um or .na oun y, .., a.C....a .na .. . Ilhl I I I .1 b "'\1'1 L 11"\\"11 th 1.1 Executox' W " I an "yen or'f maco y . .J.~ _ _ ...... ..~,", - ,,~._.... ..__._....~___.._-.___'I. '1 a_ of Ih. onllro ..tal. of ..Id d.o.denl, con.lsllng of olllh. p.rsonal properly and reel ost.te, ..e.pt reel utal. outsld. the Commonwealth of renn.ylvanla, ond Ihil Ih. flgur.. oppo.it. eieh It.m 01 the Invontory repruont It'. f.lr velu. .. of the dolo of docodonl'. doolh, boln9 duly. ... q~JQ)'1J. ~J..;._.._--- of) .19_,_1::~_ l )...r' J / /1 .'''''-' ._.Cr.<t-I_ e"i, />I~' ",-A..., ..11-;<,,,.-,-..,,,.(',- I.tcut., .~ S\>IOx'n _____ and .ub.erlb.d bolor. m., 101.8 8. ~~l!'vlBw st., n~4 Peol'la, U~ (,161'; , . Add,." Dal. of Deeth ___ __.__..~ll,-,_,_,__ DIY Oet-Dbo!' Month 199'7 Y"'r INSTRUCTIONS I. An Inv.ntory must bo fII.d within three monlh. aHer appointm.nt of pononal ropru.ntatlve. 2. A .upplom.nt inv.ntory mu.t b. flI.d within Ihlrly day. 01 dl.cov.ry of addillon.l ....ts. 3. Addillonal .heels may b. .lIaeh.d as to personalty or realty 4. S.. Arllcle IV, Fiduclarl.. Act of 1949. ~ ~ l!! bO 1 )... f~ r-. <\, ~ Ql ... ~ [! .0 j 'H . g ~ 0 LU ~LU fI, V> I j!.; ',I 0 ~ !Z ... '1 Of" oi <0.... ~ LL r~ ..., 0 ," Il. LL -I l~ CIl , W ~ ---. > 0 0:: . ,rl i: .1> \(\ Z 0 0 0 co ~, Q OJ " - II> ~ 1.1 " ~ Ql 0 fll ,"-1 ... ,0 Z u ... ' . .... 0 . , co p:: 1'1 .. ft; '1; "t: . .. \~ Jl ~J t; 1 oM l E J 'I j (J it 0.) ( ;~ ) (3) (~) (. ) (6) ( 7) (9) ( 10) Inventory of the real and personal eslale of UT,,'\J\ ]':1IU J!: U ,111':ilV'll; --~-~~-~-~~.-._._~_..~-_.._----_._-_.,.,-_.--~.,. - deoeased -::::::;~_-:;7.::::::;:=='-::;~=.o='.::=;:":':"';:'":::::::'-~':;-';';::~-==;;:":::":::.:'.:=:;::::- --~":.-' I!O\lflf) . nnrl l,ot: 0 r (J]'ol1\1(l II t I,UI11;o 1. n [,ilo I)(Il'nUI'\! nr' 110()ho.nioob1U'g, Ol1ll1hm'l.n,n(l O()n'd~;r, }'O\l1\fI;llvlltllll, 1mo\ln Itnd tlIIPII,o)'c1Cl nn hOO 1!:ll.ilb 1-1lu'b1o Db'on l~. 1\: OOI'Ost:n,t,O/l aooup\\; 1.on Cor'l'., \n'!of\\;nlnn\', t\o(lOllld: !1o, 0')f1-lfl0'7311.' ill<lHfll,tJ ,Tonnr\, TnvoI:\:'''''rll; !\ 0('. 1)\\.1\ I: 1'0. ;''1rJ.nll()(,II.' OCH'o81;n\;ou 111\1\1(', Uhool'1.ng ^ononn[; 110. 11I.l'I()~lll.01. OOl'oSI:o.\;on Ilflnl~, ::,n v.\ 111'," 1\0(\')111\\: I" y)()01.(,lll11. 1nt:oPMJ\: (w01'1",,1 \;il 1.0/1.II/')'!. l'J1IJ J\f1.n1(, ]]. 1\.. \;I"'(ll~ I.nl', JlnorWllt 110. r':0'!001',()261~. 1n\;nrO[:I: [l0<1t'1I()(1 \:0 lOllll/')'!. PJ!O 1.111111(, N. ^., 1)!1v1.1\(~n :\eool1nt nil. r:O:,\OOOl'lOl. In1;nl'(1r\\: Iln">,,,,,,l to lO/lll/9'1. YOl'k 1'odo1'n1 :In.v11'l(!;i1 un'] Lon\! ^flnn., ^ooo\111b liD. ()OO-21.217. Intol'nu\; nCel'lInd \:0 lO/lll/')'!' 19<)'\ GI\OVI'nlot, lil,\lni.nn n1.\\;o\1\obl1o. Jlo~1s()ho1d .l'Ul'lllnh.\.nglJ. ( fJ) rJ.io'be.l........... " [\!I"OOO ;>00,00. 19,9()1) 1. 11,1,11.'1 1 ~;,OH - p.~ ~ ;0 " . g.; . {~~ fl' ~. H' 'i ~ ( c, -0 " ; 1 ~c:_' ~ fh' .. '" ;:]: ~ ... Ul f 'OR OATIS D. DIA'H AnlR 12/3' /91 CHICK HIRI ~~,~ INHERITANCE TAX RETURN ~o~::g.ul:~Dn IS CLAIMID [) COMMO"WM'"' m l'fNN$Yl ""'A (TO R::'~~~J I~E~~fp~~TA TE ,iLl NUMiii.;'l.:;;"T~n:\i II, ____.m O(PAR'Mf.~~1 or Rr;VHHlE IlA~~lllq~,,-,}~)191,,;~~o). . .____'lJ'~H~~~I~!E~~~_VVI_I.I:~} ... .~9lINl\'Co.Q~ 122L VEAR ogilW-mUMBER. O(lCfOEN,'!'mMTlr.uT:fjEI.Aj.~iiMiiWtnmni;ir-'-' .~.._-_._----~-_.~~- ~- i1fITimTFnoMliE'[ AtJo_rS! II ;lIJ~II: 01.(1)'I)\lU(' U. 11()() 11;1\1, I; Ih.phlo ~H;. i socLksmijjTY~H1;.(if~ - jt>^lfor IJfAltf 1"Ai'6'''';1I I IOClifH.d.on 1..)Ure, 1'1\ 170;.;5 ~ 'V'7-l)r;_I,:,C:, .\ n/11,/')'7 I' ';"'/1:' em' U'ullho.I'lnll(l ._.___ ~_ :'''"~;/~Vi'''''''i "0,,'" ",;" ,,,,,',,,,, "" ",,,"', '''''''II l'oclA' ","";, 'HlMi,. . {AMO'"'' if~,v:r''';:i,ijC:''''--=~_-~~.~_:-- fKl L Original Relurn I -I 2, Supplemenlol Return LJ 3, Remainder Return .- (fa, dol.. of d.olh p,lo. 1<, 12.1 ~.B21 LJ 4. I.Imlled Ellale I ) del, future lnleret' Compromll& rl5, Federnl Eslate Ta/( Return Rt€1v1r.d lfor dolt" of death afler 12.12,821 P9 6. Dec.dent Oled T IIlole [ . J 7. Oectldenl Maintained 0 Living 1 rU11 --1. 8, T alaI Number of Sof. Oepollt Box.. . IAlIoch copy of Willi (AlIach copy 0' 1 'VII) AnCell.ISPOND.NtE ANll CONFiDENTIAL TAX INPOIMAtlOtfiHOULb 1.1l1.ltttDTOI"I,,"i','~!:I'1X'af (r.l!1J"'r~\'>",;','"' 11IJ;W---~------'---'-----~'-"-"""---"-'--~-----'-'-'-' cOMPi.fif-iJAilTNO'A'OiiRE~---" --- _...~___0~.!-...iJ~)_~_~_~:~-~_L___;)._~ ,1:\;1/).' 0 )~'_L_.~\J;.Ly~_.. I lLtp 1- p "I; ~;q llfl.l'O B lele; . "'''''ON! NUM", lloc!tanlonbul'{" 1'/\ 1'70;;~; 'l "(J-\~") :J' .-.I,=..._....__.._*~.OO~7._"==C=_=.7...'.7 .,.._7===C_-~-'='.""'."==.~=~7=.'.__... I. R.ol E,lolt Isch.dul. AI III. .. ._..D4,DQ(l.()Q 2. Slack. ond Bond, (sch.dul. B) 121._...____--''J...2...'1..l}f2.'-0_Q~ ??~J ~. Clo..ly H.ld s'ock/Pa,'n".hlp In,,,..1 (sch.dul. q 131_.__~_.~_____Q._QQ_ ~." 4. MO'lgog.. and Nol.. Rtctl,nbl. (schedul. DI 141 ...._._._________..... ...O.QQ_ . "01 J"(' ,'r' 5. eel,h, Ban~ O'pollh & Mltc.llan.o\'. Personal Properly 151 ~__,_..~._..f.._._~,. ';'L__e.';;_;.L~ (sch.dul. e) 6. Jolnlly Own.d P,op"ly (sch.dul. P) 7. T,on.'." Isch.dul. 0) Isch.dvl. l) 8. '01010,0" A..." ('olollln.. \ ,71 9, Funeral Expln..., Admlnl'lratlve COlli, MIIe.Uan.oul 191 bp.n", (sch.dul. HI 10. D.b", Mo,'gag. llablllll.., 1I.n. Isch.dule II 11. '0101 D.ducllon. 1'0'01 lln.. 9 & 101 12. Nel Valu. 01 e'lol.(lln. B mlnu. lln. 111 13. Cho,ltobl. ond Oovtrnm.n1ol hqu.." Isch.dule JI 14. N., Volu. ~'" ,a To, (Lln. 12 mlnu. line 131 15. spou,ol 1,0n.'". (for do'" 0' d.o'h oft.. 6,30.94) St. Instruction. for Ar.pllcablt Percentage on R.....n. Sid.. (Includ. volv.. rom sch.dul. K 0' sch.dul. M.I 16, Amount of Un. ,.. IOlil,oble a16% rnle (Indud, valu.. from Schedule K or Sch.dule M.) 17, Amount of lln. 1 It taMable at 15% ral. (Includ. volu.. from s,h.dul. K or Sch.dul. M.I 1B, Prlnclpollo, due (Add 10' f,om lln.. 15, \6 and 17.) 19. Crodll. spou,ol pov'W. Tl~" Prior P"O:'8Ib Dlleovnl _._.___~~___ + +___O.OQ..- ~ RfV. 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Ilollko ~~-~'';;i:T;;;;-----~'--''-'- ~ - - \ii -iiiti1;;;;it';;,.;~tFraiiOln M. 800hn, EBqul.re 400 F..ot Morbie atroot Meahanloghur:g, PJI.. 110~)!i -i8i.l~' 's'O..I,"t'I.,-;:;M;lto--rk-et,--a-t-.----l'0'4'/"I,f6-/"9'et.liIt; Borough of MechRnloRbllJ'g cumberlend County Meohonio.bu,q, Ph 17055 2:~~'-!~~~:Ti.''-'~~~i.=~'::::::=~:-~='::'-::':'': ',;-,""",-,,, ....,.,,'. ..,..iiil;;;;;----- :~: ;:~:.:::;i~;:~;~~-~::"~:~==:=:-~:.\===,,''"~~~= -~.~t;=~?:-~Bfif:~:;ff.i"''''''-::'~~I'.=. E.!!oo,oo_. tol. ..HI,..'llt chu~" to 1101(0...,,(llIII 14t)nl l.tOI,". 40\,. . 10'. ._--_.--~..---~_.~--- \.....~..._._~_.._R .".I~4..-"""----------~-------' --- ,,,,,,=~_==:====::=~:==:=:-_:::::_::=:::--==:= ::!.-.,::,==='=-==~===--" ---:::::-- ~liiu,l'''IOU tor il.... r'\11 hy ..II.. III .,h'lln. AIi!u.t,,"U I." IU'''' I,.id by ..II" in .....n.." '" ;-;it,i;;';-;;~;;'------'; -",,---" -" - -.------------ -.;..",i,,-'-t~-;;'W:";-----"-W----"- -Io,.C;;;.;";;;,--'oi/ii;iI-,;i;i,,iii"---- . ----ii',-;-..- . 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Ull'llW/rolt 1l0ll.1l;(l"r.1l. ,~~ ~~~I, UDUCTIOM ~t;OU1I1 bU. .,1.\.1. -;;;O;:""-..."iiTT,~;.,~~-'_';H;;;;:...~~-'~=---= ______~ _--'~~'_,_'__'_C!'!!!_'!'!!'!..~'!'::~- 101. Oro" .",mHlt. dll_ frOll h/lUlN.f\llll- UOlj II/111.U fill. Ornu ..ount d\l' to ..Uul~h\. 4101 ~~7;,~;;;;;;ltr;;i;ib;if;~(-b;~~;r.tll~;>>Di. (7t~7M-i -..,:-;:;;;7,:;;;;"." '"0.,,--';;;;-;;1\..,1\0' '10' - -- ._.~_._---. - ~"o.."l.M-'!"!!!.!.bL~~~!~--- ---,!'~c"_ .2!.c~.~.2~I[J "''l~,- ',UO,OO ",HI" ~~ ",HI." 'fhlllll,,,,..tloll cnlltlln.oIln Illoell;. I, 0, 'II .nd 1 ""I nn 110_ Ullol, if \In_ .01 I' ."..'.k.'. "". .., ,,' ,"II to ,.".."., ,.. ,.,,,'",,,,, ,,' ,. h"" ,,,,,,.hod " th. ","'., ....... ....,... II I.' ... ..,"'....011\. . ..."", . ",II,..". '''''11'' .11'" ...,,1\0' ,\II h. ",'"''0''' If .hI. ,,,' ,. ..,.h"'o b. "."to' end th. tU d_t.r..lnu U..\ It h.. not bun urorl.... ' e ~o'''l'lIt.. "1I~in_' .nd conllllt.nU ,.10I_US.U' "un.IUT'I'I,tM'Il"T 11l'",r..tllllT W""HUI'11 ,~ I. . 011.. 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IIUP.IIJ"llhlll."1 .t.l...."t. 3~~)~...-~:- ~~h~ri,~-~'~;~~;~~~~-;,t~. ..~---' ---.~- .:tg~!W,i(' f:-At~f:tt;.~:;~-.-- ", i.. ,---------.--------- """""_",, "....".",...",.",", ""..''''"..",...."..".,.",.,,,,,.,,"",,,,,,,,,.....,,....,".1'...'''...".," ~In.. i>e-tllk1" to h~ dll\1'1".'\ 11?,,1 ""'II1;(l~tll thl. .~.hll..nt. :::J~~::oc=-__l7j..d~2-L~.._-- "., '.'.:..~~ \-UtI.lll Mint ,un,,11 H, 1I(j~b.' , 1I1ql!lfl l;~i" --- ,.....-...,."...-----.... "~_..~-,. -,- ... 2 D of' ' ~ 04 ~ .0 JI, ; i.... II .. ; ~ ~ .. ~ l lli U II , I~ i ~ ;'l " II, .. j.... ~. . II ! ! i IW I ij~ .g Il III .l~ )! I S I I~ H h I lift in .' il I ! 1 I H i n I 111 U I ~II ~Ii ~Ii ti~ lie i~ i 'M ~~ I ~~E ~~e ~~e I Mil ~ !~ Uhi ~b~ "~~II .~ I Ilti :ti Uti br .'1 ~J '" 1 '~il;li!;~~i!;I~ ~ IU !~ !) ~ Ii! '" uu I l'l aal r 0 I! It ~ Q .i " 1 ~I~ :) I , ~ ~ ~ h Li ; I I. I . ~~~ II ~ . . " ,. - Ii i .. 1 n J:: II~ II i 1 ,~~ ;) Q h; ~ I :) ~.~ . J a@I~1 II! 1l ! J I 1 ! ~H ~ H ~ ill .J d~~ . i:i !~~ ~ '. . >\ N" t. is .~\ ~ 1'1 " ~\, .- J. " "" " --- - N C) :c .. t:I I-l ~ (.D' - II i i i I , ( . It · .. .. ,I .I ~ '" I 1 , 1, i I I t 1 ! HI , I 1\ t ~ · , ~, ~ I II I 1 ..,. , tn i .... 1 C) ~ co N t r"'l 1 t ~!; ~I\ ~,i ~ co i ~ea ~ea ea I 0'0 1 ~ h~ ;l~' i~~ Q i .\, i :~ ~ i~ ~ ~~! I .. \ I'l~i\~~ili' ~ I- z III I' , :l 0 h ~ u 1 n .1 ~ ~ ~ u c( ..-,. - UVI\lllltl (1-Ul ~.._~~~~!!.!'.'!-~'11\'.1J."!11'!---= filJliUMm 21.fn.()/),JIII~ ._--- .1')(lLMOI)[)hLL. AMOUNT . C:OMMONWEMfll or PflH~~nVM'll^ 1~IIIERI'M~CE TAl( R(WltH RfSllmH OEC((JUH mAlf~T"~~':':':;:.:.-e:-=:::;'~~ .m+_" - _.'~:;:.=~"~.;;~_::;.,,~.';":':::';:C"c.;.;.:...;....;;.;-,.::.:;...;.:.;:.c~-__.;..:::.;:.:::.,-;"':;'-:"-="=--":';;:=:,,;';";~'':::;'--~--::=''- ITEM NUMBER A. 1. Ul,^nJ(;i'll11': u. -:1,,;111:..'; DESCRIPTlOU _ ,_~,_,~,,___'__'4'_"_~'_ ..- Fune,al Expen.e" Ilnlpo~,v,.l }o'\1nOl'nl 110nlo, fnnorRl expenueR. !.jo()l1nnlCllbl1l'g, 1'1\, 1'(055, 1. B. Admlnll',allve Ca.lI' 2. . . 3. 4. C. I. 2, 3. 4. 5, O. 7. 8, Pellonal Representative Cammlnlans - - Social Security Number 01 Pellonal Representative, _._.----c-- Year Commllllons paid _....---.-.---.--_.~----- Allorney Fees J. Hobert ~t.Rl\.crer, lG~CJ., attot'\1oy's fee. Family Exemption Clalmanl ___.. --_.._._..+.._..~-~~. Relationship -"~--..~-~ n/A Add,e.. of (I(llmant al decedent's death Street Addres, ---------------..---------..-.~~-------- City _~____________ _________________,_Slale Zip Code___~__ I'robale Fee, IleglAtor of Hills of Oumborland Oounty, Pennsylvanln, LettiorfJ '['ofJtamontary. MI.eellan.ou, Expen.e.. no{',iote:t' of \'/1118, f:tvo (S~) :J\101't Certi.1'loates. Gumbel'land T./I11 :fOUI'\\l\l, ]i~Bt[lto !lotice. 0\.\il1bo1'1[\ nrl Oount;T Pl'othonotIH'y, copy of ))1 VOl'Oe })e01'80. Penna. T'O\I~)1' [~ 1,1[';\11; Co., October 1998 olootl'ic. Suburban Cable, bl\19.l1cO due 011 acoount. 11m: Corpor'll.blon, Ootober 19'17 gna. IInJ.tod viator PonnfJylv~\\11a, Hater thru OoLohEll' 1997. IllJ.l1oilJ ni\nl~, cbm'go for nO\'1 oheolc book for I~lltate Aooount. .~.._~_.-- _....~-,,-~....--_._...----- .______ __._~n______-' __0-----..--- -...-....- -~.. -.. -~----------------- TOTAL (Also enter on line 9, Recapitulation) (If ma,. .paee I. no.dod, In,er' additional .h.." of .ame .1...) --_..-~-----~...- * 7, 2i1,2. 50 0.00 7,500.00 235 . 00 15.00 60.00 2..50 27.30 l~.ll 1.66 39.54 12.25 S CI\Hnnm li'On\'IM PI\G1~ . 1 UY,ltll U. 118~1 SCHEDULE H FUNERAL EXPENSES, ADMINISTRATIVE COSTS AND MISCELLANEOUS EXPENSES PI.a.. PrInt or Ty~. .. - ~cC. . - - -= - - - - --~=I ~ILr fluMIIR~~-;, i _ ;)'i-= oT\IIfi~"==="' ",,;1'" I~ESCRIPTlON . :_-~ ___~~(r?-_O~~~~_~~.~_.__ ,t~ (oMMOIlWEMIJI or pnINSYIVA,tIlA INllfRITAU<.:f 1M IHHlRN I\[StUfIH ()fCWftlf IlfAU-oji"c",,===,-== ,,=.=_~=,~=_=._.,...,_..="'==c=. ITEM NUMBER () . 10. 11. J.2. 13. 11,.. 1~. 16. 17. 18. J.9. 20. 21. 22. 23. 211' 25. 26. 27. 2(1. 29. 30. 31. 32. 33. 31\. 35. 36. 37. 38. 39. ()Lf\nl,;i!()II; tJ. IlorOtll'Y [lo.cIn1.n/j, 1no., 11lnpolJ.ln[!; of.' lnOPUIll'-.v loontod 1n l'on I.donoo. (1; urn (101'1'tW11L Lon, 110 v ',rnlJ'.H' 1')')'1 I,nrl. nolI 1\tlnni;lo, fllHll 1:o1nl'hono b111. ronna. rO\'T01' I: L1i:lll; Go., )[ovornlloI' l')')'1 0100tl~lo. UGI C:pl'pol'l\l~lon, Doo(Jmbol.' 1')')'l gau. Nanoy );:bop1;1, l'o.l'llIHl fol' 1'0[;\1,1'n 0(' clo.l'(Jct1.vo ltem pl.\l.'ohnfJOd nt p\\lJ1J.e auctIon. Gn[;orl of HOl\von UOlilOtol'Y, I'oplo(Jlllg lost oomo top'Y Hl'ol\'th. '1'110 Soni:lnol, Ji:ntnto Hot,loo. 1'1\ Do1'o.)'tl<lont of J{ovonuo, Iltb 1),lWl'tOl' 199'1 ont1.nll\tod l.1lcolnn f.pnx Po.7rVJf1 n'L. 1ntol'nl\l j,ovetluo ;;ol'vloo, 11th '/,uf,ll'tOl' 1()'Y! ostlmutod Inoo\l\o 'I'l\X 1'aYlnont. Dorol1.[\h 0:[' 110c.hu\il.uf!)l\Il'!\, lnt 1),L111)'tol' 1C)98 SGHOl' o.ncl ro1'uno OllfU'L~os. Pennu. 1'0\.101' f.. Ll[b[; Go., DecO\llbeX' 1')')'1 eloctric. 110C;I.sto1' ()i'I,Hll~l; 1:111'00 (;.) Shol't Gor[;Jj'lcutos. . 1.lU1 GOl'po)'o.[;loll, ,TI:\I1\\1.\1':I 1')')0 [\tw. ronna. j'01l01' P,: L1ght; Co., ,Tumwl';T l')r)f\ (\lectrlc. Unl tOil Hatol' Po nnny1 vnnle., HlltOl' to Ji'ebl'ul\l'Y 1998. Gordon g])ol'ly, l'cd.lrlbUl'somont fo)' oos t of Illd.pping meY'cUl'Y to r,rOl'01.11'Y rloflnlll{j, Ino. UClI OOl'pOl~f1t:l.on, gnn chul'ge, to FebI'uary '7, 1998 only. lIand10y-SmHh J\(JDoun[;lng, prep!U'8.tJ.on of 1997 Incomo 'J'ale ){O[;Ul'llS. VUI OOl'POplltlon, CJW fl'O\rl Febl'ul\l'Y '7, 1')90 to Fohruary 17,1')')0. I'onna. POl-Wl't: T,lf,;hl; CO., j"n\)l'uHl'Y 1')98 oloctl'lc. UUI COl'pol'Dtlon, gau fl'OPI Fobl'nUl';" 17, 19'1[', to Harah 18, 199[\. 1'0.111'10.. 1'0\101' '" L1C:l1t (Jo., 11fll'ch 191)[\ olectl'lo. Dorough of Heehanlcubul'g, 2nd Qunl'tEll' 199[1 SOHOl' nnd 110,['1.1.8 G C hnrge [J . nnl'l')T T,. lIoolct\l:'cl, 'J'nx (Jolloctol', 1']0[\ COUllty nnd .!3011()uC;h r'onl ontnto tn;:of.l. HJ':/!lnx HOlllty IlfJi1ocll\to8 l\nd EllA 1\111101'8011 Hoal IIstnto, (JoltlldlHfl1.on 011 fl!l.le of pl'01nlfJ80 110. 1100 fi:o.nt 1'1ap1.110 Gtl"oot, 11eehl\nl0811lu'g, l'ennny1 valli e.. Fl'allo:l.o II. Socha, J';Ufj., llottlon\ont 010s111[~ :Cee. Prnnoln l'1. Dochn, l'inq., ]1l'Opfll'lLng Ji:8Cl:'OH Agreement. GafJh, paid 1'01' ]1ot"l';! l'ul111e foos I1t flol;\;lel1lont. Rocordol' of Deods, l'enl eotato Tl'O~Bfor Tl\x. GnDh to J!:OCl.'oH Fund to COVG1' ')omple\~lon of' mloce11unoous 1-101'1: on 1,t1uldotlI;O IlJ'tOl' final lJEltt1onlOnt. ~;o.oo 77 .13 ()9.93 19.83 106.12 L~8. 00 16.00 73.68 160.00 2,127.00 65.20 lL~. 00 9.00 96.09 12.13 2)~.01 34.25 136.52 J.50.00 31-1-.75 12.04 92.40 10.72 65.20 230.32 5,(1(10.00 35.00 25.00 5.00 840.00 100.00 ...1MJ:E - 2 RIVUllf~.fIUI ~~ I I ~- "U~~R~~~~~:N~ES, WI.iMOIIW,^UU 0' ;w,mlvANIA ADMINISTRATIVE COSTS AND "m(""ANcr 'A~ !!I1"N MISCELLANEOUS EXPENSES -,-, -~. A!~!l>!1'1.'!.!,l!!,!~! ~-- __n_. --.--_hm~_.~. _ . . PI.a.. ",Int., Tl'e' 'IfAfnw-' -'- ~---- '-----____h_____,______,.,~_=~="""_ ,i1.I'mfMIIR 2J-::'):{:O()!ih .~ ---",--- U),\11 ':IllJ":"U,-,_.!!li:11n: . I 199'1.001)1,1/ - o~;'RI_ .. _ .;';"''''00===- T A."OU"' 110. lJob HOl'lllnn, ntll11 bUT :C01' IIlHII CONI. :p ,50.00 Ill. lloHAl'll P0111; Gontl'ol, 1.110.. '.['Ol'ldl;o Inllj10obl.on. 30.00 1,.;~. nu;/nux Iloo.11;:r MIIJoolnbolJ, lJulolJ Pl'OOOl.lIJ1ng .('00. 75.00 1,.3. f./attonl-r:l.dc ]f01l10 1'!rll'l'Unty, Pl'OIllIUlr' Oil HOllln \Inl'ranty poltoy P1lJ.'ohr.wod for fInnl l.Ietblo/llont. 1,4. HobOl't VhgnnIc, 0100t1'1oa1 l'opah's lit 1,00 East Harble 8troob rootdonoo. 45. Un:l.t(!U Ho.tol' POllnnylvlln.la, fInal b:l.ll. 1,6. urn Oorpol'nt:to.l1, final bDl. 'I.? Heg:Lstol' or HU.1l1, f.lllng Involltol'y IInd PonnsYlvania InhorHo.l1oo Tux Hotul'n. 305.00 225.00 16.62 52.78 Total...............$ 26.620.26 22.0<2 PAGEl ~ rL /'j.,;;({?,V. It' COMMONWEALTH OF PEHNOVLVANIA DEPARTMENT OF REVENUE .1 c.."" 'URE~U Of INDIVlOU~L TA~ES IHHf:MIlAHCf lAM UJ~ISIOH Pt:Pf. 110'01 HAMMISIUftO, IIA 111l6~OflOl NOTICE Of INHERITANCE TA~ APPRAISEHENT, ALLOHANCE DR DISALLOWANCE Of DEDUCTIONS AND ASSESSHENl Of TA~ 08-10-1998 HENKE 10-14-1997 21 97-0844 CUMBERLAND 101 [~~_~:-::,~==::==H~.d__ --I MAKE CHECK PAVABLE AND REMIT PAVMENT TOl REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE ... RETAIN,LOWER PORTION FOR YOUR RECORDS .. iii:-V:isiij"EX--AFi'-"fo'F9,"i"NCii'"icniF"'iiiiiERifANCE"TA'in-PPR'AiSEMEilr;"Ai:.l"oWAiicE-oi----------------- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX CLARENCE C FILE NO. 21 97-0844 ACN 101 DATE ESTATE OF DATE 0,.. DEATH FILE NUMBER COUNTY ACN J ROBERT STAUFFER ATTV MARKET SQUARE BLDB MECHANICSBURG PA 17055 ESTATE OF HENKE T~)( RETVRN HAS I I X) ACCEPTED ~S FILED RESERVATION CONCERNING FUTURE INTEREST . SEE REVERSE APPRAISED VALUE OF RETURN BASED aNI ORIGINAL RETURN 1. R..l Eot.t. I Sch.dul. ~) 2. stock. and 'ondl ISoh.duh 8) 3. Clo..ly Held stock/Partnership Int.".st (Schedule C) 4. "ortg...../Not.. Receivable (Soh.dul. D) S. C..h/Bank Oepositl/"iac. P.rlonal Property (Schedule E) 6, Jointly OWned Proplrty (Sohodul. f) 7. Transfers (Schedull G) 8. Tctel Au.h APPROVED DEDUCTIONS AND EXEMPTIONS I 9. Funeral El<Pln.../AdM. Custl/HiSle, E>cpan,., C Schedule H) 10. Debts/Hortgage LiabiUties/Liens (Schedule IJ 11. Tot.l Deduotlon. 12. Net V.lue of To, Return 13. Chartt.ble/Govflrllllantal Beque.t., NonRelected 9113 Trusts 14. Net V.lue of Eot.t. Subj.ot to T.. I CHANGED (1) 121 (3) 141 IS) (61 171 84.000,00 219.986,00 ,00 ,00 201.356,55 ,00 ,00 181 * UHut U ." Ut.'11 CLARENCE C 191 1101 26,620.26 . DO. Ill) (12) (13) 1141 DATE 08-10-1998 NOTE I To in.ur'e proper credit to your account, sub_it tha upp.r portion of this for~ with your tax p.y..nt. 505,342,55 ?6.6?O :>6 478,722.29 20,000.00 458,722.29 If .n .......ent w.. i..ued previOUSly, line. 14, IS .nd~or 1&. 17 .nd 18 will r.f1.ot figure. th.t in~lud. the total of 6bb r.turn. .e.....d to d.t.. ASSESSMENT OF TAXI 1&. AltOunt of Line lit at Spau..l rate US) 16. Aecunt of Lln. 14 to,.bb .t Lin..l/Cl... A r.t. (16) 17. AMount of Line 14 taxable at Co11atera1/Cl... 8 rate (17) 18. Prlnclp.l T.. Du. NOTE I TAX CREDITS I P~VHENT DATE 05-26-1998 RECEIPT NUHBER AA27D130 DISCOUNT 1+) INTEREST/PEN PAID I-I .00 . If PAID AfTER DATE INDICATED, SEE REVERSE fOR CALCULATION Of ADDITIDHAI. INTEREST. 1 Schedule J) . Ot!. ~. 00, 323,722. 29 ~. 06, 135,000,00 ~,15. (18) AHDVNT PAID 39 , 673 , 34 TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE .00 19,423.34 20,250.00 39,673.34 39,673.34 .00 ,00 .00 If TOTAL DUE IS LESS THAN $1, NO PAYHENT IS REqUIRED. If TOTAL DUE IS REflECTED AS ~ "CREDIT" ICRI, YOU HAV eE DUE A REfUND. SEE REVERSE SIDE OF THIS FORH fOR INSTRUCTIONS,) !") ("', G~ -:; ~;' ~.- , \ ~ ::o~ {fl C) ',"j '1" L', rj"i -",.1 (.J " {,'1 """ h' RESERYATlOHI btatl' of dtoldentl dying on or beforl Oeo..ber 12, 19&2 ~~ if any future Intlreat In the ut.t. h trftnlfarred In po.....lan (Ir InjOll'Hnt to CIa.. B (oollahral) benoflclarln of the d.cadant after the 8MPlraUun of 8nY ..t.t. for life or for ya.r., thll CQlMlonw..lth harlllby .xpr...h r.l.rv.. the right to apprMha and a..alllli trln"lr JnhlrltanClI T.".. et the lawful ChIS. (collahr.O rate on any auch future Inter..t. PURPOSE Of. NOTlCEI PAYttEMT: REFUND (CR) I To fulfill the requira..nts of Section 2140 of the Inherlt.nce and htata TflX Act, Aot 21 of 1995, 17l P.S. S.otton 9140), Detach thl top portlon of thls Notice ttnd lub.1t with YOUr pay.ant to tho Rallhtlr of WHit pr lntld on thl 1'11,11"41 ,Id., --Make check or .OrnlY of-der payable tOI REaISTER OF MILLS, ADENT A refund of " t.~ oredlt, Nhlch was not rllquuted on the Tel< Raturn, .IIY ba reque.ted by cOllpleUng an ""ppUo.Uno fo, R.fl.lnd of Pllon.vll1anl. Inhlritance and Estllte 'a>o:" (REV-BBl. Applicationli 11'0 available at ttwl Offiol of the Reghter of Wllh, any of th9 23 Rev.nue Dhtrlot Offlc.., or by oa111ng tho .p.olal Z4~hour anlNlrlng ..rvlo. nUllberl for fO"5orderingl In Pennlylvllnla l..aOO-J6Z~ZI)50, outside P.nn.ylvllnh. and Nithln 10011 tl.rd.burg area (117) 187-8094, TOUA (717) 11Z-Z2SZ (Hearing I.palred only), OBJECTIONS I Any pllrty In Inter..t not lothflod with the apprllhlUlent, allowano8 or dlaaUoNanoe of deduotion.. or .a......nt of taM (lnoluding dlsoount or lntl.,,,t) ft. .hown 011 this Nottoe .ust objeot within stllty (60) day. of r.celpt of thlt Notice bYl ADMIN ISTRATIYE CORRECTIDNSI DISCOUNT I PENAlTVl INTERES11 --Nrittln prot..t to the PA Depart.,mt of Revenue, Board of Appeals. lIept. 281021, Hllrrisb"ro, PA --eleotlon to have thfl Matter deter.lln.d at audit of the acoount of th~ p.rsonlll "pres.ntativI, --IIPPIIl to the Orphlnl' Court. 11128-}O21, OR OR faotual errors dhoovlred on this a..en..."t .hould ba Ilddrened in writing \01 "" o-.part..nt of Rey.nue, aurllu of Individual TaMIS, AlTNI Pott A.\Jou.ent Review Unit, O.pt. 280601, Harri.burg, PA 11128~0601 Phone (717) 7a1~650S. See page 5 of the booklet "Instnmtlo"s for Inherltftnee TI'II( Rlturn for I R..ldlnt Ololdent" (REV-ISO}) for an ellplllnat!on of IIId.inlstrat!vely oorr-Iotable errort. If anv tall due it paid within three (J) cAllndar lIIonth5 after the dftolcltnt's death. II flv. percc.nt (SiO dltcount of the tllM paid is .llowed. Th. 15% t.M MI08.ty non-participation p.....lty Is oOllputed on the t:otllll of the tax and Int.relt .......d, IN1d not pald before Jatl\.lsry 18, 1996, tho first day nltor the Ilnd of the t.ll D.nuty period. This non-plrtlolpatlon p.naltv 11 appealable In the talle lIannllr .Ild in the the nile tlllQ pllrlnd a. YOU ",nuld apPle! thll tall and Interllt that has been ."'''lId as Indlollted on thls notloe. Inter..t It chllrgod beginning ",Uh first dfty ('If d.llnquency, or II1n8 (9) .0nth51 and on. 11) day froathe d.te of deBth. to thl data of plly..nt. TaxIS which bec8lle dollnquQnt before January 1, 1982 bllflr interl.t It ttN rate ~f llhe (6%) perclnt plr _MUll olllcullllted at II dlllUy rille of .000164. All t8)(e51 whloh tleoa.. d.llnquent on and after JlInuary ), 1982 will ball' Interest at a rate whloh will vary fro. call!lndar year to calend8r year with thnt rate announr:ld by the PA Depart..nt of R.venue. The appl10llble interest rllltes for 1982 through 199ft 81'11 '!!!! Interest Rato Daily lnt.rest FlIIotor :!!!r Interest Rut. DallY Interest faotor 19112 zoX .000548 1981 9% .000241 19113 16% .0004311 1911a-191H 11% ,000301 1984 11% .00nOI 1991 9% .0007.41 1985 U% .0003!ib 1993-1994 1'1. .000197- 19116 10% ,000214 199!d91J8 9Yo .000247 '--Intlrl.t Is oaloulated os fOUowsl INTEREST . BALANCE OF TAX UNPAID X NunBER OF DAYS DELINqUENT X DAILY INTEREST FACTOR --Any Notlc. hluld eftlr the tall beoo".. dellnqullnt will r6f1lctllln lnternt calculation to flft.ln (1S) day. beyond the date of the ......Il.flt. If pny.ent is .ade aftlll' the lntlrut floeputatlon d"t. IhoMn on thtl Motlol, IddHlonll1 Inter."t llIu.t be calculated.