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1)lnITION Jt'()l~ PROIIATE "nd GRANT OF LI~TTERS
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Decol1doul ill dOlllh nwuod propol'lY w\(h oSlltnnlod vul\lOs Us follows: ~
(1I'dnmicll.'d Il1l'u,) All porsnUlI1 Prol\~IW $~U()~', UP
(It' unl \Iomlollodln I'll,) I'orslllllll PI:OI10I'IY lu 1'01lllsyII'UIIIII $___"
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OATH <W PEI~SONAL Iml)RESENTA'tIVE
(,:OMMONWI.:ALTH OF IJENNS\'I,\' ANIA L tiS
COlINT\' OF _ CUMJlIRLAND . J
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IIHive!;) "I' Ihl' nhlll'o,r1oo~d~111 pl'lillonor(sl wll1l\'l'1I nnd'lnll~' Ildlllil1lslor the osllltc lIecordll1g to Inw,
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WARNINGIIT IS ILLliGAL TO AI.T~H THis COpy OR
to DUPLICATE BY PHOTOSTAT OR PHOTOORAPH.
COMMOtlWf.A~TII OF patltl6V~VAtllA
DFFAATMF.tlT OF tmA~ TIt VirAl. JH;OClIHl3
LOCAL REGISTRAR'S CERTIFICATION OF DEATH
CERT, NO, 3 5 81 7 51
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October 27, 1997
,. ii~i;(;;-I;\i;..OfIIlI' CttwliO-ii,.um-
Namo of Decedenl ____n..__.. I;' Willal:<1 E" '".i" Freet!_~::\~,_~~n_'___"_'~"~H"
MIlle '" ,185~03~5074 . October 21,1997
Sox ~.__~_._______~_~~",o(llal SnmHlty No. .. .......__.___.H... u..." [Jnl(l Df Uoull1u..._..n___.._._.__H.m....
pate of Olrll1 Jun_e.~!~?1.~ '._ _, n I3hlhplaco -n .._:~h.~~a.~B~ale , Penna, ,., _.._~u_._..__~+H___'_u_.m..
Place of Deatti _n___~r_l~~!ElliosPi.t~1..u.9lIl\_~~.1~~d-.'?''- Carlisle ..__"I,n.__.m.u..__JOI1I1!!y!ya.lll!l
IM"Ifl;Y"~ . (;;"''''t ';1;.11"""'(;1'(" "...",1,,[1 ,
RacL.~~_~~.-.u~,OcoupfJlloll ...~lx;:~~/~~.:~~e~.!~B . Anllod Ft)l(:es? (Yes or No) .~_~....__~.'1 ---i'-n~.
Dooodent's ~ ' -' li 1 . P 17013
Marital Status .~!E~t;lli.n_"_ MriillllQ Addtess 422 Walnut Po~tom Roa", Car B e, a.
- ,-,.-...... ~ --~-(:It~;--f,;';l""''''- u. n-----' ~.--.-----.{j.\i;;..u.-.. - '" .._-- ,-
Sonja 1\, Freet ..', CaX'Bon W, sprow
Informant ___..__.._..d.__'". n. .-"_'~___.' Funoral Dlrootor._ '_m__ _.~,,~__......_nm__H_'_.__
~~~~an~I~~rll~~~~o~\ . '-.m .". ,.R,ot~Elt111f3.~ ..~.,H:,...2~. ~ '. ..!ine_st ,,_.P:=lmy~.~~m~a ~.1~~_~~ um__'
I .
I Inlorvnl Belweon
: Ol1sel Md Death
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I 3 Day
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~ilateral Basile+ Pneumonia
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(c) ~_'n'"__'...__. ,....... ."._..____.__~__......"._._.._.~,.,_u.. ..-.-
Pari II:
(d) ~....:.._.__.__.___m--. '"...~_ 'U.".".__.m'_"--"-~'_.'.'.. ..__._n--
Other Slgnlfioant (Jondlllolls
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Nalliral ~
Accident Ll
Suloldo L')
l)osorlbo how Inlmy ocourrod:
Homloldo
Pandlng Invostl()atlon
Could not bo D')te[!nlnod
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Nall10 and TUla of Cerlllor ___ ':1:OE!'~.!'_ ~!:~.~s,~un...
AddreSS .....u___,.._.._._u8.~~Wlllntl.~ .~!:t':11'..~.'!...9I\l:!~B.l.El,_pa.~ .
------.,----~,.~..'---TM,D-:~ D',Q'i OVd.ll'O" fA.~
This Is \l)o(l[tlfy that Ihnlllforlllntlon haro glvon Is corrootly coplod 110m nn original oerllflcale
of death d, uly fllod w, ,111'1 1110 ns Local Floglstrar. n,l,f )jUlnal colllfir;,jlo will bo fO/'JrdOd to Ihe
Slata Vltol I~ocordfl Of.fiCO for pormanel11 f"'n:~l!t~~4~'rJM-;ZZ..~;J2('O \,;~,:357 ~
October 25,19,97 159 N, Railroad St" Palmyra, Pat 17078
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CERTI~ICATION O~ NOTICE UNDER RULE 5.6Ia)
, -
Name of Deoedent! WI /I (1, ,. J f. F"'~A.-,t
Date of Death! (),,~-t,., h j)~ ~ ,;) .1 19q1{
,
Will No. /QQ7'. n~9"','F; Admin. No.jB ..2. J '/'1,- (,90S
To the Register!
I certify that notice of benefioial interest requireQ by
Rule 5.6(a) of the orphans' Court Rules was served on or mailed to
the (ollowing beneficiaries of the above~captioned est~te on
~~~~1id~~Y ~~l Iqq;:l I
Name
-
~,,), "I" E F .,.p_,,-.t.
,-
)A/dlili-,.LUr""'f.: J:
R"..;t:.., F )J)PVl~".J..
Address
I,!Jn.II:l'lt.:y,,, ft,,,,~ W O~.. Ii!> I," R,J
~ . .,
1:Q;B")(!f-fiCJ{"nt:;' I<,SS,I..., ......,.. .~L.?1.f7if,c:;.f.)&,,.,5"
&9/),1"001.- /d.-LL ISLF'I.."./;.......... F>......k. .'1Ij,J" mq,l'J,;L _
NQticehas now been given to all pe+sons entitled there,to under
R\jle 5.6(a) except ...,,-1' ","hL,Od L./..
, I
bate! M1'....J..~ J ~'l~
.
i~, tJ;'/ ~L~..-"*
S gnatu
Name,t;",i./JI'1 I~ j:' Il. fL go',!""
Address rfQo~ ~.e: 1011<.1 PI (I,",JA 1"
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'Mtlllil\IL~"~"~&Lo""j' ~ I ,.(o~t.::'
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Telephone (I]J'71 '7<},t; - '1t:J,;}.. (D .
capacitYI,....2L Personal Representative
Counsel fot personal
repreeen tati ve
-,.~,
,-_._,
/.S'-,'VJ. Jj"
BUREAU OF INDIVIDUAL TAXIB
IHHERIUNCE ilK DIYIIIDN
DEPT, 110601
11t.llRIIIURO, PA 17111-0601
OOHHONMIALTH OP PINNIYLVANIA
DIPARTHINT 01' RIVINUI
HOTICI OF INHIRlTAHCI TAlC
ArrRAIaIHINT. ALLOWANCI DR DIaALLOWANCI
OF DIDUCTIONa AND AIIIIIHIMT OF TAX
c....'
'*
UV.II~' II ii' m.'I!
l
HAKI OHIOK PAYABLI AND'RIHIT PAYHIINT Tal
R~GIST~R OF WILLS
CUM8~RLAND CO COURT HOUSa
CARLISL~. PA 17013
. OUT ALONQ THII LINI ... RITAIN LOMIR PORTION paR YOUR RIOORDI ....
fiiN: laW.lY .A~'Ji"r &V:O')""~oYiiil"d'~.liiAilfiflllcl'I.Y~njS~~Aiiliifi''''7.At l.'6"Allcl'l.b1i~",'""""..."...""
. , D18ALLOWANol OP DIDUonoNI AND AIIIIIMINT OP TAl( .
. - - '1 '
IITATI 01' FRE~T WILLARD ~ PILI NO. 21 97'090B ACN 101 DATI 04-06'91
RICHARD J DALBA
DALBA ~TAL
123 COLUMBIA TPK 202A
FLORHAM PARk NJ 07932
DATI
IITATI 01'
DATI OP DIATH
PILI NUNBIR
OOUNTY
ACN
04'06-98
FR~~T
10-21-97
21 97.090B
CUMBERLAND
101
Allount ..Ut.d
WIL LARD
Ii
TAX RITURN WAa, (X I ACCIPTlD Aa FILID
RI.IRVATION OONCIRNING PUTORI INTIRIIT " III RIVIR81
APPl\A18ID VALUI OP RITURN BAIID ONT ORIGINAL RRTURN
I. R..I I.t.t. laoh.dul. A) III
I. Itook. .nd BOIId. ,(a.h.dul. BI III
I. Clo..ly H.ld stook/p.rtn.r.hlp Int.r..t laohodul. Cl ISI
4. ,".rt...../NOt.. R...lvobl. laoh.dul. DI (4)
a. c..hllonk D.po.it./Hh.. P.r..nd Pr.porty laoh.dull EI ,(II
6. J.lntly Dwn.d Prop.rty la.h.dulo Fl (61
7, Tron.f.r. laoh.dUlo 01 17)
I. Tot.1 A...t.
I I CHANGIO
.00
218.&12.00
.00
.00
.00
76,269.00
.00
lal. 294.781. 00 .
NOTII To In.ur. proper
.radli to yo~r ~oount,
.,,"It tho upp.r portion
of thl. forll with your
taM p.y"""t.
APPROVID DIDUOTXONI AND IXIHPTIONII
9. Fun.rol IKP.n.II./A~. Co.t./HI... IMPIn... laohedul. HI 191
10, Dobh/Hort,... LloIII1IH../Llono la.hedul. II \lOI . DD
11. Tot.l D.du\>t1on. 11I1 q 0
II. Not V.luo of TilMR.tur" 1121 294,781,00
11. Ch.rUoIIl./Goy.r_tola._.hl Non-.l..tad 9111 Tru.h lSohodul. JI IUI .00
14, Not V.luo of IIt.to a"J..t to T.M' (14) 294,781,00
NOTII If ,n ........nt w.. i..u.d pr.viaully, lin.. 14, 11 .ndlar 16/ 17 .nd 11 will
rlfl.at figur.. th.t inalud. the ,tat.l of ~ r.~urn. .......d't~ d.t..
ASIIIIHINT OP TAXI .
11. AIIOW\t of ~Ine 14 ot Bpou..l rot. UII 294,781,00 x' 00.
16. AIIOW\t of Line 14 t.M0II1. .t LI.,..I/C1... A'r.t. 1161 .00 X .06.
17. AIIOW\t of Line l~ t.M0II1. .t C.U.tor.l/CI... B. r.ta (171 .00 X .lB.
II. Prlllolp.l TIM Duo 1111
TAX ORIDnl,
PAVHetlT
DATI
.00
.00
.00
,00
.00
RlCUrJ
",,"BI"
, DIacllUl4T l+ I
INTIRIST/PEN PAID 1-)
AHDUIlT PAID
TOTAL TAX ORIDIT
BALANOI 01' TAX DUI
INTIRIIT AND PIN.
TOTAL DUI
,00
,00
,00
.00
o IF PAlD AFTER DATBIHDICATED. au REVERSE
FoR CALCULATiDN OF ADDITIONAL INTERlaT.
I IF TOTAL DUI Ia Lesa THAN .1, NO PAV"ENT Ia REqUIRED.
IF TOTAL DUE IS REFLICTED AS A "CRIDIT" ICR), YOU HAY al DUE
A RIFUND, SEE REVERal aIOI OF THIS FOR" FOR INSTRUCTIONa.)
PUAPoIIi 01'
HOTICI, To fUlfill lhe '.qul'...nlo of h.Uon n41 (bl of Ih. Inhotllon" ..... a,l.t, T'w Aot, Aol 21 .f IOU.
(72 P.8. 8,011on 9141l.
PAV",NT, ,1lI1.." lhe lop pO'U." of Ihh' WoUo, ""d ,ull.1I wllh y.u, p,y..nl I. "" R,glot" of Wllh prlnt.oJ .n lhe.
r'Vlr...Jtftt,
-, HII<. oheok 0' ..n.y .rd" ",yol/I. 10' RQOXSTSR OF "X~L&, AOSNT.
OI"'CTl0H8,
RttFUHO CCRl,A".lund of . I'. o"dll ~V b, r.qu.,I.d by ,oopl.tlng "" "Appil.'\lon fo, R,lund of P,...yIYIII1I.
I""'rllono. ond 101.1. T.w" lREV-!!U). APPUo'lIon.." "'1111I1. .1 tho Offlo, Of Ih, R"htor of Wllh,
,"~of tn. as Rlv.nut bJltrJotOffJQ" Dr frol thIO,p.rt..",,_ 14-hour anlwlrJng ..rvlo. nu.btr. for fara. ordlrSng,
In 8,"",Y1Y,",I.I.800-5,,'IOIO. out.ld. P"~.yl"nl. .nd,wllhln 1...1 H."I'bu'l .,.. (7171 787'8094,
TOOl (717) 7r2-UU CH..,lnl lop.l"d Only). .
Anv parb In ~nhr..t not ..Uaf1td Hith th-l ........nt of hit II .howo on ,thh noUOI lay ob~80t wUhln
.IWIy (10) dlY,ol "Ollpl 01 thh WOUOI hY, ' ,
,..wrltten prot'.t- to t~ PA Dlpart.'nt af RIVlnu., loard of 'pp,.ll, D,pt.,al021, Harrl'burp, PA 171ia-l0al, DR
..o.'ll.oUhg to-hlv. the ..U.r d...,..1nld .t IUd1t of thl-p."liIonalrIPr.,entaUvl, OR
".'PPI.! to thl Urphanl' Court.
AllftIW'
IITRmY!
eORRlCTl0H8,
FlOtV.l error. dl'QoVlr.d un thi. .......~nt 'h~uld b.'.ddr.~..d lnwrltlng tal PA,DtPlrt..nt of R.v.nue~
aur..... of lr,cUvlc:kfll TtIIWI', ATTNI Po.t A......."t R,vh., Ut11t_ Dlpt. 880601, 'tI,.d.buru; PA l1Ua-0601;
Phone (7l?) 181-6&0&. 8.. plge S af thl baokl,t "In.truotJan. for Inhlrlt.nol T.~ R.turn fqr I Rllldtnt
Geold'"t" (REY-ISOll for an IMplenatlon of ad,'nl.t,.ltlvlly oorreat,bl'arrore,
PlN.\LTY,
Thl 1.~t'N -.nl.ty no~~p'rtJalp.tJon p.n.lt~ 1. cO~ut.d on thl total of thl tlX andlnt.r..t .~~....d# and nat
P.t~befor. J.nu.r~ll, 19~6, thl f1r.t dIY.lftt,. thl .nd of thl tlK ..n..t~ p.rlod. Thi, nO"~p.rtJalp.t.on '
PtnIltY,J..,p..llb1. In th.,.... ..nn.,. Ind lntht thl .... tll. ~'rlod ft. ~ou wOUld apPlal the tiN and Intl,.a.t
thlt hi' n." "......d II indloated on thh noUol.
~or dati. of dtath on or .fter 10.3~91J Plnn_vlyanileltete '1M b".d on the Fld'rll Eltit.'Ta~
rlturn;b.o~. dllinquent at thl Ixpiratlon of ntnl (09) ~onth~'fro. t~1 dltl of dl.th,
For dat., of dllth prior to 10-3"'1, P,nnlYlYanla <at, Tllil( ba.'d on the Ptld'rll btate lIH return,
boq..., d.llnqu.nl ,tlhl Iwpl,"tlon'.1 Ilehl'.n (18) _onlh. f'o. In. dlt. 01 ~.Ih.
'1M.. Whiah blO... d,linqu.nt blforD JanUary 1, '982 b.ar int.rl.t It the rate of IlK (6~) ~ero."t plr annu.
aaloUlated It a daily rate of ,000164, All taKI' WhlOh b,o... dll1nqu.nt on or'.fter Januer~ 1, 1982 will bl.r
lnt.r'lt .t . rite whioh wUl Ylr~ frol olllnder n.r to o.lInd.r YIElr wUh ,that rat. announold by the PA
nlp.rt,,"t bf Rlvlnul. Th. .ppl1albli tnt.r..t rat.. for 1982throuDh 1998.1".'
IHTIlla8Tl
Y,er Int"..t RI\I Dally Inter'.t Flotar Vellr ~nt.r..t Rat, QIUy Jntlrl" Flotor
- -
1981. iO~ .000808 1981 9~ .000147
1m II~ .000458 19880\?91 m .000501
1984 U~ .000501 1092 91 .000l47
1981 !!~ .0005&1 1995-1?94 71 ,000192
1916 1O~ .0002t4 199&-1?91 91 .000247
...tntir..t 1. oaloul,tld Ii follON"
%II18RIlII'I' . IIA~A"OS '0' 'AK UNPAID )( NU"BSR OF DAY$ OSLINQUSNT )( DAXLY 'XHTnS8T "ACTOR
w-An~ Motto. J..Uld .ft'r the t.~ bloo." dllthqUtnt will r.fllot an lnteril. aeloul,ttan to flft"n CI.)4.~.
~~~ tft. dati of th. ...'....nt, If PIY.lnt it .ed, .fh;- the InUI,...t aOllPut,tion det., .~n on thl '
Hollo', ~ltl""1 Intl,..t".1 bo o.loUI.lld.
_,,,